scholarly journals FUNGAL KERATITIS WITH CORNEAL ULCER IN FARMER

2020 ◽  
Vol 3 (1) ◽  
pp. 58
Author(s):  
Nugraha Wahyu Cahyana
Keyword(s):  
Visual Acuity ◽  
Corneal Ulcer ◽  
Fungal Keratitis ◽  
Eye Drops ◽  
Slit Lamp ◽  
Good Clinical Response ◽  
Specific Diagnosis ◽  
The World ◽  
Corneal Blindness ◽  
Test Result

Fungal keratitis is an important cause of corneal blindness all over the world, especially in developing countries. Fungal Keratitis can diagnosis by slit-lamp biomicroscopic examination and culture is essential for early specific diagnosis and must be taken into consideration to establish the most effective treatment and avoid severe complications. The study was present a case of Fungal Keratitis in Farmer with a corneal ulcer caused by rice seeds corneal corpus allienum. A corneal ulcer is a complication was caused by ineffective therapy especially Steroid topical that should be avoided. The culture test result was C. Albicans and was treated with natamycin 5% Eye drops. Finally, patients have a good clinical response, however with the sequel of decreased visual acuity.  

scholarly journals Preventing corneal blindness caused by keratitis using artificial intelligence

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Zhongwen Li ◽  
Jiewei Jiang ◽  
Kuan Chen ◽  
Qianqian Chen ◽  
Qinxiang Zheng ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Vision Loss ◽  
Learning System ◽  
Automated Classification ◽  
Slit Lamp ◽  
Resource Limited ◽  
The World ◽  
Different Types ◽  
Corneal Blindness

AbstractKeratitis is the main cause of corneal blindness worldwide. Most vision loss caused by keratitis can be avoidable via early detection and treatment. The diagnosis of keratitis often requires skilled ophthalmologists. However, the world is short of ophthalmologists, especially in resource-limited settings, making the early diagnosis of keratitis challenging. Here, we develop a deep learning system for the automated classification of keratitis, other cornea abnormalities, and normal cornea based on 6,567 slit-lamp images. Our system exhibits remarkable performance in cornea images captured by the different types of digital slit lamp cameras and a smartphone with the super macro mode (all AUCs>0.96). The comparable sensitivity and specificity in keratitis detection are observed between the system and experienced cornea specialists. Our system has the potential to be applied to both digital slit lamp cameras and smartphones to promote the early diagnosis and treatment of keratitis, preventing the corneal blindness caused by keratitis.

Continuous administration of voriconazole enhances therapeutic effect for recalcitrant fungal keratitis

2021 ◽  
pp. 112067212110686
Author(s):  
Weiyan Liang ◽  
Chang Liu ◽  
Xiansen Zhang ◽  
Ling Li ◽  
Zexia Dou ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Therapeutic Effect ◽  
Clinical Symptoms ◽  
Treatment Protocol ◽  
Corneal Stroma ◽  
Fungal Keratitis ◽  
Slit Lamp ◽  
Continuous Administration ◽  
Conventional Medical Treatment

Purpose To evaluate the therapeutic effect of incorporating continuous administration of voriconazole in the treatment of recalcitrant fungal keratitis. Methods In this prospective case study, 5 consecutive patients (5 eyes) with fungal keratitis were treated with a standard protocol after the failing maximal conventional medical treatment. The protocol involved continuous lavage of the ulcer with 1% voriconazole through an irrigator for 2 h, twice a day, combined with local and systemic antifungals. Visual acuity, slit lamp findings of the ulcer, and fungal hyphae density by confocal microscope were documented, respectively. Results In 4 patients, the clinical symptoms and slit lamp examination were significantly improved after only 3 days of treatment. The hyphae were shown to decrease in number and morphologically fragmented in corneal stroma by confocal microscopy. After the infection was controlled, 2 cases required further keratoplasty. In one case, the treatment was deemed ineffective and a conjunctival flap had to be created to help control the infection. In all 5 patients, the best spectacle-corrected visual acuity had improved after treatment. With more than 3 months of follow-up, no recurrence of infection was seen in any cases. Conclusion Our treatment protocol demonstrated improvement in the treatment of clinically resistant fungal keratitis. Continuous lavage of voriconazole is easy to be implemented and well-tolerated by patients. Modification of the current protocol should be further explored to optimize the therapeutic effectiveness in future.

scholarly journals Cultivated autologous oral mucosal epithelial transplantation

2021 ◽  
Vol 23 (1) ◽  
pp. 171-177
Author(s):  
S. A. Borzenok ◽  
B. E. Malyugin ◽  
M. Yu. Gerasimov ◽  
D. S. Ostrovsky
Keyword(s):  
Visual Acuity ◽  
Cell Therapy ◽  
Visual Impairment ◽  
Treatment Method ◽  
World Health ◽  
Epithelial Culture ◽  
The World ◽  
Corneal Blindness ◽  
New Treatment ◽  
Health Organization

According to the World Health Organization, corneal blindness is the fourth most common cause of blindness and visual impairment worldwide. In Russia, up to 18% of blindness is caused by corneal damage. Limbal stem cell deficiency (LSCD) is one of the causes of corneal blindness and visual impairment due to anterior epithelial replacement with fibrovascular pannus. Bilateral LSCD may develop in patients with aniridia, Steven-Jones syndrome, and severe corneal burns of both eyes, leading to severe decrease in visual acuity in both eyes and, as a consequence, physical disability associated with blindness. In such cases, cell therapy, based on autologous oral epithelial culture as an alternative to allogeneic limbus transplants, is proposed for reconstruction of the anterior corneal epithelium. This new treatment method promotes corneal reepithelization, better visual acuity, reduced nonspecific ocular complaints and improved quality of life of patients. The effectiveness and significant increase in the frequency of transparent engraftment of donor corneas after cell therapy drives huge interest in this topic all over the world. This review presents literature data on the features of histotopography and methods for obtaining a cultured autologous oral mucosal epithelium, on cell markers that are used to identify epithelial cells, and on methods for creating cell grafts for subsequent transplantation to the corneal surface in LSCD patients.

scholarly journals Microbial keratitis: A five years retrospective clinical study in tertiary eye hospital of eastern region of Nepal

2017 ◽  
Vol 4 (4) ◽  
pp. 118-125
Author(s):  
Lila Raj Puri ◽  
Gauri Shankar Shrestha
Keyword(s):  
Visual Acuity ◽  
Clinical Study ◽  
Clinical Features ◽  
Corneal Ulcer ◽  
Health Concern ◽  
Eye Drops ◽  
Microbial Keratitis ◽  
Corneal Ulcers ◽  
Retrospective Clinical Study ◽  
Corneal Scraping

Background: Corneal ulcer is a sight threatening disease of significant public health concern. Early diagnosis with microbiological identification of the causative organism and institution of the proper medical therapy are important for successful visual recovery.Objectives: To find out the demographic and predisposing factors associated with corneal ulcers, evaluate management of ulcers on the basis of clinical features and corneal scraping results.Methods: It was a retrospective clinical study conducted among 1897 subjects with microbial keratitis in Sagarmatha Choudhary Eye Hospital, Lahan, Nepal from January 2010 to December 2014. Assessment included detailed eye examination with slit lamp for size, depth and location of ulcer, presenting visual acuity on internally illuminated Snellen’s chart, and corneal scrapings for Gram’s stain and 10% Potassium hydroxide wet mount. A standard treatment was delivered on the basis of clinical features and corneal scraping results. Subjects were evaluated subsequently after 48 hours, one week, two weeks, three weeks and four weeks of initiation of therapy. Non-responding cases were admitted to perform re-scraping and to modify therapy.Results: Majority of subjects (71.2%) belonged to the age group of 26 to 55 years  (71.2%), presented after two weeks (82.3%) and used non-prescription eye drops (71.9%) before visiting to the eye hospital. Ocular trauma (54.5%) was the most commonly reported predisposing factor. The central and paracentral ulcers comprised of 72.8% of ulcers withsize greater than 2mm in 2.7% and moderate ulcer in 71.1%. Microbiological test revealed fungal ulcers in 78.1% subjects. Presenting visual acuity better than 6/18 was reported in 7% only.Conclusion: Corneal ulcer was one of the commonly reported eye disease in Terai region of Nepal. Trauma is the commonest cause of corneal infection. Fungal corneal ulcers werecommonly noted.

scholarly journals ND: YAG LASER

2018 ◽  
Vol 25 (12) ◽  
pp. 1848-1851
Author(s):  
Mohammad Alam
Keyword(s):  
Visual Acuity ◽  
Nd:Yag Laser ◽  
Posterior Capsular Opacification ◽  
Eye Drops ◽  
Slit Lamp ◽  
Yag Laser ◽  
Corrected Visual Acuity ◽  
Nd:Yag Laser Capsulotomy ◽  
Department Of Ophthalmology ◽  
Best Corrected Visual Acuity

Objectives: To find out the visual acuity outcome after Nd: YAG laser capsulotomy in posterior capsular opacification in pseudophakic patients after cataract surgery. Study Design: Analytical study. Setting: Department of Ophthalmology Khyber Medical University Institute of Medical Sciences / K.D.A Teaching Hospital Kohat. Period: January 2016 to June 2017. Materials and methods: Special proforma was designed for record of patients. PreNd:YAG laser posterior capsulotomy best corrected visual acuity was checked and noted. Anterior and posterior segments examination was done with slit lamp and indirect slit lamp bimicroscopy. Pupils were dilated with tropicamide eye drops. Nd:YAG laser capsulotomy was done. All these procedure were conducted as out door. Patients were put on topical steroid and antiglaucoma drops for ten days to control inflammation and rise in IOP. Post laser best corrected visual acuity was recorded after one month of laser. Results: Total 92 patients were selected with age range from 21 to 83 years. Out of these patients 43(46.74%) were male and 49(53.26%) were female. Post surgical laser period was from 7 months to 13 years. Prelaser best corrected visual acuity of 6/24-6/36 was present in 59(64.13%) patients, 6/60 in 24(26.08%) patients while 9(9.78%) patients had visual acuity of counting finger (CF). Post laser best corrected visual acuity after one month of 6/6-6/9 was recorded in 43(46.39%) patients ,6/12-6/18 in 27(29.34%), 6/24-6/36 in 13(14.13%)and 6/60 & below in 9(9.71%) patients. Conclusion: Post laser best corrected visual acuity is highly improved with Nd:YAG laser capsulotomy in posterior capsular opacification.

Topical Natamycin Versus Voriconazole for Fungal Corneal Ulcer

2020 ◽  
pp. 21-26
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Clinical Trial ◽  
Visual Acuity ◽  
Topical Treatment ◽  
South India ◽  
Corneal Ulcer ◽  
Fungal Keratitis ◽  
Treatment Trial ◽  
Active Comparator ◽  
The Difference ◽  
Ulcer Treatment

The Mycotic Ulcer Treatment Trial (MUTT) was a randomized, active comparator–controlled, double-masked, clinical trial carried out in South India to determine whether topical treatment with natamycin gave better clinical and microbiological outcomes than voriconazole in patients with smear-positive filamentous fungal keratitis and visual acuity of 20/40 to 20/400. Treatments were applied topically every hour while awake until reepithelialization, then 4 times daily for at least 3 weeks. The study showed that natamycin treatment was associated with significantly better clinical and microbiological outcomes than voriconazole treatment for smear-positive filamentous fungal keratitis, with much of the difference attributed to improved results in Fusarium cases.

scholarly journals Sweet disaster: use of honey-based eye drops as an alternative treatment for vernal keratoconjunctivitis

2019 ◽  
Vol 1 (2) ◽  
pp. 133-138
Author(s):  
Kenneth Teow Kheng Leong ◽  
Rebecca Jennifer Mary Louis ◽  
Lai Yin Peng ◽  
Rohanah Alias ◽  
Safinaz Mohd Khialdin
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Alternative Treatment ◽  
Marked Improvement ◽  
Traditional Healer ◽  
Fungal Keratitis ◽  
Vernal Keratoconjunctivitis ◽  
Eye Drops ◽  
The Past

A 16-year-old boy with underlying bronchial asthma, vernal keratoconjunctivitis, and bilateral eye steroid-induced glaucoma presented with right eye itchiness, redness, and progressive painful blurring of vision for the past 3 weeks. His mother had been treating him with honey-based eye drops purchased from an unregistered source/traditional healer. On presentation his right visual acuity was counting fingers, the cornea was hazy, and a small central stromal abscess with a large endothelial plaque was seen in the anterior chamber. He was treated for right eye fungal keratitis and subsequently admitted for intensive treatment. He showed marked improvement and was discharged. His final vision on follow-up was 6/15.

scholarly journals Voriconazole in Treatment of Resistant Fungal Keratitis

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Sidrah Riaz ◽  
Muhammad Tariq Khan ◽  
Khalid Mehmood ◽  
Mahfooz Hussain ◽  
Sara Riaz
Keyword(s):  
Penetrating Keratoplasty ◽  
Corneal Ulcer ◽  
Tertiary Care ◽  
Fungal Keratitis ◽  
Eye Drops ◽  
Corneal Perforation ◽  
College Hospital ◽  
Medical College ◽  
Corneal Scar ◽  
Average Size

Purpose:  To study the effect of intrastromal Voriconazole for treatment of resistant fungal keratitis in a tertiary care eye hospital in Lahore, Pakistan. Study Design:  Experimental interventional study. Place and Duration of Study:  Avicenna Medical College Hospital, Lahore, from July 2017 to July 2019. Methods:  Sixty four patients were selected. All patients with fugal keratitis were included. The patients with previous corneal scar, mature cataract, endophthalmitis, Panophthalmitis, scleral involvement, impending or frank corneal perforation and uncontrolled diabetic patientswere excluded.Corneal scrapings of all patients were sent for 10% KOH staining. All patients were given intrastromal Voriconazole at 3 to 4 sites in divided doses in one ml syringe with 27-guage needle. Injection was repeated on 4th and 8th day. It was combined by topical antifungal and antibiotic eye drops six hourly. Patients were followed at day two, five, nine, three weeks and at 3 months. Results:  There were 55 males and 9 females. Average size of ulcer was 6.4mm ranging from 5.5mm ± 1.8mm. Fifty six (88%) patient showed improvement while eight (12%) patients ended up in melting of cornea which was managed with tectonic corneal graft. In three (5%) patients penetrating Keratoplasty was done. Conjunctival congestion and ocular pain improved significantly one week after third dose but final visual acuity was not significantly improved due to scarring. Conclusion:  The intrastromal corneal voriconazole is an effective treatment for fungal keratitis in term of healing corneal ulcer, control of infection and saving of eye from corneal perforation and permanent blindness. Key Words:  Voriconazole, Fungal keratitis, Penetrating Keratoplasty.

scholarly journals Fortified Fluconazole Eyedrops for Treatment of Culvularia Corneal Ulcer

2020 ◽  
Vol 3 (2) ◽  
pp. 58-65
Author(s):  
Muhammad Reza Arlas ◽  
Petty Purwanita
Keyword(s):  
Visual Acuity ◽  
Clinical Manifestations ◽  
The United States ◽  
Fungal Keratitis ◽  
Ergosterol Biosynthesis ◽  
Eye Drops ◽  
Dematiaceous Fungi ◽  
Blurred Vision ◽  
Fungal Cell ◽  
Clinical Series

Abstract Introduction. Fungal keratitis is less common than bacterial keratitis, generally representing less than 5%–10% of corneal infections in reported clinical series in the United States. But in developing countries (Ghana, India, China) it accounts for more than 90% of the cases. Corneal trauma by plant or vegetative material is the leading risk factor for fungal keratitis. One or more topical antifungals are usually administered with systemic support of oral antifungals. The most common classes of antifungal used for medical therapy include the polyenes, azoles, and the echinocandins. Case Illustration. A 47-year-old male presented with a widening white patch on his left eye since 4 days before coming to our hospital. The left eye was injured by wood flakes 3 weeks ago. He felt a sore, red, watery left eye and blurred vision. He washed his eyes with betel leaf water. His left eye visual acuity was 1/60 and not improved with pinhole. There were blepharospasm, ciliary and conjunctival injection. Corneal examination showed a cloudy cornea, a central corneal defect sized 8x6 mm with an irregular margin, 2/3 to stromal depth, infiltrate, satellite lesion, and positive fluorescein staining at the defect margin. KOH examination demonstrated hyphae. The culture test of left corneal discharge identified a fungi species (Curvularia sp). We prescribed fortified fluconazole eye drops in combination with supportive therapy for 2.5 months. This regimen showed a significant increase in visual acuity to 6/30 with pinhole improvement of 6/21 in the left eye. Discussion. Imidazole acts by inhibiting ergosterol biosynthesis of the fungal cell wall, through action on the cytochrome P450-dependent enzyme. This leads to cell membrane destabilization and leakage. Curvularia sp belongs to the family of dematiaceous fungi. Its clinical manifestations include raised lesions and feathery edges; hypopyon rarely occurs, and the prognosis is quite good. Fluconazole (2 mg/ml) is available for injection and is a well-tolerated eye drop. The intravenous injection can be used as a topical treatment and can be given subconjunctivally at the same concentration. Conclusions. Fortified fluconazole eyedrops (2 mg/ml) can become an alternative and additional therapy for deep fungal keratitis, especially for Curvularia sp.

scholarly journals Topical Tacrolimus as an adjunct to Conventional Therapy for Stromal Herpetic Keratitis: a Randomized Clinical Trial

2019 ◽  
Author(s):  
Mitra Akbari ◽  
Reza Soltani Moghadam ◽  
Ramin Elmi ◽  
Amir Nosrati ◽  
Ehsan Taghiabadi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Control Group ◽  
Case Group ◽  
Eye Drops ◽  
Slit Lamp ◽  
Herpetic Stromal Keratitis ◽  
Adjunct Treatment ◽  
Topical Tacrolimus ◽  
Corneal Inflammation ◽  
Iop Measurement

Purpose: This study investigates the effects of 0.05% topical tacrolimus as an adjunct therapy for patients with non-necrotizing herpetic stromal keratitis (HSK). Methods: Patients with non-necrotizing HSK, referred to the Cornea Clinic at Hospital in Rasht, Iran, between September 2016 and February 2018, were randomly assigned to two groups. The case group (N = 25) and the control group (N = 25) received conventional treatment with systemic acyclovir and topical prednisolone. The case group (N = 25) additionally received 0.05% tacrolimus eye drops four times a day for one month. Complete ocular examinations, including best-corrected visual acuity (BCVA) assessment, intraocular pressure (IOP) measurement, slit lamp biomicroscopy, and photo slit lamp imaging, were performed before treatment, and 3, 7, 14, 21, and 28 days after the intervention. Results: The mean age of the patients was 46.2 ± 12.9 years, and 70% of the patients were male. There was no difference between the groups in terms of age, sex, and baseline ocular measurements (P > 0.05). The case group had a lower mean logarithm of the minimum angle of resolution (LogMAR) for BCVA, lower grading scores, and steeper decreasing trends for corneal haziness, edema, neovascularization, and epitheliopathy compared to the control group after the second week (P < 0.05), while IOP remained unchanged between groups (P > 0.05). Conclusion: The addition of 0.05% topical tacrolimus enhances visual acuity and reduces corneal inflammation, neovascularization, and scarring; thus, it can used as an appropriate adjunct treatment for patients with HSK.

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