Hemorrhagic conjunctivitis

Tests of single drops of aqueous solutions applied to the eyes of animals have shown that 1% solution causes severe irritation, 5% causes hemorrhagic conjunctivitis, and 16% causes severe reaction with conjunctival hemorrhages, corneal edema, and opacities, followed by some clearing but much vascularization. ... 

Most of the toxic effects of vanadium compounds result from local irritation of the eyes and upper respiratory tract rather than systemic toxicity. The only clearly documented effect of exposure to vanadium dust is upper respiratory tract irritation characterized by rhinitis, wheezing, nasal hemorrhage, conjunctivitis, cough, sore throat, and chest pain. Case studies have described die onset of asthma after heavy exposure to vanadium compounds, blit clinical studies to date have not detected an increased prevalence of asthma in workers exposed to vanadium. 

Both Enterovirus and Coxsackievirus are recognized as causing acute hemorrhagic conjunctivitis (AHC). Dmang the last 25 years, several large epidemic outbreaks of AHC have occurred worldwide. 

Tavares FN, Costa EV Acute hemorrhagic conjunctivitis and coxsackievirus A24v, Rio de Janeiro, Brazil, 2004. Emerg imect Dis 2006 12 495-497. 

Pharyngoconjunctival fever and acute hemorrhagic conjunctivitis are similar to EKC in presentation except for a recent history of upper respiratory problems and fever in pharyngoconjunctival fever and development of large subconjunctival hemorrhages in acute hemorrhagic conjunctivitis. The cornea typically is less involved in each of these conditions, but they are treated in the same manner as EKC. 

Acute hemorrhagic conjunctivitis Eye disease caused by an enterovirus. 

Coxsackie A Herpangina, hemorrhagic conjunctivitis, meningitis Feces contamination... 

Enteroviruses Meningitis, encephalitis, hemorrhagic conjunctivitis, fever Similarity with polio virus... 

Abnormal vision, cataract, conjunctivitis, dry eye, eye disorder, flare, iris discoloration, keratitis, lid margin crusting, photophobia, subconjunctival hemorrhage, and tearing... 

In a second experiment, Ayers and Stahl studied the effects of discharging a CS pen-gun cartridge into a rabbit eye at a distance of 20 cm. At that distance, the wad caused less damage than the blast and the particles of CS. Only three of 10 animals suffered severe eye lesions, which appeared to combine mechanical damage (lacerations) from the wad and conjunctivitis, intraocular hemorrhage, keratitis, and corneal edema probably from the blast and CS particles driven into the eye. The other animals showed only mild conjunctivitis, which cleared after 3 d. 

Special Precaution Gastrointestinal hemorrhage may occur Patients with renal impairment have shown higher MPA and MPAG AUCs than normal volunteers Should not be used in conjunction with azathioprine Repeated laboratory monitoring is required Pregnancy Category C... 

As a chemical antidote, chloride of sodium may bo administered in poisoning by nitrate of silver. As an alterative and tonic, it is useful in scrofula and glandular diseases. As an astringent In hemorrhage, dysentery, and diarrhoea, it has been given in conjunction with lime or lemon juice. It is frequently employed as a dentifrice. 

All isocyanates are known to cause pulmonary toxicity. Isocyanates are the most common causes of occupational asthma and have led to the development of immediate or late asthma among workers. Isocyanates have caused bronchitis, rhinitis, conjunctivitis, chronic obstructive lung disease, contact sensitivity, dermatitis, allergic alveolitis, and immunologic hemorrhagic pneumonitis.29... 

Gastroenteritis Multiple petechiae Anaphylactic syndrome Congestion, liver, spleen, lung Hemorrhage, pancreas Ulcerative colitis Keratitis, chronic Conjunctivitis, lymphocytic... 

S. pneumoniae is a common cause of acute bacterial conjunctivitis in children (Figure 25-5). Concurrent upper respiratory tract infections and otitis media, especially in children younger than 4 years, are common. In moderate climates S. pneumoniae is often the cause of acute bacterial conjunctivitis epidemics. This condition commonly presents with diffusely scattered petechial hemorrhages, especially on the superior bulbar conjunctiva, a mucopurulent discharge in the lower fornix, and transient marginal corneal infiltrates. Pseudomembranes may form. 

Figure 25-5 Streptococcus pneumoniae conjunctivitis with petechial hemorrhages.

Examination typically reveals a marked conjunctivitis with a primarily follicular and papillary response of the palpebral conjunctiva.The follicles typically are worse in the inferior palpebral conjunctiva, with papillae more common in the superior. Preauricular lymphadenopathy is present in about 64% of patients at presentation and lasts approximately 1 week. Small subconjunctival hemorrhages are not an uncommon characteristic. 

Phenylbutazone can damage the eyes. Conjunctivitis, damage to the cornea with vascularization and scarring, adhesion of the lids to the eyeballs, amblyopia, retinal hemorrhage, and even blindness have been reported (12). 

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