Acute Corneal Research Articles

Acute bilateral corneal hydrops caused by high temperature and high moisture in the Finnish sauna

A 44-year-old healthy male with bilateral keratoconus developed acute hydrops of both his corneas with an interval of 3 years. On both occasions he had bathed in a hot, humid Finnish sauna the preceding evening. Penetrating keratoplasty had to be performed in the acute stage in both instances, as medical therapy brought no improvement. The contributory role of hot, moist air to the development of acute hydrops is discussed. Histopathological examination of the corneal buttons revealed clear-cut breaks in Descemet's membrane with marked posterior stromal oedema.

Acute Pellucid Marginal Corneal Degeneration

Pellucid marginal corneal degeneration is a bilateral disease characterized by a narrow band of corneal thinning localized 1-2 mm from the inferior limbus. The disease is diagnosed usually between 20 and 50 years of life, and its etiology remains obscure. During the clinical course and evolution of pellucid marginal corneal degeneration, acute hydrops with corneal edema in the lower half may develop (acute pellucid marginal corneal degeneration). However, since cases of acute pellucid marginal corneal degeneration are not frequently encountered in clinical practice, each new patient is evaluated and managed with the utmost care to contribute to our better understanding of this disease. This is a report of two cases of acute pellucid marginal corneal degeneration that had a relatively favorable functional outcome when treated medically, so that corneal grafting was not necessary.

Calcific Band Keratopathy After Intraocular Chondroitin Sulfate

A patient developed an acute onset of pseudophakic bullous keratopathy and a diffuse, gray, subepithelial corneal deposit ten days following surgery during which sodium chondroitin sulfate was used. The deposit, identified histologically as calcium, was noted throughout Bowman's layer. The absence of chronic pathologic features in the posterior cornea eliminated Fuchs' endothelial dystrophy as the cause of the acute corneal decompensation. This histopathologic confirmation of calcium deposition with one formulation of chondroitin sulfate, combined with similar conclusions from previous case reports, stimulated the reformulation of the product, which has been shown to be useful in clinical practice.

Acute Idiopathic Corneal Endotheliitis

Seven patients presenting with acute corneal stromal edema without prior surgery, trauma, ocular disease or known exposure to noxious agents are reported. One patient had a severe iridocyclitis; two others subsequently developed herpetic keratouveitis. Four cases, however, were unassociated with other known ocular disease. All four of these patients exhibited keratic precipitates and displayed minimal or no flare and cells in the anterior chamber, although the latter was largely obscured by the corneal edema. In each of these four instances, the inflammation and corneal edema resolved following topical corticosteroid therapy. In two of the four cases, both children, antibody to Herpes simplex virus could not be identified. We suggest that, in patients without known prior corneal disease or trauma, acute diffuse corneal stroma edema may stem from severe iridocyclitis or a primary endotheliitis due either to herpetic infection, the recently described presumed autoimmune corneal endotheliopathy, or a condition which we herein designate acute idiopathic corneal endotheliitis.

Corneal Endothelial Damage with Neodymium:YAG Laser

Acute corneal endothelial changes following Nd:YAG laser application were evaluated in two series of rabbits. The first series underwent anterior capsulotomy, while the second series received laser applications at calculated distances ranging from 0.0 mm to 1.8 mm posterior to the endothelium. The rabbits were killed 24 hours after treatment and the endothelium evaluated with scanning electron microscopy. None of the eyes undergoing anterior capsulotomy showed endothelial damage, but the endothelium was focally denuded when laser shots were applied within 1.0 mm of it, and Descemet's membrane was disrupted by laser shots focused within 0.1 mm. Implications for clinical laser surgery are discussed.

Acute bacterial infections of the eye: their aetiology and treatment.

The aerobic microbial flora of 823 eyes with acute bacterial conjunctivitis, corneal ulceration, dacryocystitis, discharging sockets, blepharitis, and postoperative infections has been investigated. Staphylococci, Streptococcus pneumoniae, and nonfermenting Gram-negative bacilli including Pseudomonas aeruginosa were the main pathogens. Fermenting coliforms were also infrequently isolated. The least overall resistance of 30.9% was to chloramphenicol, but no one antibiotic was effective against all pathogens. Cloxacillin is the best drug for staphylococcal and polymyxin B for pseudomonas infections.

Keratoconus and Acute Hydrops in Mentally Retarded Patients with Congenital Rubella Syndrome

Four patients with the congenital rubella syndrome had keratoconus and evidence of acute or previous corneal hydrops. All four of the patients vigorously rubbed and poked their eyes. The keratoconus and acute corneal hydrops in these patients probably resulted from chronic traumatizing mannerisms common in other patients with mental retardation and are not specific for the congenital rubella syndrome.

Corneal ulceration following measles in Nigerian children.

Acute corneal ulceration in malnourished children is the commonest cause of childhood blindness in Northern Nigeria and usually develops after measles. Other severe diseases in malnourished children rarely precipitate corneal ulceration. A survey in a school for blind children showed that 69% of the children were blind from corneal disease, and a survey of children with corneal scars showed that at least 42% were caused by ulceration after measles. The clinical appearance of the active ulcers was very varied. The serum retinol-binding protein and prealbumin levels in children with corneal ulcers following measles were below normal, but a group of malnourished children without eye complaints following measles were found to have even lower levels. Thus a specific deficiency of vitamin A does not appear to be the primary cause of these ulcers, though it may be a contributory one. A specific measles keratitis and secondary herpes simplex infectious may be local factors contributing to this ulceration, and there is nearly always a background of protein calorie malnutrition. Racial factors may also be of some significance.

Immunoglobulin concentrations in human tears in ocular diseases.

Immunoglobulin concentrations in human tears were determined in 165 patients with different eye diseases by a standard radial immunodiffusion method. IgA was present in all the samples in measurable quantity. The mean IgA values were significantly higher than the controls in patients with acute bacterial conjunctivitis, keratomalacia, corneal graft reaction, blepharoconjunctivitis, and acute keratoconjunctivitis. The values in the patients with vernal conjunctivitis, phlyctenular conjunctivitis, acute bacterial corneal ulcer, and acute endogenous uveitis were not significantly different from those in the controls. IgG could be detected in the majority of the samples but it was in measurable quantity in 18 samples. IgM could be detected in fewer samples. IgD was not detected in any of them. The study indicates that, whenever the immunoglobulin levels in tears are altered in diseased eyes, it is the IgA level that is predominantly altered and not the IgG level.

Climatic changes in the eyes of Eskimos, Lapps and Cheremisses.

Chronic and acute climatic changes observed in the eyes of Eskimos and USSR Cheremisses are described. Chronic climatic lesions are more common in men than in women. Pterygium seems to be about equally common in Eskimos and Lapps. The occurrence of pinguecula was about the same in all three populations and much higher than in the urbanized Finns. Band‐shaped climatological corneal degenerations seem to be less common and less malignant among the Eskimo populations studied living in the regions at latitudes 70° than among those living in the more southern regions of Labrador.In January 1970 all the Eskimos who had been driving motor sledges were observed to have acute corneal and conjunctival epithelial lesions stainable with fluorescein.

Coagenase in corneal ulcerations.

Collagenase activity was found in the corneal epithelium of ten cases of corneal diseases associated with either acute or chronic corneal ulcerations. Sixteen cases, which included autopsy corneas, nondiseased corneas, and diseased corneas wihout ulcerations failed to reveal detectable activity. The collagenolytic activity was demonstrated by lysis of reconstituted collagen gels upon which epithelial explants were cultured in vitro. The enzyme was active at physiological pH, and inhibited by disodium ethylenediaminetetraacetic acid (EDTA). The role of collagenase in the pathogenesis of corneal ulcerations is discussed.

Acute metastatic corneal abscess.

Acute metastatic corneal abscess.