Management of Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP)-A Case Report.

Background and Objectives: This study reports a case of a 62-year-old patient experiencing a significant decline in vision over the past three months. The initial best-corrected visual acuity (BCVA) of 20/20 in both eyes diminished to 20/200 in the right eye (RE) and counting fingers (CF) in the left eye (LE) within this timeframe. The patient was diagnosed with stage 4 ovarian cancer just one month before the significant vision deterioration. Materials and Methods: A thorough ophthalmologic examination revealed a notable progression of cataracts and the presence of subretinal fluid on the posterior pole, accompanied by choroidal thickening. The right eye exhibited multifocal, orange-pigmented, and elevated choroidal lesions, while the left eye's fundus examination was impeded by dense cataracts. Optical coherence tomography (OCT) revealed bilateral choroidal thickening with overlying folds and subretinal fluid, and ultrasound imaging of the choroidal lesions indicated moderate homogenous internal reflectivity. Results: The patient received a diagnosis of BDUMP (bilateral diffuse uveal melanocytic proliferation), a paraneoplastic syndrome marked by simultaneous, bilateral, painless vision loss and the rapid onset of bilateral cataracts with serous retinal detachments. Despite cataract extraction, the expected visual recovery was not achieved (RE: CF; LE: 2/200, respectively). Plasmapheresis showed some success in stabilizing vision loss attributed to serous retinal detachments. Conclusions: BDUMP necessitates addressing the underlying malignancy for effective treatment. Left untreated, it can lead to near blindness within a year. The prognosis remains grim, with an average survival time ranging from 12 to 15.7 months from the time of diagnosis. Considering this case report, it is crucial to establish effective management plans and further investigate potential treatment methods and predictive markers centered around BDUMP. Collaboration between healthcare professionals and researchers is crucial in addressing the complexities of BDUMP, as the timely diagnosis and treatment of the disease remains a top priority.

Perforating corneal injury in rat and pentadecapeptide BPC 157.

Based on its healing effects in various tissues, we hypothesized that the stable gastric pentadecapeptide BPC 157 heals corneal ulcerations in rats and effects corneal transparency. We made a penetrant linear 2-mm incision in the paralimbal region of the left cornea at the 5 o'clock position with a 20-gauge MVR incision knife at 45° under an operating microscope. Medication was BPC 157 (2 pg/mL, 2 ng/mL, and 2 µg/mL distilled water, two eye drops/left rat eye) immediately after injury induction and then every 8 h up to 120 h; controls received an equal volume of distilled water. In contrast to the poor healing response in controls, BPC 157 significantly accelerated the healing process in 2 µg and 2 ng BPC 157-treated eyes, starting 24 h after the injury, and the fluorescein and Seidel tests became negative. The epithelial defects were completely healed at 72 h (2 µg BPC 157-treated group) and at 96 h (2 ng BPC 157-treated group) after injury. Aqueous cells were absent at 96 h and 120 h after injury in the 2 µg and 2 ng BPC 157-treated groups, respectively. In conclusion, BPC 157 effects the rapid regaining of corneal transparency. Whereas controls developed new vessels that grew from the limbus to the penetrated area, BPC 157-treated rats generally had no new vessels, and those that did form in the limbus did not make contact with the penetrated area. Thus, BPC 157 eye drops successfully close perforating corneal incisions in rats.

Treatment of anti-vascular endothelial growth factor-resistant diabetic macular edema with dexamethasone intravitreal implant.

PURPOSE: To investigate the efficiency of intravitreal dexamethasone implant in patients with chronic diabetic macular edema nonresponsive to three consecutive monthly intravitreal injections of anti-vascular endothelial growth factor administered previously. METHODS: Fifteen patients (16 eyes) were included in this 4-month prospective clinical trial. Main observed outcomes were the changes between initial and monthly visits in best-corrected visual acuity, central foveal thickness, and intraocular pressure (IOP). Patients included had central foveal thickness of >225 µm (measured by optical coherence tomography) and were nonresponsive to previously administered 3 consecutive monthly intravitreal injections of 1.25-mg bevacizumab. Administration of intravitreal dexamethasone implant was performed at baseline, and patients were followed-up monthly. RESULTS: Statistically significant changes from baseline were observed in best-corrected visual acuity (at 2 months), central foveal thickness (at 1, 2, and 3 months), and IOP (at Months 1, 2, and 3) as follows: mean best-corrected visual acuity significantly increased from 0.29 Snellen lines at baseline to 0.39 lines after 2 months (P = 0.0381). At Months 1, 2, and 3, the mean central foveal thickness significantly decreased, from 462 µm at baseline, to 366 µm (P = 0.0343), 346 µm (P = 0.0288), and 355 µm (P = 0.0370), respectively. When compared with baseline IOP of 15.38 mmHg (12-19 mmHg), IOP increased significantly at Months 1, 2, and 3: 18.93 mmHg (range, 16-24 mmHg; P = 0.0003), 19.5 mmHg (range, 16-27 mmHg; P = 0.0003), and 17.5 mmHg (range, 15-21 mmHg; P = 0.0048), respectively. CONCLUSION: Dexamethasone intravitreal implant may present an alternative option in the treatment of chronic diabetic macular edema nonresponsive to three consecutive monthly bevacizumab injections administered previously. However, IOP measures were only slightly increased. It seems that the effect of dexamethasone may last till 4 months after initial injection.

Stable Gastric Pentadecapeptide BPC 157-Possible Novel Therapy of Glaucoma and Other Ocular Conditions.

Recently, stable gastric pentadecapeptide BPC 157 therapy by activation of collateral pathways counteracted various occlusion/occlusion-like syndromes, vascular, and multiorgan failure, and blood pressure disturbances in rats with permanent major vessel occlusion and similar procedures disabling endothelium function. Thereby, we revealed BPC 157 cytoprotective therapy with strong vascular rescuing capabilities in glaucoma therapy. With these capabilities, BPC 157 therapy can recover glaucomatous rats, normalize intraocular pressure, maintain retinal integrity, recover pupil function, recover retinal ischemia, and corneal injuries (i.e., maintained transparency after complete corneal abrasion, corneal ulceration, and counteracted dry eye after lacrimal gland removal or corneal insensitivity). The most important point is that in glaucomatous rats (three of four episcleral veins cauterized) with high intraocular pressure, all BPC 157 regimens immediately normalized intraocular pressure. BPC 157-treated rats exhibited normal pupil diameter, microscopically well-preserved ganglion cells and optic nerve presentation, normal fundus presentation, nor- mal retinal and choroidal blood vessel presentation, and normal optic nerve presentation. The one episcleral vein rapidly upgraded to accomplish all functions in glaucomatous rats may correspond with occlusion/occlusion-like syndromes of the activated rescuing collateral pathway (azygos vein direct blood flow delivery). Normalized intraocular pressure in glaucomatous rats corresponded to the counteracted intra-cranial (superior sagittal sinus), portal, and caval hypertension, and aortal hypotension in occlusion/occlusion-like syndromes, were all attenuated/eliminated by BPC 157 therapy. Furthermore, given in other eye disturbances (i.e., retinal ischemia), BPC 157 instantly breaks a noxious chain of events, both at an early stage and an already advanced stage. Thus, we further advocate BPC 157 as a therapeutic agent in ocular disease.

Anti-VEGF in treatment of diabetic macular edema.

Diabetic macular edema is the leading cause of moderate visual deterioration in patients with diabetic retinopathy. Ranibizumab) blocks vascular endothelial growth factor (VEGF) induced hyperpermeability of blood vessels. In this prospective case series we investigated the efficacy and safety of anti-VEGF treatment in reduction of central retinal thickness (CRT) and improvement in visual acuity (VA) in patients with diabetic macular edema (DME). 9 patients were followed up for 6 months and treated monthly with intravitreal ranibizumab. VA and CRT were measured at each visit. Treatment was discontinued as the peak improvement of either parameter was reached and reinstituted in case of deterioration/recurrence of edema. Study endpoints included: VA using ETDRS chart, CRT and number of injections at 6 months. Mean VA from all 9 patients increased by 0.3 lines of logMAR (p < 0.05 compared to baseline), and CRT decreased from 515 +/- 123 microm to 310 +/- 110 microm. The improvement of VA after ranibizumab injection was in correlation with a decrease in CRT. Mean of 4 injections were needed to control the disease during the follow-up period. Ranibizumab treatment was effective in VA and reducing CRT. Several injections were needed to control the disease. Regular OCT examinations and retreatment are advised in order to maintain initially reached VA.

Anti-VEGF in treatment of central retinal vein occlusion.

Macular edema along with macular ischemia is responsible for decreased visual acuity in central retinal vein occlusion. Bevacizumab (Avastin, Genentech) blocks vascular endothelial growth factor (VEGF) induced hyperpermeability of blood vessels. In this prospective case series we investigated the efficacy of anti-VEGF treatment in reduction of central retinal thickness (CRT) and improvement in visual acuity (VA). 25 patients were followed up for 12 months and treated monthly with intravitreal bevacizumab. VA and CRT were measured at each visit. Treatment was discontinued as the peak improvement of either parameter was reached and reinstituted in case of deterioration/recurrence of edema. Study endpoints included: VA using ETDRS charts, CRT and number of injections at 12 months. Mean VA from all 25 patients increased by 3.1 logMAR lines (p < 0.05 compared to baseline). The improvement of VA after bevacizumab injection was in correlation with a decrease in CRT In subgroup analyses, patients receiving bevacizumab injection within the first 3 months after CRVO showed an average VA gain of 4.2 logMAR lines. Mean of 4.5 injections was needed to control the disease during the follow-up period. Bevacizumab treatment was effective in VA and reducing CRT. It appears from subgroup analysis that initiation of treatment early in the course of disease produced better functional outcome. Several injections were needed to control the disease. Regular OCT examinations and retreatment are advised in order to maintain initially reached VA.

Enlarged Foveal Avascular Zone after Whiplash Injury-Acquired Berlin's Edema.

We describe a case of optical coherence tomography angiography (OCTA) changes in the foveal avascular zone (FAZ) in a patient that had suffered Berlin's edema after a whiplash neck injury. The patient reported central scotoma throughout the 1-year follow-up, confirmed by visual field examination. OCTA showed FAZ enlargement of the left eye as compared to the healthy right eye in the superficial capillary layer and even more in the deep capillary layer. To the best of our knowledge, FAZ enlargement has not been previously described by OCTA after whiplash-related macular injury.

Comparison of diffractive and refractive multifocal intraocular lenses in presbyopia treatment.

Multifocal intraocular lenses (MFIOL) enable good near and far vision after cataract surgery. Excellent results with cataract patients encouraged ophthalmologists to implant MFIOL after clear lens extraction (CLE). There are two types of MFIOL: diffractive and refractive. In our prospective study we compared clinical outcomes after CLE and bilateral implantation of diffractive (Tecnis Multifocal), (N=100 eyes, 50 patients) and refractive (ReZoom), (N=100 eyes, 50 patients) MFIOL to patients with presbyopia and hyperopia. Near and distant uncorrected visual acuity (UCVA), spectacle dependency, subjective satisfaction and visual disturbances were measured and compared between two groups. Patients achieved good near and distant UCVA in both groups. "Tecnis" group had better near UCVA (statistically not significant) and less night time visual disturbances. "ReZoom" group reported less problems with intermediate vision. Diffractive and refractive MFIOL enable high rate of spectacle independency to presbyopic hyperopic patients with low rate of side-effects. Refractive MFIOL provide better intermediate vision and diffractive slightly better near vision and less haloes and glare.

Autologous Neurosensory Retinal Free Flap Treatment for a Large Macular Hole.

A patient presented with a large chronic macular hole (MH) of 700 µm. Best-corrected visual acuity (BCVA) was 20/200. Since the MHs edges were attached and stiff, an autologous neurosensory retinal flap was harvested and placed into the MH to close it. Perfluoro-n-octane heavy liquid (PFC) was instilled over the flap and exchanged with silicone oil (1,000 cs). Seven days postoperatively, the MH was closed, with a BCVA of 20/80 that improved to 20/60 at months 1 and 3. Optical coherence tomography and angiography showed patch incorporation with fovea formation and normal circulation. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e89-e92.].

Postoperative Late-Onset Endophthalmitis Caused by Leishmania donovani: A Case Report.

Leishmania donovani is a human blood parasite that belongs to the genus Leishmania. We would like to present a case of late Leishmania donovani endophthalmitis in one eye of a patient that underwent simultaneous bilateral grade 3 cataract surgery.

Verteporfin therapy and intravitreal bevacizumab combined and alone in choroidal neovascularization due to age-related macular degeneration.

OBJECTIVE: To evaluate the efficacy and safety of photodynamic therapy (PDT) with verteporfin combined with intravitreal bevacizumab in choroidal neovascularization (CNV) owing to age-related macular degeneration (AMD) in comparison with individual monotherapies used as controls. DESIGN: Randomized controlled pilot clinical trial. PARTICIPANTS: Males or females, aged > or =50 years, with minimally classic or occult CNV owing to AMD in at least 1 eye that had never been treated previously. METHODS: One hundred sixty-five eyes in 165 subjects (53 males, 112 females) aged between 60 and 87 years (mean [standard deviation]: 75.7 [6.0] years) were randomly assigned to receive either a single PDT session with verteporfin (PDT group; n = 55), or a single administration of intravitreal bevacizumab (1.25 mg; BEV group; n = 55), or their combination (COMB group; n = 55). In the COMB group, bevacizumab was administered within 1 hour of PDT. Subjects were followed up at 1 and 3 months after treatment. Ophthalmic evaluations including optical coherence tomography, fluorescein angiography, and visual acuity (VA) and central foveal thickness (CFT) measurements were performed at each visit. MAIN OUTCOME MEASURES: Changes from baseline in best-corrected VA and CFT measured at 1- and 3-month follow-up visits. RESULTS: One hundred fifty-six subjects (54 BEV, 50 PDT, and 52 COMB) completed the study. At the 3-month follow-up, significant improvements in best-corrected VA were observed in the BEV and COMB groups (0.079 and 0.223 logarithm of the minimum angle of resolution [logMAR], respectively; P<0.0001 for both). In the PDT group, a slight worsening was noted. Significant reductions of CFT were observed in the 3 groups (-34.0 microm [BEV], -59.6 microm [COMB], and -50.5 microm [PDT]; P<0.0001 for all). At the 1-month follow-up, 46 subjects (16 BEV, 29 COMB, and 1 PDT) had an improvement >0.2 logMAR in best-corrected VA; at 3-month follow-up, this improvement persisted in 23 subjects (1 BEV, 22 COMB, and 0 PDT). CONCLUSIONS: Significant improvements in best-corrected VA after 1 month and their maintenance over a 3-month period were observed after verteporfin PDT combined with intravitreal bevacizumab. These results should be confirmed in larger and long-term prospective randomized trials.

Photodynamic therapy combined with intravitreal bevacizumab (Avastin) in treatment of choroidal neovascularization secondary to age-related macular degeneration.

To evaluate photodynamic therapy with verteporfin combined with intravitreal bevacizumab in minimally classic and occult choroidal neovascularization secondary to age-related macular degeneration. 46 eyes of 46 patients (mean age 74.5) included in this prospective, noncomparative, interventional case series. Median follow-up was 24 weeks (12-36). Verteporfin photodynamic therapy (PDT) was followed by 0.05 mL (1.25 mg) of bevacizumab injected intravitreally within 24 hours and again after 6 weeks. Whole procedure was repeated in 3-month intervals in case of leakage. Visual acuity (VA) improved in majority of patients (baseline VA 1.041 log MAR) by mean increase of 1.45 lines (last follow-up) (p = 0.001). Central foveal thickness (CFT) and total macular volume (TMV) decreased by 53 microm (p = 0.03) and 1.04 mm3 (p < 0.001) respectively. No serious complications were observed. Combined treatment may improve outcome of monotherapy. Significant improvement in VA, CFT and TMA was noted in majority of patients and maintained during follow-up.

Intravitreal bevacizumab (Avastin) in treatment of neovascular age-related macular degeneration.

To evaluate the efficacy and safety of intravitreal bevacizumab in treatment of minimally classic and occult choroidal neovascularization secondary to age-related macular disease 48 eyes of 48 patients (mean age of 74.8) included in this prospective, noncomparative, interventional case series. Median follow-up was 18 weeks (6-24). Intravitreal bevacizumab injection of 0.05 mL (1.25 mg) was administered at baseline and in 6 week intervals until leakage resolved, and repeated in case of leakage recurrence. Visual acuity (VA) improved in the majority of patients (mean baseline VA = 1.078 log MAR) by mean increase of 1.32 lines (last follow-up) (p = 0.001). Central foveal thickness and total macular volume decreased by 51 microm (p = 0.01) and 0.84 mm3 (p < 0.0001) respectively. No serious complications were observed. As initial therapy, intravitreal bevacizumab appears to be safe and effective. A significant functional and anatomical improvement was noted in majority of patients and maintained during follow-up.

Blue light filtering intraocular lenses in phacoemulsification cataract surgery.

Blue light can damage retina and cause age related macular degeneration. After cataract surgery and lens removal retina stays unprotected. Blue light filtering intraocular lenses (IOL) increase protection of the retina. In our prospective study we investigated clinical results after bilateral implantation of Acrysof Natural IOL to 30 patients (N = 60 eyes). In a control group (N = 60 eyes, 30 patients), standard acrysof IOL was implanted bilaterally. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and Nd YAG laser capsulotomy rate were measured and compared with control group. Subjective patient's satisfaction and subjective colour perception were also investigated. There was no significant difference in UCVA, BCVA and Nd YAG laser capsulotomy rate between the two groups. High patient's satisfaction was noticed (96.7% of patients would implant Acrysof Natural IOL again). Acrysof Natural IOL enables good visual acuity VA, low rate of Nd YAG laser capsulotomy and high patient's satisfaction without colour perception disturbances.

Influence of interleukin-1alpha and tumor necrosis factor-alpha production on corneal graft survival.

AIM: To determine pro-inflammatory cytokine secretion from human corneas with different pathology and to establish whether cytokine profile influences corneal graft outcome. METHOD: Secretion of both proinflammatory cytokine interleukin (IL)-1alpha and tumor necrosis factor (TNF)-alpha was measured after cultivation of 47 corneas collected from corneal graft recipients suffering from different corneal diseases. Non-inflammatory corneal diseases were keratoconus (n=8), keratoglobus (n=2), bullous keratopathy (n=11), and Groenouw stromal dystrophy type II (n=2), whereas inflammatory included vascularized corneal scar (n=14), rejected graft (n=6), and corneal ulcer (n=4). Corneas were cultivated at 37 degrees C for 24 hours and frozen until cytokine detection was measured by immunoassay. Donor corneas unsuitable for transplantation were used as controls (n=7). Corneal graft recipients were followed at least 18 months and rejection rate was calculated for each group. RESULTS: The median concentration of IL-1alpha secreted from corneas of recipients with non-inflammatory diseases was 2.47 pg/mm(3) (range, 0.13-9.95). In inflammatory corneal diseases, IL-1alpha concentration was significantly higher (median, 5.92 pg/mm(3); range, 0.48-12.68; P=0.005). IL-1alpha production in controls (median, 0.63 pg/mm3; range, 0.36-1.29 pg/mm(3)) was significantly lower than in inflammatory corneal diseases (P<0.001) and non-inflammatory diseases (P=0.008). Low level of TNF-alpha was detected only in 5 cases of vascularized corneal scars, 3 cases of bullous keratopathy, and 3 cases of graft rejection. Rejection rate was significantly higher in inflammatory than in non-inflammatory group (46% vs <10%, respectively, P=0.008). IL-1alpha and TNF-alpha were absent from all patient's sera, confirming its local intra-ocular production. CONCLUSION: Increased production of IL-1alpha in corneal recipients with inflammatory diseases suggests its role in corneal graft rejection in humans.

Interleukin-1alpha production in human corneal scars.

We studied IL-1alpha level in corneal scars with/without neo-vascularization. A total of 27 patients underwent grafting for corneal scar. Recipients were grouped according to number of vascularized quadrants (0 to IV/IV): none (n = 12), one (n = 5), two (n = 4) and four (n = 6). Recipient corneas were collected during surgery and IL-1alpha measured by immunoassay. Controls were donor corneas unsuitable for transplantation. Graft rejection rate was calculated for each group. Mean IL-1alpha concentration in corneal scars was 6 +/- 3.93 pg/mm3; significantly higher as compared to controls (1.25 +/- 2.03 pg/mm3). IL-1alpha correlated well with amount of blood vessels, except in IV/IV scars: 5.17 +/- 3.65 pg/mm3 for 0/IV; 8.02 +/- 2.51 pg/mm3 for I/IV; 8.27 +/- 3.62 pg/mm3 for II/IV and 4.47 +/- 5.03 pg/mm3 for IV/IV corneal scars. Vascularization of corneal scar is associated with increased IL-1alpha level (in all but highly vascularized scars), indicating that IL-1alpha promotes early stages of vascularization. Graft rejection rate increases in patients with higher vascularization, independently of IL-1alpha level.

Gastric pentadecapeptide BPC 157 promotes corneal epithelial defects healing in rats.

We evaluated the role of human gastric pentadecapeptide BPC 157 in corneal epithelial defects healing in rats. 48 rats, in 4 groups (N=12). Total debridement of corneal epithelium preformed unilaterally and lesions stained and photographed. Animals medicated as follows: distilled water (control group) or BPC 157 2 pg/ml, 2 ng/ml, 2 microg/ml, 2 drops/rat eye started immediately after injury induction, every 8 hours up to 40 hours (i.e., at 0, 8, 16, 24, 32, 40 h). Lesions were photographed before application or sacrifice (at 48 h). Defect area was analyzed using a special program. Through 48 hour period a steady recovery is noted in controls. Recovery was markedly accelerated in eyes on microg- or ng-topical regimen of BPC 157 (p < 0.05). Of note, unlike control lesion present also after 48 h, these lesions disappeared already following 40 h (microg) or 48 h (ng) post-injury. BPC 157 was shown to be effective in promoting corneal defects healing in rats. Results were dose dependent.

[Effect of viscoelasticity on corneal endothelial cell loss in phacoemulsification]. / Utjecaj viskoelastika na gubitak endotelnih stanica roznice pri fakoemulzifikaciji.

UNLABELLED: One of the most important factors for successful intraocular surgery is deep anterior chamber which is maintained using viscoelastics that protect corneal endothelial cells. This single endothelial cell layer may sustain a varying degree of injury during surgery and is known to be incapable of regeneration. THE AIM: Of the study was to determine optimal visoelastics for the protection of corneal endothelial cells during phacoemulsification and intraocular lens implantation. PATIENTS AND METHODS: A series of 156 patients were included in this prospective study. Patients were randomly assigned to three groups based on the type of viscoelastics used. In the first group, 1.4% sodium hyaluronate, in the second group a combination of 4% sodium chondroitin sulfate and 3% sodium hyaluronate, and in the third group 3% hyaluronate was used. Endothelial cell count and morphology changes were determined centrally with a specular microscope on the day before, on day 7 and one month after surgery. Intraocular pressure was measured before surgery, and at 6 hours, 24 hours, 7 days and 30 days of the surgery. Pachymetry as a measure of "endothelial pump" function was evaluated before surgery and 7 and 30 days postoperatively. All surgeries were performed by two surgeons using the same technique. RESULTS: Endothelial cell loss was lowest (16.1%) in the eyes protected with a combination of 4% sodium chondroitin sulfate and 3% sodium hyaluronate. In the groups where 1.4% sodium hyaluronate and 3% hylunorate were used, the loss was 7.6%; and 7.9%, respectively. Although endothelial cell loss was not significantly different among the three groups, the lowest morphology change rate recorded in group 2 suggested that a combination of chondroitin and hyaluronate offered the best endothelial protection. There was no statistically significant difference in the postoperative intraocular pressure increase and pachymetry values among the study groups.

[Evaluation of the efficacy and safety of lodoxamide in patients with allergic eye diseases]. / Procjena ucinkovitosti i sigurnosti lodoksamida u bolesnika s alergijskim bolestima ociju.

PURPOSE: To evaluate the effectiveness of lodoxamide in the therapy and prophylaxis of the ocular allergies. PATIENTS AND METHODS: This prospective study included 64 patients divided in 2 groups. In the first group there were 47 symptomatic patients suffering from seasonal allergic conjunctivitis (n = 27), perennial allergic conjunctivitis (n = 16) and giant papillary conjunctivitis (n = 4). The symptomatic patients were examined upon arrival and every 2 weeks until the symptoms were reduced. During the period, lodoxamide drops were administered 4 times a day. In the second group there were 17 patients who had a history of seasonal ocular allergies during previous years but were still not symptomatic upon arrival. In the group of 17 patients who were very likely to develop ocular allergy but up to inclusion into the study had no ocular symptoms, 12 (70%) presented with allergic rhinitis while 5 (30%) had asthma. The symptoms intensity (itching, discomfort, foreign body sensation, pain, tearing) was graded on a 0-3 scale. The clinical signs (follicles, papillae, hyperemia, conjunctival edema, Trantas dots, stromal infiltrates) were detected on a slit lamp examination and graded on a 0-3 scale. RESULTS: In the group of 47 symptomatic patients 2-4 weeks after lodoxamide administration, 70-80% of symptomatic patients examined clinically had less or no follicles, 60-70% had reduced or no edema, the secretion was stopped or greatly reduced in 50-70% of patients. All of the patients reported reduced or no itching, 60% of patients reported less discomfort, photophobia and reduced tearing. In the asymptomatic group two weeks after the initiation of the prophylaxis 88% of patients were still with no ocular signs of allergy while 12% of patients had a conjunctival hyperemia and follicles. After 4 weeks of the prophylaxis 76% of patients patients were still asympthomatic while only 4 developed a mild form of allergic conjunctivitis (conjunctival hyperemia and papillae), but less severe than during previous episodes. CONCLUSION: Lodoxamide was effective in reduction of symptoms and clinical signs of the ocular allergies. The best results were obtained if the drug was administered as a prophylaxis or very early in the course of the disease.