Evaluation of the impact of subepithelial corneal infiltrates on corneal biomechanics after epidemic keratoconjunctivitis

Purpose: To compare the effect of topical steroid with cyclosporine eye drops in recurrence of sub-epithelial corneal infiltrates in epidemic keratoconjunctivitis. Study Design: Quasi Experimental study. Place and Duration of Study: CMH Kharian from Jan 2017 to June 2018. Methods: Eighty eight patients with epidemic keratoconjunctivitis were divided into two groups. Group A included patients who received topical steroid drops and group B received topical Cyclosporine eye drops. The inclusion criteria comprised of fresh cases of SEIs, between the ages of 20 to 50 years, having a vision of 6/6 before the illness. The exclusion criteria included patients suffering from allergic conjunctivitis, ocular surface disease like Sjogren syndrome, corneal ulcer, blepharitis, old corneal opacity, glaucoma and those who had been using steroids in the past e.g. uveitis. The patients were followed up at 2, 4, 8 and 12 weeks. On resolution of sub-epithelial infiltrates (SEIs), both regimen were tapered off in next two weeks. The patients were advised to continue monthly follow up for two months to see any recurrence. Results: SEIs resolved in both the groups by week 12, however the resolution was slightly quicker in group A. SEIs resolved in 84.1% of cases in group A and in 70.4% cases in group B at the end of 4 weeks. Recurrence was higher in group A (11.3%) while it was 4.5% in group B. Conclusion: Cyclosporine eye drops are a safe and equally effective treatment of epidemic keratoconjunctivitis related SEIs, with an added advantage of reduced recurrence rate. Key Words: Epidemic, Keratoconjunctivitis (EKC), Cornea, Subepithelial Infiltrates, Cyclosporine.

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Corneal Biomechanics in Ectatic Diseases: Refractive Surgery Implications

The Open Ophthalmology Journal ◽

10.2174/1874364101711010176 ◽

2017 ◽

Vol 11 (1) ◽

pp. 176-193 ◽

Cited By ~ 14

Author(s):

Renato Ambrósio, Jr ◽

Fernando Faria Correia ◽

Bernardo Lopes ◽

Marcella Q. Salomão ◽

Allan Luz ◽

...

Keyword(s):

Refractive Surgery ◽

Front Surface ◽

Corneal Biomechanics ◽

Screening Tests ◽

3D Tomography ◽

Biomechanical Assessment ◽

Current State ◽

Corneal Refractive Surgery ◽

Corneal Shape ◽

The Impact

Background:Ectasia development occurs due to a chronic corneal biomechanical decompensation or weakness, resulting in stromal thinning and corneal protrusion. This leads to corneal steepening, increase in astigmatism, and irregularity. In corneal refractive surgery, the detection of mild forms of ectasia pre-operatively is essential to avoid post-operative progressive ectasia, which also depends on the impact of the procedure on the cornea.Method:The advent of 3D tomography is proven as a significant advancement to further characterize corneal shape beyond front surface topography, which is still relevant. While screening tests for ectasia had been limited to corneal shape (geometry) assessment, clinical biomechanical assessment has been possible since the introduction of the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Buffalo, USA) in 2005 and the Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany) in 2010. Direct clinical biomechanical evaluation is recognized as paramount, especially in detection of mild ectatic cases and characterization of the susceptibility for ectasia progression for any cornea.Conclusions:The purpose of this review is to describe the current state of clinical evaluation of corneal biomechanics, focusing on the most recent advances of commercially available instruments and also on future developments, such as Brillouin microscopy.

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A silent “shipyard eye”: lessons from an epidemic keratoconjunctivitis outbreak in Portugal

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.615 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Moreira ◽

F Abreu Gomes ◽

M Mouro ◽

D Lopes ◽

M Bragança Pereira ◽

...

Keyword(s):

Public Health ◽

Early Detection ◽

Health Services ◽

Severe Form ◽

Initial Assessment ◽

Public Health Services ◽

Epidemic Keratoconjunctivitis ◽

Contagious Disease ◽

The Impact ◽

Close Contacts

Abstract Issue Adenoviral conjunctivitis is the most common cause of conjunctivitis. Its most severe form is epidemic keratoconjunctivitis (EKC). This highly contagious disease is the only form to significantly involve the cornea and may cause visual impairing sequelae that persist for years. Description On January 2020, staff members at a childcare facility (CCF) alerted the Public Health Unit of Loures-Odivelas to a suspected conjunctivitis outbreak. The CCF was responsible for 57 children, separated in different rooms: a nursery (4-12 months), a pre-school (1-3 years) and a kindergarten (4-5 years). At the initial assessment, 4 cases of active disease were identified, all of which were at home and under treatment. CCF staff had previously identified 33 cases. Symptom onset of the index case had occurred more than 5 weeks before the alert. Infection control and epidemiological investigation were initiated. CCF staff was instructed to implement preventive measures, including careful disinfection of surfaces and toys, as well as frequent handwashing. Information about the disease and recommendations were sent to the children's caretakers. Results A total of 87 cases distributed in 8 weeks were identified: 28 at the CCF (25 children and 3 workers) and 59 close contacts (50 adults and 9 children). Average duration of disease was 14.1 days. In total, 43.9% of the children attending the CFF were affected. The highest attack rate was observed at the pre-school (69.2%, against 38.9% and 17.6% at the nursery and the kindergarten, respectively). 88.0% of the CCF children's households were affected. The average number of affected close contacts per affected child attending the CCF was 2.63. Corneal involvement was observed in 17,4% of cases. Lessons EKC outbreaks may go unnoticed by public health services, despite its high contagiousness and impact. Improvement of communication with organizations in the community is essential to secure future early detection and intervention. Key messages Epidemic keratoconjunctivitis is a highly contagious disease with potential long-term consequences. Early detection and intervention by public health services are essential to mitigate the impact of outbreaks and depend on well-established communication lines with institutions in the community.

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Formation of Lunar Craters and Bright Rays as a Result of Meteorite Impacts

Symposium - International Astronomical Union ◽

10.1017/s0074180900178404 ◽

1962 ◽

Vol 14 ◽

pp. 415-418

Author(s):

K. P. Stanyukovich ◽

V. A. Bronshten

Keyword(s):

Explosive Charge ◽

The Moon ◽

Meteorite Impacts ◽

The Earth ◽

Lunar Craters ◽

The Impact

The phenomena accompanying the impact of large meteorites on the surface of the Moon or of the Earth can be examined on the basis of the theory of explosive phenomena if we assume that, instead of an exploding meteorite moving inside the rock, we have an explosive charge (equivalent in energy), situated at a certain distance under the surface.

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The Geosciences Applied to Lunar Exploration

Symposium - International Astronomical Union ◽

10.1017/s0074180900178222 ◽

1962 ◽

Vol 14 ◽

pp. 169-257 ◽

Cited By ~ 9

Author(s):

J. Green

Keyword(s):

Lunar Surface ◽

Probable Mechanism ◽

Point Of View ◽

Lunar Exploration ◽

Geological Model ◽

Apply Geophysics ◽

Surface Features ◽

The Impact

The term geo-sciences has been used here to include the disciplines geology, geophysics and geochemistry. However, in order to apply geophysics and geochemistry effectively one must begin with a geological model. Therefore, the science of geology should be used as the basis for lunar exploration. From an astronomical point of view, a lunar terrain heavily impacted with meteors appears the more reasonable; although from a geological standpoint, volcanism seems the more probable mechanism. A surface liberally marked with volcanic features has been advocated by such geologists as Bülow, Dana, Suess, von Wolff, Shaler, Spurr, and Kuno. In this paper, both the impact and volcanic hypotheses are considered in the application of the geo-sciences to manned lunar exploration. However, more emphasis is placed on the volcanic, or more correctly the defluidization, hypothesis to account for lunar surface features.

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