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Turkish Journal of Ophthalmology Jun 2018A 21-year-old male patient with no history of systemic disease or drug use presented to our clinic with redness and pain in the right eye. Best corrected visual acuity...
A 21-year-old male patient with no history of systemic disease or drug use presented to our clinic with redness and pain in the right eye. Best corrected visual acuity was 20/20 in both eyes. Inflamed pinguecula was observed on slit-lamp examination and the patient was prescribed ophthalmic nepafenac eye drops. After instilling the drops that day and the next day, the patient presented again due to pruritus and rash. Upon consultation with the dermatology department, the patient was diagnosed with drug-induced allergic urticaria and the nepafenac drops were discontinued. Although urticaria has been reported as a side effect after systemic non-steroidal anti-inflammatory drug (NSAID) use, such a reaction has not been reported with an ophthalmic NSAID and ours is the first reported case of urticaria following ophthalmic nepafenac use. This unique case highlights the fact that ophthalmologists must also keep urticaria in mind as a potential side effect when prescribing this drug.
PubMed: 29988879
DOI: 10.4274/tjo.78614 -
Indian Journal of Dermatology,... 2018Psoriasis is a common disorder worldwide. The prevalence of psoriasis in Egypt, an African country with a Caucasian population, ranges 0.19-3%. Despite this relatively...
BACKGROUND
Psoriasis is a common disorder worldwide. The prevalence of psoriasis in Egypt, an African country with a Caucasian population, ranges 0.19-3%. Despite this relatively high prevalence of psoriasis, there are no epidemiologic data regarding the burden of associated eye affection. Determining the magnitude of the problem could help in offering better integrated health services.
AIM
The purpose of this study was to evaluate eye involvement in a sample of Egyptian psoriatic patients.
PATIENTS AND METHODS
This case-control study included 100 patients with psoriasis and 100 age and sex matched healthy controls. Psoriasis extent and severity was graded by psoriasis area and severity index (PASI). Complete ophthalmological examination and tests for dry eye were performed to all subjects.
RESULTS
The mean age of the psoriasis group was 50.7 ± 14.3 years. Thirty eight percent of the cases were females. The mean duration of psoriasis was 10.1 ± 7.5 years. Psoriasis patients had more conjunctival injection (n = 40, P = 0.035), more pinguecula (n = 38, P = 0.048) than controls. Ocular surface disease index (OSDI), tear breakup time (TBUT), Schirmer I, and Rose Bengal staining showed statistically significant positive results in the psoriasis group.
CONCLUSION
This is the first report on the prevalence of eye comorbidities in Egyptian psoriatic patients. Dry eyes were more common with psoriasis, particularly the erythrodermic type. Other ocular findings were not statistically significantly different except for conjunctival injection and pinguecula.
Topics: Adult; Aged; Aged, 80 and over; Case-Control Studies; Dry Eye Syndromes; Egypt; Eye Diseases; Female; Humans; Male; Middle Aged; Prevalence; Psoriasis; Young Adult
PubMed: 29067934
DOI: 10.4103/ijdvl.IJDVL_1239_15 -
Journal of Ophthalmic & Vision Research 2017To evaluate the risk factors for pterygium in the dry, high altitude province of Ilam, Iran.
PURPOSE
To evaluate the risk factors for pterygium in the dry, high altitude province of Ilam, Iran.
METHODS
The study included patients who presented to ophthalmology clinic. The patients were divided into two groups: 210 diagnosed with pterygium or pinguecula (unilateral or bilateral), and 210 healthy controls. Demographic variables, living environment, disease type, disease laterality, family history of pterygium as well as history of smoking, working outdoors, baking, welding, ocular conditions (trachoma keratopathy, glaucoma, refractive error, and dry eye), use of glasses, ultraviolet light exposure, and systemic conditions were collected from both groups and compared for risk assessment.
RESULTS
Univariate analysis revealed that age ( = 0.001), sex ( = 0.001), family history of pterygium ( = 0.001), positive history of smoking ( < 0.001), history of baking ( = 0.045), welding experience ( < 0.001), severe blepharitis ( < 0.001), hyperopia ( < 0.001), dry eye ( < 0.001), hypertension ( < 0.001), ischemic heart disease ( < 0.001), obesity ( = 0.038), and primary residential area ( = 0.025) had significant associations with increased incidence of pterygium. However, in multivariate analysis, only family history of pterygium, cigarette smoking, history of baking, age, and severe blepharitis were significantly associated with the incidence of pterygium (<0.001, <0.001, = 0.002, = 0.023 and = 0.002, respectively).
CONCLUSION
This study tested more risk factors related to the prevalence of pterygium compared to previous studies. It also confirmed previously established risk factors. Family history of pterygium and blepharitis were risk factors that have not been reported in previous studies and were found to be significantly associated with the development of pterygium in this study.
PubMed: 28791059
DOI: 10.4103/jovr.jovr_85_16 -
International Medical Case Reports... 2017To describe an unusual case of unilateral, chronic symptoms and signs of dry eye, and recurrent episodes of ocular irritation related to pinguecula, which were...
PURPOSE
To describe an unusual case of unilateral, chronic symptoms and signs of dry eye, and recurrent episodes of ocular irritation related to pinguecula, which were refractory to prior medical treatments, successfully treated with argon laser photocoagulation.
METHODS
A 36-year-old man presented with an elevated yellowish mass on his conjunctiva in his left eye, which was associated with dry eye symptoms and general discomfort, such as "tightening sensation" and "stiffness". On clinical assessment, the left eye revealed a mild conjunctival injection, a fluorescein break-up time (FBUT) of 3.5 s, an abnormal fluorescein staining, and a Schirmer test of 5 mm. Optical coherence tomography (OCT) imaging evidenced a height at the most elevated point of the pinguecula of 740 µm. The patient underwent argon-laser photocoagulation.
RESULTS
After 2 weeks postoperatively, no residual of pinguecula or focal injection of the conjunctiva was detected by slit-lamp biomicroscopy and there was a significant improvement of clinical symptoms and signs: Schirmer test and FBUT increased to 12 mm and >10 s, respectively, and fluorescein staining was absent. OCT imaging revealed a smooth structure of conjunctival contour, with a height of 404 µm. According to an ex juvantibus line of reasoning, definitive diagnosis was pinguecula-related dry eye disease.
CONCLUSION
Based on the concept that tear film instability and inflammation are two key components of the pathogenesis of dry eye, we coined the term "pinguecula-related dry eye disease," which can be successfully treated by a complete, accurate removal of the lesion with argon laser photocoagulation.
PubMed: 28769593
DOI: 10.2147/IMCRJ.S138786 -
BMJ Case Reports May 2016We describe the case of a presumed metastatic adenocarcinoma discovered in the conjunctival limbus of a 75-year-old male with a history of prostate adenocarcinoma. After...
We describe the case of a presumed metastatic adenocarcinoma discovered in the conjunctival limbus of a 75-year-old male with a history of prostate adenocarcinoma. After an initial clinical diagnosis of pinguecula and unsuccessful topical steroid therapy, the lesion was excised and sent for pathological evaluation and special staining. The histopathological evaluation was consistent with a diagnosis of adenocarcinoma, without evidence of lacrimal tissue. Surprisingly, results from special staining were most consistent with lung adenocarcinoma rather than that from a prostate origin. Systemic radiographic evaluation did not locate the primary tumour, and the patient did not present with any symptoms consistent with malignancy. Watchful waiting was chosen as the therapeutic strategy to manage the patient. This is the first report of an adenocarcinoma, likely metastatic, at the conjunctival limbus.
Topics: Adenocarcinoma; Adenocarcinoma of Lung; Aged; Conjunctival Neoplasms; Diagnosis, Differential; Disease Management; Humans; Lung Neoplasms; Male; Prostatic Neoplasms; Watchful Waiting
PubMed: 27190113
DOI: 10.1136/bcr-2016-214501 -
The Ocular Surface Jul 2015To evaluate the use of a commercially available, high-resolution, spectral-domain optical coherence tomography (HR-OCT) device in the diagnosis of corneal and... (Review)
Review
PURPOSE
To evaluate the use of a commercially available, high-resolution, spectral-domain optical coherence tomography (HR-OCT) device in the diagnosis of corneal and conjunctival pathologies, with a focus on malignant lesions.
METHODS
Eighty-two eyes of 71 patients were enrolled in this prospective case series, including 10 normal eyes, 21 with ocular surface squamous neoplasia (OSSN), 24 with a pterygium or pingueculum, 3 with lymphoma, 18 with pigmented conjunctival lesions (nevus, flat melanosis, or melanoma), and 6 with Salzmann nodular degeneration. Subjects were imaged using photography and HR-OCT (RTVue, Optovue, Fremont, CA). When clinically indicated, surgery was performed and histopathologic specimens were correlated with OCT images.
RESULTS
HR-OCT was useful in differentiating among various lesions based on optical signs. Specifically, in OSSN, HR-OCT findings included epithelial thickening and hyper-reflectivity, whereas pterygia and pinguecula showed a subepithelial mass under thinner epithelium. In lymphoma, a hypo-reflective, homogenous subepithelial mass was observed. Differentiating between pigmented lesions with HR-OCT was more difficult, but certain characteristics could be identified. Eyes with nevi and melanoma both displayed intensely hyper-reflective basal epithelial layers and discrete subepithelial lesions, but could be differentiated by the presence of cysts in nevi and intense shadowing of sublesional tissue in most melanomas.
CONCLUSION
We found that a commercially available HR-OCT was a useful noninvasive adjunctive tool in the diagnosis of ocular surface lesions.
Topics: Conjunctiva; Conjunctival Diseases; Cornea; Corneal Diseases; Humans; Image Processing, Computer-Assisted; Tomography, Optical Coherence
PubMed: 26045235
DOI: 10.1016/j.jtos.2015.02.001 -
Journal of Ophthalmology 2015Anterior segment optical coherence tomography (AS-OCT) was recently developed and has become a crucial tool in clinical practice. AS-OCT is a noncontact imaging device... (Review)
Review
Anterior segment optical coherence tomography (AS-OCT) was recently developed and has become a crucial tool in clinical practice. AS-OCT is a noncontact imaging device that provides the detailed structure of the anterior part of the eyes. In this review, the author will discuss the various clinical applications of AS-OCT, such as the normal findings, tear meniscus measurement, ocular surface disease (e.g., pterygium, pinguecula, and scleromalacia), architectural analysis after cataract surgery, post-LASIK keratectasia, Descemet's membrane detachment, evaluation of corneal graft after keratoplasty, corneal deposits (corneal dystrophies and corneal verticillata), keratitis, anterior segment tumors, and glaucoma evaluation (angle assessment, morphological analysis of the filtering bleb after trabeculectomy, or glaucoma drainage device implantation surgery). The author also presents some interesting cases demonstrated via AS-OCT.
PubMed: 25821589
DOI: 10.1155/2015/605729 -
International Journal of Ophthalmology 2014To investigate the relationship between pinguecula and the use of tandoor ovens.
AIM
To investigate the relationship between pinguecula and the use of tandoor ovens.
METHODS
A total of 539 women, ranging in age from 20 to 86y who attended an outpatient clinic were enrolled. All the patients were asked whether they used tandoor ovens. Women exposed to tandoor ovens (n=286) were accepted as participants in the study group and they were compared with participants in the control group (n=253). The age, presence of pinguecula, duration of exposure to tandoor ovens as years and occupations were recorded for all the subjects.
RESULTS
Mean duration for exposure to tandoor was 20.26y (range 1-62y) in the study group. The rate of pinguecula in the study group was 82.2% (235/286), and the rate in the control group was 37.5% (95/253); this difference was statistically significant (P<0.05). Pinguecula was seen in 61.2% (330/539) of all the participants.
CONCLUSION
Pinguecula is strongly associated with exposure to tandoor ovens.
PubMed: 25540757
DOI: 10.3980/j.issn.2222-3959.2014.06.19 -
Clinical Ophthalmology (Auckland, N.Z.) 2014To evaluate the clinical characteristics of patients with conjunctivochalasis (CCh).
PURPOSE
To evaluate the clinical characteristics of patients with conjunctivochalasis (CCh).
METHODS AND MATERIALS
This retrospective study enrolled 30 subjects diagnosed with conjunctivochalasis. Complete ophthalmic examination, including visual acuity assessment, slit-lamp examination, applanation tonometry, dilated funduscopy, tear break-up time, Schirmer 1 test, and fluorescein staining were performed in all patients. Age, sex, laterality, ocular history, symptoms, and clinical findings were recorded.
RESULTS
The study included 50 eyes from 30 cases. Ages ranged from 45 to 80 years, with a mean age of 65±10 years. CChs grading were as follows: 30 (60%) eyes with grade 1 CCh; 15 (30%) eyes with grade 2 CCh; and five (10%) eyes with grade 3 CCh. CCh was located in the inferior bulbar conjunctiva in 45 (90%) eyes, and in the remaining five (10%) CCh was located in the superior bulbar conjunctiva. Ten (33.3%) patients had no symptoms. Dryness, eye pain, redness, blurry vision, tired eye feeling, and epiphora were the symptoms encountered in the remaining twenty (63.6%) patients. Altered tear meniscus was noted in all cases. The mean tear break-up time was 7.6 seconds. The mean Schirmer 1 test score was 7 mm. Pinguecula was found in ten patients.
CONCLUSION
Dryness, eye pain, redness, blurry vision, and epiphora were the main symptoms in patients with CCh. Dryness, eye pain, and blurry vision were worsened during downgaze and blinking. So CCh should be taken into consideration in the differential diagnosis of chronic ocular irritation and epiphora.
PubMed: 25210435
DOI: 10.2147/OPTH.S61851 -
Middle East African Journal of... 2014To describe the limitations of Fourier-domain optical coherence tomography (OCT) in imaging common conjunctival and corneal pathology.
PURPOSE
To describe the limitations of Fourier-domain optical coherence tomography (OCT) in imaging common conjunctival and corneal pathology.
MATERIALS AND METHODS
Retrospective, single-center case series of 40 patients with conjunctival and cornea pathology.
RESULTS
Fourier-domain OCT imaged laser in situ keratomileusis (LASIK) flaps in detail, including its relation to other corneal structures and abnormalities. Similarly, in infectious or degenerative corneal disorders, Fourier-domain OCT successfully showed the extent of infiltration or material deposition, which appeared as hyper-reflective areas. In cases with pterygium, the underlying cornea could not be imaged. All cases of common conjunctival pathologies, such as nevus or pinguecula, were successfully imaged in detail. Nevi, scleritis, pterygium, pinguecula, and subconjunctival hemorrhage were hyper-reflective lesions, while cysts and lymphangiectasia were hyporeflective. The details of the underlying sclera were not uniformly imaged in conjunctival pathologies. Fourier-domain OCT imaged the trabeculectomy bleb in detail, whereas the details of structures of the anterior chamber angle were not routinely visualized in all cases.
CONCLUSIONS
Light scatter through vascularized, densely inflamed, or thick lesions limits the imaging capabilities of Fourier-domain anterior segment OCT.
Topics: Adult; Aged; Conjunctival Diseases; Corneal Diseases; Corneal Surgery, Laser; Diagnostic Techniques, Ophthalmological; Female; Fourier Analysis; Humans; Male; Middle Aged; Retrospective Studies; Tomography, Optical Coherence; Young Adult
PubMed: 25100905
DOI: 10.4103/0974-9233.134673