Ocular involvement in facial nerve paralysis: risk factors for severe visual impairment and ocular surface exposure in 1870 patients.

PURPOSE: To identify the risk factors associated with the development of ocular surface exposure and severe visual impairment (SVI) in patients with facial nerve palsy (FNP). METHODS: Ocular data of all consecutive FNP patients (N = 1870) presenting to an eye-care network over the past 10 years were reviewed. Risk factors associated with SVI (best-corrected visual acuity <20/200) and ocular surface exposure at presentation were evaluated using multivariate analysis and odds ratios (OR). RESULTS: The prevalence of SVI was 15%, and 47% had ocular surface exposure at the first presentation. The presence of corneal scar (28% vs. 10.2%, p < .001; OR 3.05), corneal ulcer (12.9% vs. 2.3%, p < .001; OR 4.67), older age at presentation (p < .001; OR 1.02), >10 mm lagophthalmos (p < .001; OR 8.7), male sex, and duration of FNP (p = .021; OR 1) were independent risk factors for developing SVI. Of the 893 eyes with ocular surface exposure, 75 (3.9%) had a corneal ulcer, and 11 (0.6%) were perforated, with the rest having epithelial defects and punctate keratopathy. Patients with neoplastic etiology (15.9% vs. 5.7%; p < .001; OR 2.39), lagophthalmos (49% vs. 29.7%; p < .001; OR 2.25) and poor Bell's phenomenon (9.4% vs. 4.2%; p = .005; OR 1.8) had twofold risk for developing ocular surface exposure. CONCLUSION: Eyes with lagophthalmos, poor Bell's phenomenon, and FNP of neoplastic etiology have a higher risk of developing ocular surface exposure. Male sex, increasing age, longer duration of FNP, and >10 mm lagophthalmos are associated with SVI in FNP patients; hence, early and timely intervention is necessary.

Effect of leaf extract of Aegle marmelose (L.) Correa ex Roxb. on histological and ultrastructural changes in tissues of streptozotocin induced diabetic rats.

Light and electron microscopic examination of tissues of rats rendered diabetic with a smaller dose of 45 mg/kg of body weight of streptozotocin were carried out in the present study. The dose of the drug given altered the function of pancreatic beta-cells and the acinar cells. The changes in the acinar cells were coarsening of endoplasmic reticulation (ER) and alterations in their secretory function. The changes in the liver were (1) dialation of veins, (2) loss of usual concentric arrangement of hepatocytes, (3) liver fibrosis and (4) decrease in glycogen content. The kidney tubules were thickened and the glomerulus was expanded. The leaf extract of Aegle marmelose reversed the altered parameters to near normal. The treatment of leaf extract on diabetic pancreas showed improved functional state of pancreatic beta-cells. The results indicate the potential hypoglycemic nature of the leaf extract, helping in regeneration of damaged pancreas.