Efficacy of Honey-based Ophthalmic Formulation in Patients with Corneal Ulcer: A Randomized Clinical Trial.

AIM: The aim of this study was to evaluate the efficacy of honey-based ophthalmic drop in patients with foreign body induced corneal ulcer. BACKGROUND: Honey is traditionally used for skin, mucosal and corneal ulcers. Its use is well studied in human skin and mucosal ulcers and animal model of corneal ulcer with promising effects. METHODS: In this randomized clinical trial, 50 patients with foreign body induced corneal ulcer were allocated to receive 70% sterile honey-based ophthalmic formulation or 0.3% ophthalmic ciprofloxacin, as the standard treatment every 6 hours. All the patients were examined for the size of corneal epithelial defect, corneal infiltration and depth and followed on a daily basis until complete healing. Duration for complete healing was considered as the outcome measure. Smear, culture, antibiogram and minimum inhibition concentration (MIC) tests were performed for honey and ciprofloxacin in all patients. RESULTS: The average durations of complete healing of corneal epithelial defect in the honey and ciprofloxacin groups were 3.88 ± 3.44 vs. 6.32 ± 3.69days, respectively (p=0.020). No significant difference was observed between two groups regarding an average duration of healing of corneal infiltration (8.12 ±1.94 days vs. 8.64±2.15 days, p=0.375). MIC of honey for pseudomonas aeruginosa was 60%w/w, for E.Coli 40% w/w, and for staphylococcus aureus 30% w/w. CONCLUSION: Honey based ophthalmic drop can acceleratethe corneal epithelial defect healing in patients with foreign body induced corneal ulcer, compared to ophthalmic ciprofloxacin as a standard treatment. The study was registered in Iranian registry of clinical trial center (IRCT) with registration number IRCT2015020120892N1.

Artistic assault: an unusual penetrating head injury reported as a trivial facial trauma.

The authors report a case of penetrating head injury that presented with a deceptively mild complaint. To our knowledge, it is the first report of a paint brush penetrating the brain. The patient reported being punched in the left eye and presented with a minor headache, swelling around the left orbit, a small cut on the cheek and slightly reduced left eye abduction. After radiological evaluation, a penetrating head injury was diagnosed. Under general anesthesia, through a lateral eyelid incision a 10.5 cm long paint brush, which had penetrated from the left orbit to the right thalamus, was removed. No post-operative infection was seen at six months follow-up. This brief report serves to highlight that penetrating brain injury can occur without neurological deficit and that a minimally invasive surgical approach was successful in avoiding any complications.

Removal of intralenticular magnetic foreign bodies with intraocular magnet.

PURPOSE: To investigate the possibility of conservation of the lens after removal of intralenticular magnetic foreign bodies with intraocular magnet. METHODS: Intralenticular magnetic foreign bodies of 15 patients were removed by using an intraocular magnet. The lens of each injury eye was conserved. Follow-up observation of these cases ranged from one to four years. RESULTS: The intralenticular magnetic foreign bodies of 15 patients were successfully removed. The lens of each injury eye was conserved and the transparence of the lens was properly maintained. Sizes of these foreign bodies were measured, ranging from 0.3 mm to 3 mm in diameter. The follow-up observation showed that the corrected visual acuity of 14 cases was not changed after operation. CONCLUSIONS: The intraocular magnet is very helpful for removal of magnetic foreign bodies from the transparent lens. This magnet allows removing of the foreign body by the surgeon and no damage to the lens was induced during the operation. Thus, maintenance of visual acuity of most of the patients can be achieved.

[Complaints following treatment of common acute eye diseases]. / Gener efter behandling af almindeligt forekommende akutte øjenlidelser.

The aim of the study was to determine the duration of symptoms in patients treated in the emergency room at Glostrup Hospital for acute eye-trouble. Nine common diagnoses were selected for the study. All patients seen during a 2 1/2 month period were asked to complete a questionnaire one week after the consultation. Those who did not return the questionnaire, and cases where the diagnosis was changed by a doctor in the days following the consultation, were excluded. The final material comprised 422 patients. 28% did not have any complaints after the consultation. 50% were free of symptoms within 24 hours and 75% within 48 hours. 10% had symptoms for more than a week. Cases of infectious conjunctivitis and trauma to the eye (without intrabulbar lesion) had the highest risk of developing symptoms after the consultation. The lowest incidence of complaints was seen among patients in whom a foreign body was removed from the cornea or conjunctiva. The longest duration of symptoms was seen among patients with infectious conjunctivitis. Cases with a foreign body on the cornea or conjunctiva or trauma to the eye (without intrabulbar lesion) had a slightly longer duration of the symptoms when a corneal tear was present. Patients with photoelectric conjunctivitis and conjunctivitis caused by chemical products had the shortest durations of symptoms. Patients with pain should be treated with analgesic tablets as the pain-relief after application of local anaesthetics was brief. Only half of those who had a prescription for chloramphenicol used this for as long as it had been recommended. Compliance was better to ointment than to eye-drops.

Management of corneal foreign bodies.

Optimal management of corneal foreign-body injuries includes an accurate history, thorough examination of both eyes, atraumatic removal of the foreign body, elimination of the rust ring, appropriate antibiotic prophylaxis and protective patching. Pitfalls to be avoided include using topical steroids, which may promote ulceration from fungal contaminants, and prescribing topical anesthetics, which can mask the pain of a retained tarsal foreign body or a developing corneal ulcer. Careful records of care and follow-up are essential.

Management of posterior-segment foreign bodies.

Of 28 patients with a foreign body in the posterior segment, 24 were managed primarily and 4 had been referred for treatment of associated injuries or complications after extraction. There were 19 magnetic and 9 nonmagnetic (including 6 copper-containing) foreign bodies. Preoperative localization was achieved mainly by visual and radiologic (Sweet's) methods, supplemented by computer-assisted tomography and ultrasonography. The magnetic foreign bodies were extracted through the pars plana or sclera. The nonmagnetic foreign bodies were extracted mainly by a two-instrument vitrectomy technique through the pars plana. Secondary procedures included vitrectomy, lentectomy, scleral buckling and dissection of preretinal membranes. In a follow-up period ranging from 1 to 53 (average 14) months the overall salvage rate (final visual acuity 6/60 [20/200] or better) was 46%. Four eyes were enucleated.

[Action of gentamycin against a background of magnetotherapy of the anterior chamber in a traumatic infected erosion of the cornea]. / Vozdeistive gentamitsina na fone omagnichivanii perednego otrezka glaza pri travmaticheskoi infitsirovannoi érozii rogovoi obolochiki.

Fifteen patients with surface infections of the cornea due to a foreign body in one eye were treated with magnetophoresis and gentamicin before and after removal of the foreign bodies. The lower eyelid was turned back and a cotton tampon impregnated with 1 ml of a 0.3 per cent aqueous solution of gentamicin was applied. After that the tube of the alternating magneto was placed before the eyelids. The magnetic field (50 oersted, 50 Hz) was applied for 9 minutes. Such a treatment promoted suppression of the eye inflammatory reaction and accelerated corneal epithelization.

Conjunctivitis in children. A refresher survey of diagnosis and contemporary treatment.

The management of acute conjunctivitis need not be confusing. In the newborn period the common etiologic agents are chemical, TRIC, and bacterial. The latter two causes are effectively treated with sulfacetamide ophthalmic preparations. Dacryostenosis should be suspected in any child with recurrent conjunctivitis in the first six months of life. With older children the major causes can be classified as viral, allergic, foreign bodies, and bacterial. Bacterial conjunctivitis almost always responds to sulfacetamide ophthalmic preparations.

Management of ocular foreign bodies.

Fluorescein staining is helpful in diagnosis. Many conjunctival foreign bodies can be removed by swab or irrigation, without anesthesia. Cycloplegics can prevent painful ciliary spasm. A surgical opening may be required for deeply embedded objects. Topical anesthesia is required for corneal foreign body removal. Caution: x-rays must be made to rule out intraocular foreign bodies in cases of flying metal. Rust rings must be removed. Mydriatics or cycloplegics can precipitate glaucoma. Corneal abrasions are easily infected. Secondary iritis may follow deeply embedded foreign bodies.