RESUMEN
INTRODUCTION: Air pollution has steadily increased for several decades, with widely studied effects on human health, including increased mortality, incidence of stroke, respiratory and allergic disease. However, the effects of pollution on the ocular surface, in direct contact with the outside world, have been less precisely studied. MATERIALS AND METHODS: We conducted a literature review of articles on the subject published from 1966 to October 2020. Among the 661 articles identified, 33 were retained. Ocular surface disease associated with pollution included non-specific conjunctivitis, dry eye disease, blepharitis, and allergic conjunctivitis. The studied pollutants were particulate matter less than 2.5µm and 10µm (PM2.5, PM10), ozone (O3), nitrogen dioxide (NO2), carbon monoxide (CO) and sulfur dioxide (SO2). Certain air quality parameters such as temperature and relative humidity were also studied. RESULTS: Among the markers of air pollution possibly associated with ophthalmic disease, NO2 and SO2 appear to be the most frequent and highly correlated. High temperatures and low humidity levels also appear to be aggravating factors for the ocular surface. However, due to the heterogeneity of the studies, the results must be interpreted with caution. Indeed, the methodology and the results of the various studies are sometimes contradictory. The inclusion of patients, the analysis of environmental data, and the correlation between these two elements indeed raise numerous methodological questions. CONCLUSION: Air pollution control would appear essential, as well as the development of new studies based on reliable methods of studying the environmental and its clinical effects.
Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Ozono , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Humanos , Dióxido de Nitrógeno/efectos adversos , Dióxido de Nitrógeno/análisis , Ozono/análisis , Material Particulado/efectos adversos , Material Particulado/análisisRESUMEN
Demodex is a saprophytic mite of the ocular adnexa, which can in certain circumstances proliferate on the skin of the face and on the eyelid margins. It is involved in facial rosacea (especially in the papulopustular form) and in the development or aggravation of anterior and/or posterior blepharitis or even keratoconjunctivitis, often in association with cutaneous lesions ; the pathophysiology is often multifactorial. Symptoms are non-specific, but the presence of cylindrical sleeves on the eyelashes is very suggestive of infestation, and certain techniques of biomicroscopic examination or imaging, such as confocal microscopy in vivo, allow direct visualization of the parasite. Parasitological examination of the eyelashes can confirm the diagnosis and can be improved by good sampling technique. Eyelid hygiene and oil-based ointments are the cornerstone of treatment. New specific treatments, in particular topical treatments based on tea tree oil, ivermectin, as well as pulsed light therapy and micro-exfoliation of the eyelid margin, can help to reduce the parasitic load and improve symptoms.
Asunto(s)
Infecciones Parasitarias del Ojo , Ácaros/fisiología , Animales , Blefaritis/diagnóstico , Blefaritis/tratamiento farmacológico , Blefaritis/epidemiología , Infecciones Parasitarias del Ojo/diagnóstico , Infecciones Parasitarias del Ojo/tratamiento farmacológico , Infecciones Parasitarias del Ojo/epidemiología , Infecciones Parasitarias del Ojo/parasitología , Pestañas/diagnóstico por imagen , Pestañas/parasitología , Pestañas/patología , Humanos , Higiene , Ivermectina/uso terapéutico , Queratoconjuntivitis/diagnóstico , Queratoconjuntivitis/tratamiento farmacológico , Queratoconjuntivitis/epidemiología , Queratoconjuntivitis/parasitología , Glándulas Tarsales/diagnóstico por imagen , Glándulas Tarsales/parasitología , Glándulas Tarsales/patología , Microscopía Confocal , Aceite de Árbol de Té/uso terapéuticoRESUMEN
Measles is a contagious viral infection that usually affects children. The disease is caused by morbillivirus, a virus of the family Paramyxoviridae. The clinical picture is characterized by four phases: incubation, invasion, eruption and desquamation. Ophthalmologic manifestations in measles are rare, dominated by conjunctivitis and keratitis. Corneal involvement is the main concern; it varies from simple superficial punctate keratitis to corneal perforation. We report three cases of acute keratitis in young adults during an epidemic. The epithelial involvement was peripheral, central or diffuse. The outcome was favorable under symptomatic topical treatment.
Asunto(s)
Infecciones Virales del Ojo/diagnóstico , Sarampión/diagnóstico , Adulto , Factores de Edad , Antivirales/administración & dosificación , Blefaritis/diagnóstico , Blefaritis/tratamiento farmacológico , Blefaritis/virología , Conjuntivitis/diagnóstico , Conjuntivitis/tratamiento farmacológico , Conjuntivitis/virología , Infecciones Virales del Ojo/tratamiento farmacológico , Femenino , Humanos , Queratitis/diagnóstico , Queratitis/tratamiento farmacológico , Queratitis/virología , Gotas Lubricantes para Ojos/administración & dosificación , Masculino , Sarampión/tratamiento farmacológico , Sarampión/patología , Persona de Mediana Edad , Soluciones Oftálmicas/administración & dosificación , Vitamina A/administración & dosificaciónRESUMEN
Allergies are frequently implicated in ophthalmologic practice. These typically benign allergies can be potentially severe for the ocular surface and have an impact in everyday life. We relate, through a case of keratoconjunctivitis involving 2 types of hypersensitivity, the various triggers and therapeutic choices to allow a more effective treatment.
Asunto(s)
Hipersensibilidad Inmediata/etiología , Inmunoglobulina E/inmunología , Queratoconjuntivitis/etiología , Adulto , Alérgenos/efectos adversos , Alérgenos/inmunología , Animales , Azitromicina/uso terapéutico , Blefaritis/etiología , Blefaritis/inmunología , Gatos , Dermatitis Atópica/complicaciones , Desensibilización Inmunológica , Perros , Quimioterapia Combinada , Eosinofilia/etiología , Antagonistas de los Receptores Histamínicos/uso terapéutico , Humanos , Hipersensibilidad Inmediata/inmunología , Hipersensibilidad Inmediata/terapia , Pruebas Intradérmicas , Queratoconjuntivitis/diagnóstico , Queratoconjuntivitis/tratamiento farmacológico , Queratoconjuntivitis/inmunología , Gotas Lubricantes para Ojos/uso terapéutico , Masculino , Pyroglyphidae , Rinitis Alérgica Estacional/complicaciones , Tacrolimus/uso terapéuticoRESUMEN
INTRODUCTION: Meibomian gland dysfunction (MGD) is a frequent disorder often associated with dry eye disease. Slit-lamp examination with digital expression of the tarsal Meibomian glands allows examination of the contents of the distal Meibomian gland and the meatus. However, the Meibomian epithelium, interglandular space and proximal secretions cannot be clinically assessed. In vivo confocal microscopy (IVCM) is a rapid and non-invasive imaging technique that provides high-resolution images of the ocular surface and eyelids. The primary objective of the present study was to establish a classification of MGD with IVCM. Secondary objectives were to evaluate this scoring system by analyzing the correlation with OSDI, infrared (IR) meibography and Demodex infestation. MATERIAL AND METHODS: Forty-six dry eye patients (Ocular Surface Disease Index [OSDI] >13) associated with MGD were enrolled. Ten healthy subjects without dry eye disease or blepharitis were also included as controls. An OSDI questionnaire, clinical examination, IVCM and infrared meibography of the lower lid were performed in all subjects by the same examiner. RESULTS: A new MGD score was established based on IVCM findings: the first stage was Meibomian obstruction with a clear epithelium, the second stage was an inflammatory state with Meibomian gland obstruction, epithelial and interglandular inflammation, and the last stage was glandular fibrosis. This score was significantly correlated with the meiboscore obtained with infrared meibography (correlation coefficient 0.47, CI95% [0.22-0.66]). CONCLUSION: IVCM of the Meibomian gland complex complements the clinical examination by determining the stage of dysfunction and may help clinicians evaluate and treat MGD.
Asunto(s)
Enfermedades de los Párpados/clasificación , Enfermedades de los Párpados/diagnóstico , Glándulas Tarsales/diagnóstico por imagen , Glándulas Tarsales/patología , Adulto , Anciano , Estudios de Casos y Controles , Síndromes de Ojo Seco/diagnóstico , Femenino , Humanos , Masculino , Microscopía Confocal , Persona de Mediana Edad , Valor Predictivo de las PruebasRESUMEN
Meibomian gland dysfunctions (MGD) are frequent affections, sometimes asymptomatic, more often responsible for disabling, potentially severe, manifestations. MGD is indeed the most frequent cause of dry eye, through the induction of tear film instability. However, eyelid inflammation, microbial proliferation that modifies melting temperature of meibum, frequent association with skin diseases, as well as potentially severe corneal complications make them complex multifactorial disorders. Complementary mechanisms combine to actually result in a vicious circle, or more accurately a double vicious cycle. The first one is self-stimulated by the microbiological changes, which create their own conditions for MGD development. The second one is related to tear film instability that results from MGD and is also self-stimulated through hyperosmolarity and inflammatory phenomena, which are both consequence and cause of dry eye. We herein propose a new pathophysiological schema on MGD, in order to better identify mechanisms and more efficiently target therapeutics.
Asunto(s)
Enfermedades de los Párpados , Glándulas Tarsales/patología , Blefaritis/etiología , Blefaritis/patología , Síndromes de Ojo Seco/clasificación , Síndromes de Ojo Seco/etiología , Síndromes de Ojo Seco/patología , Enfermedades de los Párpados/clasificación , Enfermedades de los Párpados/etiología , Enfermedades de los Párpados/patología , HumanosRESUMEN
INTRODUCTION: Phthiriasis palpebrarum is an ectoparasitosis in which Phthirus pubis infest the eyelashes. It is rare and it can easily be misdiagnosed as blepharitis. The purpose of this study is to describe seven cases of phthiriasis palpebrarum so as to discuss its mode of infestation, diagnosis and treatment. PATIENTS AND METHODS: This is a study of all cases of phthiriasis palpebrarum reported in our laboratory. For each patient, an ophthalmic examination and parasitological examination of the eyelashes were performed. RESULTS: There were five men and two women. Their ages ranged from 4 to 50years with an average of 21.57years. There were four children and three adults. The main symptom was itching of the eyelids. Clinical signs included reddish-brown crusts at the base of the eyelashes in all the cases and visible lice and nits in three cases. Biomicroscopic examination showed lice and nits anchored to the eyelashes in three cases. In the other two cases, the initial diagnosis was felt to be blepharitis. In all cases, the diagnosis of phthiriasis palpebrarum was confirmed by parasitological examination of eyelashes, which revealed the presence of adult and nit forms of Phthirus pubis. The number of adult lice ranged from 1 to 30. In all cases, treatment was based on mechanical removal of both the lice and nits. Outcomes were favorable without recurrence. CONCLUSION: In conclusion, phthiriasis palpebrarum can be easily diagnosed by close examination of the eyelashes and eyelid margins at the slit lamp and can be managed mechanically. Parasitological examination of the eyelashes can confirm the diagnosis.