Infectious conjunctivitis caused by Pseudomonas a eruginosa in infected and extrused scleral buckles.

Extrusion of the scleral buckle is one of the complications patients may encounter undergoing the surgical treatment for retinal detachment. We present two cases of persistent Pseudomonas a eruginosa-related conjunctivitis which infected the silicone explant after retinal surgery. One of them is a 73-year-old Caucasian female patient with hyperaemia, intense pain and mucopurulent discharge. After the conjunctival swabs detected a P. aeruginosa infection, she started both topical and systemic treatment without any results; for this reason we opted for the buckle removal always under systemic therapy. The second case is an 84-year-old Caucasian female patient with fever, periorbital oedema, chronic ocular pain, hyperaemia and purulent discharge. P. aeruginosa has also been detected in this case. No improvement with topical and systemic treatment, so this convinced us to remove patient's buckles and to continue systemic therapy. Both cases had the complete resolution after surgery. It is important to quickly recognise exposed scleral buckles because they can be a source of infections and a rare but threatening cause of endophthalmitis.

Dacryocystitis caused by community-onset methicillin-resistant Staphylococcus aureus.

PURPOSE: To describe the occurrence of community-onset methicillin-resistant Staphylococcus aureus (MRSA) infections of the lacrimal system and their treatment. METHODS: This cases series consisted of data obtained from seven clinical cases of acute or subacute MRSA dacryocystitis, with or without concurrent conjunctivitis, occurring in nonhospitalized individuals presenting between December 2001 and July 2003. Clinical presentations, microbial culture results, treatment modalities, and outcomes were retrospectively reviewed. RESULTS: Three patients were successfully treated with antibiotics and lacrimal surgery with no recurrence of symptoms after surgery for 6 months or longer. Four patients had temporary relief of symptoms with antibiotic therapy, but surgery was not performed for non-ophthalmologic reasons, and recurrence occurred. CONCLUSIONS: The treatment of MRSA dacryocystitis can be challenging. Microbiologic cultures should be performed in all patients with dacryocystitis that is unresponsive to conventional first-line antibiotic treatment and in patients at risk for acquisition of MRSA. Appropriate antibiotic therapy in combination with dacryocystorhinostomy appears to be the optimal treatment.

[Ocular infections of the elderly]. / Les infections oculaires du sujet âgé.

A CLINICAL ASPECT DEPENDING ON THE PHYSIOPATHOGENESIS: Ocular infections are a frequent motive for ophthalmological consultations in geriatric settings because of the mechanical factors related to age (modifications in palpebral dynamics and lacrymal function) and in local and general immune factors leading to the rapid and/or more severe development of infections. The mechanism of microbial contamination of the eye also determines the clinical damage: predominantly local (dirty hands, traumas) with involvement of the surface tissues (conjunctive and cornea) or general, hematogenic or neurogenic, frequently at the origin of more internal infections (iris, choroid, retina, optical nerve). CONJUNCTIVITIS AND KERATITIS: These provoke reddening of the eyes, tears and above all pain when the corneal epithelium is involved. Microbiological samples are useful in cases of severe, presumably infectious keratitis or conjunctivitis. Two emergency situations must be distinguished: any suspicion of herpes for which local corticosteroids are contraindicated and keratitis or conjunctivitis with the use of lenses, often due to Gram negative bacilli, amoeba or fungus, the treatment of which is intensive and the prognosis often severe. OPHTHALMOLOGICAL HERPES ZOSTER: The rapid diagnosis and introduction of efficient doses of antivirals reduces the initial pain, the ocular complications of herpes zoster and post-zoster pain. The latter, when it exists, requires specialized management. ACUTE UVEITIS: A context of intra-ocular inflammation in an elderly patient must always evoke a pseudo-uveitis syndrome, the principle cause of which is lymphoma. Conversely, an uveitis occurring in the days or weeks following ocular surgery, including cataract, must be considered as suggestive of a post-surgical infection and rapidly referred to a specialist. ACUTE DACRYOCYSTITIS: Is manifested by a hard and painful tumefaction below the internal angle of the eye. Following collection, it requires draining through an in incision in the skin, washing and packing of the sac, and systemic antibiotherapy. The preventive treatment of recurrences requires open dacryocystorhinostomy or via endonasal endoscopy.

Ocular disorders of pet ferrets.

Ocular disorders in pet ferrets are becoming more widely recognized as the popularity of these animals as companions increases. Knowledge of the anatomy of ferrets and a thorough examination are critical to accurately diagnosing ocular disease. If recognized early, some conditions can be managed successfully. Veterinarians should continue to report ocular conditions that are encountered in this species to help increase knowledge about these disorders.

Infectious keratitis after photorefractive keratectomy in a comanaged setting.

A 48-year-old man had simultaneous bilateral photorefractive keratectomy (PRK). The surgeon who performed the PRK did not see the patient in follow-up, and there was confusion regarding the comanaging doctor. Therefore, the patient was not examined immediately postoperatively. Several days later, he was hospitalized for an unrelated, painful orthopedic problem and heavily sedated. Seven days after the PRK, an ophthalmologist was consulted for ocular irritation and discharge. Examination showed bilateral, purulent conjunctivitis and severe infectious keratitis in the left eye. The patient was treated with periocular and topical antibiotics. Corneal cultures yielded Staphylococcus aureus. The keratitis resolved slowly, leaving the patient with hand motion visual acuity. A corneal transplant and cataract extraction was performed 15 months later, resulting in a best corrected visual acuity of 20/400 because of glaucomatous optic nerve damage. Severe infectious keratitis may occur after PRK. Poor communication between the surgeon, comanaging doctor, and patient may result in treatment delay.

Patogenesia homeopática limitada de "Propolis" en perros y equinos / Limited homeopathic pathogenesia of \"Propolis\" in dog and horses

Se realiza una patogenia con Propolis 30 C según Hahnemann durante 45 días, estudiándose los síntomas que aparecen en perros y equinos. Se observa en ambas especies la aparición constante y temprana de secreción purulenta en la comisura interna del ojo izquierdo primero, y luego en el derecho. Decaimiento general y estado febril con anorexia y vómitos después del mediodía. Empeoramiento entre las 13 y 15 hs. Se describe una breve Materia Médica

Nosocomial Klebsiella pneumoniae conjunctivitis resulting in infectious keratitis and bilateral corneal perforation.

PURPOSE: Klebsiella pneumoniae is a known cause of metastatic endophthalmitis. However, the organism has never been described to cause severe infectious keratoconjunctivitis. We report a fulminant case of nosocomial K. pneumoniae conjunctivitis complicated by infectious keratitis and corneal perforation in both eyes. METHODS: An 83-year-old previously healthy Chinese woman, blind in the right eye from rubeotic glaucoma and with bilateral dense cataracts, was admitted for observation after a head injury. While in hospital, she developed purulent bilateral conjunctivitis. Repeated cultures grew K. pneumoniae. This rapidly progressed to severe infectious keratitis and corneal perforation in both eyes, despite intensive antibiotics to which the organism was susceptible. The patient was otherwise well, and investigations did not reveal any source of endogenous sepsis. RESULTS: The patient lost complete vision in both eyes. The left eye turned phthisical, and the right eye was eviscerated for uncontrolled endophthalmitis. CONCLUSION: Although not previously reported, K. pneumoniae can cause devastating keratoconjunctivitis resulting in corneal melt, perforation, and uncontrolled endophthalmitis.

Bronconeumonía por Chlamydia trachomatis con enfermedad isquémica intestinal: presentación de un caso / Bronchopneumonia by Chlamydia trachomatis with ischemic intestinal disease Report of case

Se presenta el caso de un paciente de dos meses de edad por infección Chlamydia trachomatis, con los signos clínicos clásicos: conjuntivitis, infección respiratoria, e insuficiencia ventilatoria, con septicemia agregada y enfermedad isquémica intestinal. Se corroboró la infección en la madre y con ello la vía de adquisición de la enfermedad

How do general practitioners manage eye disease in the community?

A survey of the management of eye disease in the community was carried out in two general practices over a three-month period. During this time there were 238 consultations by patients with ocular symptoms, making up 2.3% of all consultations and giving an annual consultation rate for eye disease of 66 per 1000 persons at risk. The four commonest diagnoses were bacterial conjunctivitis, allergic conjunctivitis, meibomian cyst, and blepharitis, and these accounted for more than 70% of the consultations. A variety of topical and systemic treatments were used, with topical chloramphenicol prescribed in 55% of consultations. Referral to a hospital eye department resulted from 35 consultations, giving a referral rate of 15% of all consultations.