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Journal of Ophthalmic Inflammation and... Dec 2020Nocardia species are an uncommon but important cause of keratitis. The purpose of this review is to discus previous published papers relation to the epidemiology,... (Review)
Review
Nocardia species are an uncommon but important cause of keratitis. The purpose of this review is to discus previous published papers relation to the epidemiology, etiology, diagnosis and management of Nocardia keratitis. Nocardia asteroides is the most frequently reported from Nocardia keratitis. Pain, photophobia, blepharospasm and lid swelling are mainly clinical manifestations. Usual risk factors for Nocardia keratitis are trauma, surgery, corticosteroids, and contact lens wear. Several antibiotics were used for treatment of Nocardia infection but according to studies, topical amikacin is the drug of choice for Nocardia keratitis. Topical steroid should not prescribe in these patients. In conclusion, although Nocardia keratitis is rare, early diagnosis and treatment are essential to prevent any scar formation and preserve a good visual acuity.
PubMed: 33263838
DOI: 10.1186/s12348-020-00228-w -
Cirugia Y Cirujanos 2022Describe an atypical case of a morgagnian cataract with diffusion of cortical material through the intact posterior capsule.
OBJECTIVE
Describe an atypical case of a morgagnian cataract with diffusion of cortical material through the intact posterior capsule.
CLINICAL CASE
50-year-old male, with 24 hours of evolution, referring pain, photophobia, and seven year history of visual loss. Intraocular pressure of 36 mmHg, opaque cornea, anterior chamber with a whitish material, liquefied crystalline cortex. Ultrasound: intact posterior capsule, retrolental hyperechogenic material. He required maximum hypotensive treatment indicated, phacoemulsification and trabeculectomy. Retrolental material was found, with a posterior capsulotomy, through cut/aspiration with vitrector.
CONCLUSIONS
Diffusion of cortical material towards Berger's space is rare, it is necessary to recognize for surgical approach.
Topics: Cataract; Cataract Extraction; Humans; Male; Middle Aged; Phacoemulsification
PubMed: 35636943
DOI: 10.24875/CIRU.20001260 -
Neuro-ophthalmology (Aeolus Press) 2022Photophobia is considered the second most common symptom of both concussion and post-concussion syndrome. Soldiers on duty experience photophobia after blast-related... (Review)
Review
Photophobia is considered the second most common symptom of both concussion and post-concussion syndrome. Soldiers on duty experience photophobia after blast-related concussions or mild traumatic brain injury in 60-75% of instances. In addition, soldiers report other symptoms, such as asthenopia, squinting, dry eyes and headaches, for which they are considered to be at high risk. According to the International Brain Injury Association, some concussed patients report indirect symptoms such as multi-tasking difficulties, dizziness, vertigo, and fatigue. Moreover, some concussed individuals experience photophobia for approximately 6 months or indefinitely. We present the case of a 23-year-old soldier who presented with severe photophobia after a mild traumatic head injury. His photophobia was alleviated after the administration of topical anaesthetic drops in the eyes in the absence of any ocular surface pathology. He was diagnosed with post-concussion syndrome light sensitivity and was managed successfully with rose-coloured special photophobia glasses tinted with FL-41. Photophobia is a common neurological symptom in military personnel that needs more attention as it affects body and mind. We have reported an uncommon pathway of photophobia, which may unveil an unrecognised mechanism that may play a role in post-concussion photophobia.
PubMed: 35273410
DOI: 10.1080/01658107.2021.1983612 -
Digital Journal of Ophthalmology : DJO Feb 2021A 74-year-old pseudophakic white woman with pseudoexfoliation syndrome presented with right eye pain and photophobia and was found to have pseudophacodenesis with...
A 74-year-old pseudophakic white woman with pseudoexfoliation syndrome presented with right eye pain and photophobia and was found to have pseudophacodenesis with recurrent episodes of anterior uveitis, microhyphema, and elevated intraocular pressure (IOP). All episodes occurred after yoga sessions with intensive facedown postures. Ultrasound biomicroscopy (UBM) performed in supine and prone positions demonstrated significant change in the lens-bag complex position, with lens-iris touch. The patient underwent intraocular lens (IOL) explantation, anterior vitrectomy, and flanged intrascleral haptic-fixated IOL placement via double-needle technique, with resolution of all symptoms.
Topics: Aged; Female; Glaucoma; Humans; Hyphema; Microscopy, Acoustic; Syndrome; Uveitis; Yoga
PubMed: 33867882
DOI: 10.5693/djo.02.2020.11.001 -
American Family Physician Jun 2016Eye problems constitute 2% to 3% of all primary care and emergency department visits. Common eye conditions that can cause eye pain are conjunctivitis, corneal abrasion,...
Eye problems constitute 2% to 3% of all primary care and emergency department visits. Common eye conditions that can cause eye pain are conjunctivitis, corneal abrasion, and hordeolum, and some of the most serious eye conditions include acute angle-closure glaucoma, orbital cellulitis, and herpetic keratitis. The history should focus on vision changes, foreign body sensation, photophobia, and associated symptoms, such as headache. The physical examination includes an assessment of visual acuity and systematic evaluation of the conjunctiva, eyelids, sclera, cornea, pupil, anterior chamber, and anterior uvea. Further examination with fluorescein staining and tonometry is often necessary. Because eye pain can be the first sign of an ophthalmologic emergency, the physician should determine if referral is warranted. Specific conditions that require ophthalmology consultation include acute angle-closure glaucoma, optic neuritis, orbital cellulitis, scleritis, anterior uveitis, and infectious keratitis.
Topics: Education, Medical, Continuing; Emergency Medical Services; Eye Pain; Humans; Practice Guidelines as Topic; Primary Health Care
PubMed: 27304768
DOI: No ID Found -
The British Journal of Ophthalmology Jun 2021Photophobia is a potentially debilitating symptom often found in dry eye disease (DE), migraine and traumatic brain injury (TBI). (Review)
Review
BACKGROUND
Photophobia is a potentially debilitating symptom often found in dry eye disease (DE), migraine and traumatic brain injury (TBI).
METHODS
We conducted a review of the literature via a PubMed search of English language articles with a focus on how photophobia may relate to a shared pathophysiology across DE, migraine and TBI.
RESULTS
DE, migraine and TBI are common conditions in the general population, are often comorbid, and share photophobia as a symptom. Across the three conditions, neural dysregulation of peripheral and central nervous system components is implicated in photophobia in various animal models and in humans. Enhanced activity of the neuropeptide calcitonin gene-related peptide (CGRP) is closely linked to photophobia. Current therapies for photophobia include glasses which shield the eyes from specific wavelengths, botulinum toxin, and inhibition of CGRP and its receptor. Many individuals have persistent photophobia despite the use of these therapies, and thus, development of new therapies is needed.
CONCLUSIONS
The presence of photophobia in DE, migraine and TBI suggests shared trigeminothalamic pathophysiologic mechanisms, as explained by central neuroplasticity and hypersensitivity mediated by neuropeptide CGRP. Treatment strategies which target neural pathways (ie, oral neuromodulators, transcutaneous nerve stimulation) should be considered in patients with persistent photophobia, specifically in individuals with DE whose symptoms are not controlled with traditional therapies.
Topics: Brain Injuries, Traumatic; Dry Eye Syndromes; Humans; Migraine Disorders; Neuronal Plasticity; Photophobia; Thalamic Nuclei; Trigeminal Nerve
PubMed: 32703784
DOI: 10.1136/bjophthalmol-2020-316417 -
The Journal of Headache and Pain Dec 2017Based on recent findings and our own impressions we took a closer look at the relationship between (inter)ictal photophobia and psychometric variables in migraine...
BACKGROUND
Based on recent findings and our own impressions we took a closer look at the relationship between (inter)ictal photophobia and psychometric variables in migraine patients with photophobia.
FINDINGS
For this study we included 29 (27 female) migraine patients and 31 (18 female) controls with a mean age of 31.6 ± 12.5 years and 24.0 ± 4.1 years, respectively. All participants filled out the Depression Anxiety Stress Scale (DASS). Interictal photophobia in patients was significantly higher than photophobia in controls (p = .001). Patients showed statistically significantly higher levels of depressive symptoms (p < .001), anxiety symptoms (p < .001) and stress (p < .001) than controls. Among all participants, (interictal) photophobia correlated positively with age (rho = .318, p = .013) as well as with the levels of depressive symptoms (rho = .459, p < .001), anxiety symptoms (rho = .346, p = .008) and stress (rho = .368, p = .005), but not with gender. In the patients, ictal photophobia correlated positively with age (rho = .473, p = .01) and interictal photophobia (rho = .423, p = .022). Linear regression analysis revealed only a trend towards statistical significance for (interictal) photophobia as a predictor for the level of depressive symptoms (rho = .457, p = 0.056) in the whole sample.
CONCLUSIONS
Considering higher levels of photophobia in depression and the comorbidity of migraine and depression, it might be possible that depression contributes to interictal photophobia in patients with migraine. The same may be true for anxiety and stress. Both are also related to migraine and their possible impact on photophobia in migraine may be explained by pupillary dysfunction.
Topics: Adult; Anxiety; Comorbidity; Depression; Female; Humans; Male; Migraine Disorders; Photic Stimulation; Photophobia; Prevalence
PubMed: 28185159
DOI: 10.1186/s10194-017-0718-1 -
The Journal of Headache and Pain May 2023Migraine is a highly disabling health burden with multiple symptoms; however, it remains undertreated because of an inadequate understanding of its neural mechanisms....
BACKGROUND
Migraine is a highly disabling health burden with multiple symptoms; however, it remains undertreated because of an inadequate understanding of its neural mechanisms. Neuropeptide Y (NPY) has been demonstrated to be involved in the modulation of pain and emotion, and may play a role in migraine pathophysiology. Changes in NPY levels have been found in patients with migraine, but whether and how these changes contribute to migraine is unknown. Therefore, the purpose of this study was to investigate the role of NPY in migraine-like phenotypes.
METHODS
Here, we used intraperitoneal injection of glyceryl trinitrate (GTN, 10 mg/kg) as a migraine mouse model, which was verified by light-aversive test, von Frey test, and elevated plus maze test. We then performed whole-brain imaging with NPY-GFP mice to explore the critical regions where NPY was changed by GTN treatment. Next, we microinjected NPY into the medial habenula (MHb), and further infused Y1 or Y2 receptor agonists into the MHb, respectively, to detect the effects of NPY in GTN-induced migraine-like behaviors.
RESULTS
GTN effectively triggered allodynia, photophobia, and anxiety-like behaviors in mice. After that, we found a decreased level of GFP cells in the MHb of GTN-treated mice. Microinjection of NPY attenuated GTN-induced allodynia and anxiety without affecting photophobia. Furthermore, we found that activation of Y1-but not Y2-receptors attenuated GTN-induced allodynia and anxiety.
CONCLUSIONS
Taken together, our data support that the NPY signaling in the MHb produces analgesic and anxiolytic effects through the Y1 receptor. These findings may provide new insights into novel therapeutic targets for the treatment of migraine.
Topics: Mice; Animals; Neuropeptide Y; Receptors, Neuropeptide Y; Habenula; Hyperalgesia; Photophobia; Migraine Disorders
PubMed: 37231359
DOI: 10.1186/s10194-023-01596-z -
Cureus Feb 2023Migraine affects about one billion people worldwide yearly and is one of the most common neurologic illnesses, with a high prevalence and morbidity, particularly among... (Review)
Review
Migraine affects about one billion people worldwide yearly and is one of the most common neurologic illnesses, with a high prevalence and morbidity, particularly among young adults and females. Migraine is associated with many comorbidities, including stress, sleep difficulties, and suicidal ideation. Migraine, despite its widespread occurrence, is underdiagnosed and undertreated. Because of the complicated and primarily unknown mechanisms of migraine formation, several social and biological risk factors, such as hormone imbalances, genetic and epigenetic impacts, and cardiovascular, neurological, and autoimmune illnesses, have been proposed. Through the mid-20th century diversion of the now-defunct vascular theory, the pathophysiology of migraine has developed from a historical study of the "humours" to a distinct entity as a neurological disorder. The range of therapeutic targets has broadened significantly, increasing the number of specialized clinical trials. Understanding the biology of migraine through careful research has resulted in the identification of major therapeutic classes: (i) triptans, serotonin 5-HT1B/1D receptor agonists, (ii) gepants, calcitonin gene-related peptide (CGRP) receptor antagonists, (iii) ditans, 5-HT1F receptor agonists, (iv) CGRP monoclonal antibodies, and (v) glurants, mGlu5 modulators, with further targets being explored. This review provides a comprehensive overview of the most recent literature on epidemiology and risk factors and exposes knowledge gaps.
PubMed: 36879707
DOI: 10.7759/cureus.34553 -
PloS One 2023The purpose of this cohort study was to investigate the association between the prevalence of abnormal ocular examination results and the common visual symptoms of eye...
PURPOSE
The purpose of this cohort study was to investigate the association between the prevalence of abnormal ocular examination results and the common visual symptoms of eye strain, blurred vision and photophobia.
METHODS
Consecutive first-visit outpatients with best-corrected visual acuity better than 20/30 in both eyes were enrolled and those with a history of intra-ocular lens implantation and glaucoma were excluded. Dry eye-related examinations and retinal thickness measurement were conducted. The odds ratio (OR) was calculated with logistic regression analyses of ocular data in relation to the presence of visual symptoms.
RESULTS
A total of 6078 patients (3920 women, mean age 49.0 ± 20.4 years) were analyzed. The prevalence of each symptom was 31.8% for eye strain, 22.5% for blurred vision and 16.0% for photophobia. A significant risk factor for eye strain was short tear break-up time (TBUT) (OR 1.88), superficial punctate keratitis (SPK) (OR 1.44), and thickness of ganglion cell complex (GCC) (OR 1.30). Risk factors for blurred vision were short TBUT (OR 1.85), SPK (OR 1.24) and GCC (OR 0.59). Risk factors for photophobia were short TBUT (OR 1.77) and SPK (OR 1.32). Schirmer test value, peripapillary nerve fiber layer thickness and full macular thickness were not associated with the tested symptoms.
CONCLUSION
The current study successfully identified female gender, short TBUT, and SPK as significant risk factors for eye strain, blurred vision, and photophobia with considerable ORs.
Topics: Humans; Female; Adult; Middle Aged; Aged; Photophobia; Cohort Studies; Retina; Dry Eye Syndromes; Glaucoma; Keratitis; Tomography, Optical Coherence
PubMed: 37862343
DOI: 10.1371/journal.pone.0293320