Ocular manifestation

Jabs DA (1995) Ocular manifestations of HIV infection. Trans Am Ophthalmol Soc 93 623-683 Jabs DA, Enger C, Dunn JP, Forman M (1998a) Cytomegalovirus retinitis and viral resistance ganciclovir resistance. J Infect Dis 177 770-773... 

Extra-articular involvement may include rheumatoid nodules, vasculitis, pleural effusions, pulmonary fibrosis, ocular manifestations, pericarditis, cardiac conduction abnormalities, bone marrow suppression, and lym-phadenopathy. 

Urey, J.C., Some ocular manifestations of systemic drug abuse, J. Am. Op tome tr. Assoc., 62, 832, 1991. 

McLane, N.J. and Carroll, D.M., Ocular manifestations of drug abuse, Surv. Ophthalmol., 30, 298,1986. 

Moss AP, Sugar A, Hargett NA, et al. 1979. The ocular manifestations and functional effects of occupational argyrosis. Arch Ophthalmol 97 906-908. 

Nevertheless, very limited research has been carried out to develop DDS for the posterior segment of the eye in the last decades. Whereas new antiangiogenic compounds and neurotrophic factors can open new therapeutic avenues in the treatment of AMD, retinal dystrophies and ocular manifestations of diabetes, the frequent intraocular injections of these compounds remain a problem and are associated with complications and discomfort for the patient. Thus, the need for efficient noninvasive DDS for the administration of drugs to the back of the eye is awaiting a ground-breaking multidiscipline advancement. 

Hollenhorst RW (1958) Ocular manifestations of insufficiency or thrombosis of the internal carotid artery. Trans Am Ophthalmol Soc 56 474-506... 

Ocular manifestations of SM exposure are generally separated into early signs and symptoms, and late signs and symptoms. Physicians and researchers use scoring systems for how severe the typical signs and symptoms are. One... 

Derby, G. (1919). Ocular manifestations following exposure to various types of poisonous gases. Trans. Am. Ophthalmol. Soc. 17 90-105. 

Although there are five types of hypersensitivity responses, two of these, types 1 and 1 play a significant role in the pathophysiology of allergic eye disease. The ocular manifestations include seasonal allergic conjunctivitis (SAC), giant papillary conjunctivitis (GPC), vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis, contact dermatitis, and urticaria. These are discussed in Chapter 27. 

Sarcoidosis is a multisystem granulomatous disease of unknown etiology characterized by the deposition of noncaseating granulomas surroimded by lymphocytes. The infiltrative optic neuropathy in sarcoidosis may be the first and only ocular sign or may occur in conjunction with other ocular manifestations of sarcoidosis such as uveitis, candle-wax drippings (exudates around the retinal vessels), and choroidal granulomas. Optic disc edema... 

In addition to eyelid swelling on the affected side, acute conjimctivitis is the most common ocular manifestation of herpes zoster infection. The conjunctivitis is... 

Lyme disease, caused by the spirochete Borrelia burgdorferi, incites a variety of ocular manifestations, the most common being a conjunctivitis that occurs in up to 10% of patients with early disease. Although the characteristics of the conjunctivitis have not been clearly defined, several reports have described fitlhcular conjunctivitis. Increased antibody titers to B. burgdorferi indicate the presence of Lyme disease. A history of tick bite or erythema chronicum migrans should alert the clinician to consider Lyme disease in the differential diagnosis in areas of the country where this disease is prevalent. Treatment of Lyme disease conjunctivitis should include topical tetracycline as an adjunct to oral doxycycline, 100 mg twice daily for 2 to 3 weeks, which is used to treat the systemic infection. 

Therapy for SEE is both complex and, in many instances, disappointing for both patient and practitioner. Management of the systemic signs and symptoms may not improve the ocular manifestations of the disease. The most common therapy for the arthritic and cardiac complications is NSAID use. Hydroxychloroquine and chloroquine are particularly effective in treating the discoid rash associated with the disease. In some cases oral steroids are used either alone or in combination with other immunosuppressive agents. Methotrexate can effectively reduce the need for systemic steroids in the treatment of mild to moderate SEE. Cyclophosphamide and... 

Flach AJ, Lavoie MD. Episcleritis, conjunctivitis and keratitis as ocular manifestations of Lyme disease. Ophthalmology 1990 97 973-975. 

Humans are the only natural host for HSV, and more than 80% of the population carries systemic antibodies to them. However, ocular manifestation afflicts less than 1% of those exposed to the virus.The primary, or initial, HSV infection usually occurs by the age of 5 and often goes unnoticed or is too mild for the parent to seek medical attention for the child. After the primary infection, the virus settles into the central nervous system and localizes in the nerve ganglia. Latency of the virus persists for life in the innervating sensory ganglia. 

Type Causes/Immunology Symptoms lid Signs Ocular Manifestations Management Miscellaneous... 

CartUdge NE, Crombie A, Anderson J, et al. Critical study of 5 percent guanethidine in ocular manifestations of Graves disease. BMJ 1969,4 645-647. 

Anticholinesterase agents are potent drugs with many potential adverse effects iris cysts and anterior subcapsu-lar lens cataracts are the most serious and well known. Other significant but less common ocular manifestations include retinal detachment, angle-closure glaucoma, and uveitis. Common but less serious adverse effects include... 

Drugs affecting the autonomic nervous system or central vestibular system or causing extrapyramidal effects have been associated with ocular manifestations such as nystagmus, diplopia, extraocular muscle palsy, and oculogyric crisis. Table 35-8 fists drugs that can affect extraocular muscles. 

Arevalo JF, Lowder CY, Muci-Mendoza R. Ocular manifestations of systemic lupus erythematosus. Curr Opin Ophthalmol 2002 13 404-410. 

Within 5 days of being switched to valproate after developing a rash ascribed to carbamazepine, a 55-year-old man developed anticonvulsant hypersensitivity syndrome (maculopapular rash, fever, hepatitis, and eosinophilia) and ocular manifestations consistent with bilateral anterior uveitis (136). 

Four patients with corneal transplants developed ocular manifestations (bilateral graft rejection in two cases, uveitis, and epithelial and stromal herpetic kerato-uveitis) at 3 days to 6 weeks after the receipt of inactivated influenza vaccine (40). Whereas case reports of ocular manifestations after influenza immunization are known, this is perhaps the first report of vaccine-related herpetic recurrence. The authors advised caution when influenza immunization is considered for patients who have had a corneal transplant. 

In 20 Indian patients (of whom 70% were women) with Steven-Johnson syndrome and ocular involvement, co-trimoxazole was the commonest identifiable risk factor (143). Conjunctival involvement and its sequelae were the major ocular manifestations. 

Pushker N, Tandon R, Vajpayee RB. Stevens-Johnson syndrome in India — risk factors, ocular manifestations and management. Ophthahnologica 2000 214(4) 285-8. 

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. 

EuYA. 1984. Ocular manifestation of polychlorinated biphenyls intoxication. Am J Ind Med 5 127-132. 

A special issue from this Japanese experience are ocular effects of poisoning with sarin and their treatment. Some authors unsuccessfully treated strong miosis and consequential visual darkness with systemic atropine [15, 29], Others used 0.25% or 1.0% atropine sulphate eye drops, but these patients complained of atropine-induced photophobia and poor focusing [25], Our suggestion for optimal treatment of ocular manifestations of intoxication with organophosphorus cholinesterase inhibitors is topical use of pralidoxime chloride eye drops instead of atropine [42], Ocular pain should be treated with tropicamide 0.5% [28],... 

Nohara M, Sekijima Y, Nakajima T et al. (1999). Ocular manifestations in the follow-up of victims after sarin poisoning in Matsumoto area. Jpn J Clin Ophthalmol, 53, 659-663. 

Jabs DA, Green WR, Fox R, et al. Ocular manifestations of acquired immune deficiency syndrome. Ophthalmology 1989 96 1092. 

---