Inflammation keratoconjunctivitis

Dysfunction may be caused by aging, systemic inflammatory diseases, a decrease in androgen hormones, surgery, ocular surface diseases (such as herpes zoster), systemic diseases, or medications that affect the efferent cholinergic nerves. Decreased tear secretion produces an inflammatory response on the ocular surface called keratoconjunctivitis sicca. This inflammation is now a target for new medications that treat dry eye.29,30... 

Cyclosporine A (CsA, Restasis 0.05%) was approved in 2002 by the FDA as an ocular therapeutic for patients with keratoconjunctivitis sicca (dry eye). Until 2002 the therapy of choice for the treatment of dry eye was artificial tears and punctal plugs and the occasional use of pulse doses of topical steroids.Artificial tears and pimctal plugs brought some temporary relief to patients, but the underlying cause of dry eye, inflammation, was not affected. Steroids carried the threat of a multitude of side effects. With as many as 7.1 million people in the United States alone encountering dry eye symptoms, the development of a therapy that eliminates the inflammatory events associated with the disease has been a significant benefit. 

In a placebo-controlled study of the efficacy of cidofovir 1% eye-drops with and without ciclosporin 1% eye-drops four or ten times a day for acute adenovirus keratoconjunctivitis in 34 patients, the frequency of severe corneal opacities was lower with cidofovir (3). However, cidofovir caused conjunctival pseudomembranes, conjunctivitis, and erythematous inflammation of the skin of the eyelids, and the trial was stopped as a result. 

Ocular manifestations include keratoconjunctivitis sicca and inflammation of the sclera, episclera, and cornea. Atrophy of the lacrimal duct may result in a decrease in tear formation, causing dry and itchy eyes, termed keratoconjunctivitis sicca. When this is observed in association with rheumatoid arthritis, it is referred to as Sjogren s syndrome. Artificial tears may be used to relieve symptoms. Inflammation of the superficial layers of the sclera (episcleritis) is generally self-limiting. Involvement of deeper tissues (scleritis) usually results in a more serious, painful, and chronic inflammation. Rheumatoid nodules may develop on the sclera. 

Cyclosporin suppresses cell-mediated immune reactions and some humoral immunity. It is indicated in the prophylaxis of organ rejection in kidney, liver, and heart allogeneic transplants in conjunction with adrenal corticosteroid therapy treatment of chronic rejection in patients previously treated with other immunosuppressive agents increased tear production in patients whose tear production is presumed to be suppressed because of ocular inflammation associated with keratoconjunctivitis sicca (ophthalmic emulsion). Gengraf, Neorai Used for treatment of severe active rheumatoid arthritis (RA) where disease is not adequately responsive to methotrexare treatment of adult, non-immunocompromised patients with severe, recalcitrant, plaque psoriasis who have failed to respond to a least one systemic therapy or in patients for whom other systemic therapies are contraindicated, or cannot be tolerated. 

Herpetic keratoconjuctivitis Inflammation of the cornea caused by herpes virus. The epidemic form of keratoconjunctivitis is usually caused by adenoviruses. 

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