Allergic Eye Disease Research Articles

Scleral lens surface crazing in an eye with giant papillary conjunctivitis and keratoconus: Outcome of lens surface polishing

We present a case of scleral lens surface crazing in a patient with keratoconus (KC) and chronic giant papillary conjunctivitis (GPC). A 45-year-old Asian male with known keratoconus (KC) and allergic eye disease in both eyes, who is an experienced scleral lens user, presented with a 3-month history of lens intolerance in the right eye. On examination, the right eye scleral lens showed extensive lens surface crazing with poor surface wettability. The upper tarsal conjunctiva showed conjunctival hypertrophy – active GPC. After allergy treatment and symptomatic improvement, the scleral lens was refitted after intensive cleaning and polishing with aluminum oxide. The lens surface showed significant improvement and good fitting characteristics, and the patient resumed lens wear. At 6 months of follow-up, the patient was asymptomatic, and the ocular condition was stable.

Current Management of Fluorometholone Steroids in Pediatric Vernal Conjunctivitis: A Literature Review

Vernal conjunctivitis is a rare allergic eye disease, usually affecting children in the prepubertal years and can last between 5 to 10 years. Treatment of this condition is often challenging, requiring effective therapies to reduce symptoms. This literature review, conducted between 2015 and 2023, aimed to evaluate the effectiveness of fluorometholone steroid use in the treatment of pediatric vernal conjunctivitis. Recent studies comparing the effectiveness of Fluorometholone 0.1% in the treatment of Vernal Keratoconjunctivitis (VKC) were analyzed. The results showed that Fluorometholone was effective compared to Cyclosporine in reducing VKC symptoms. However, the use of Fluorometholone should be done with caution due to potential side effects such as increased intraocular pressure and risk of infection.Fluorometholone is an effective treatment option for vernal conjunctivitis in children. However, it is important to have close monitoring by an ophthalmologist to avoid serious side effects. With careful monitoring and proper dose adjustment, Fluorometholone can be a safe and effective therapy in managing this condition.

Novel therapeutic receptor agonists and antagonists in allergic conjunctivitis.

Allergic conjunctivitis is characterized by the development of pathophysiological changes to the ocular surface, which occurs when pro-allergic and pro-inflammatory mediators interact with their cognate receptors expressed on immune and nonimmune cells. Traditional treatments with antihistamines and corticosteroids provide relief, but there is a need for more efficacious and tolerable long-term therapy with a better safety profile. This article aims to provide an overview of the mode of action and clinical application of agonist therapies targeting glucocorticoid, melanocortin, and toll-like receptors, as well as antagonist therapies targeting cytokine, chemokine, integrin, and histamine receptors. There has been considerable advancement in immunology and pharmacology, as well as a greater understanding of the cellular and molecular mechanisms of allergic conjunctivitis. Recent research advancing therapy for allergic conjunctivitis has focused on developing synthetic molecules and biologics that can interfere with the process of the allergic immune reaction. This review discusses novel therapeutic receptors being explored agonistically or antagonistically to develop alternative treatment options for allergic conjunctivitis. These novel approaches hold promise for improving the management of allergic eye diseases, offering patients hope for more effective and safer treatment options in the future.

Pattern of Eye Disease in Nenwe Rural Eye Clinic, Nigeria: A Seven Year Review

Background: The establishment of eye clinics in the form of rural outreach centers as a means of educating and providing eye care to rural residents was made necessary by the lack of eye care services in rural areas within Nigeria and the need to increase the cataract surgical rate among ophthalmologists in training. Understanding patterns of eye diseases in rural areas and eye health-seeking behaviors is crucial to achieving the goals of Vision 2020 especially for aspiring ophthalmologists. Aim and objectives: To examine the types of eye conditions observed at Nenwe, a rural outreach post of a tertiary hospital, and to evaluate their distribution. Methodology: A retrospective analysis of all patients who were seen at the community eye clinic during seven years was carried out. Records of patients at the Nenwe outreach eye clinic dating from November 2016 to August 2023 were examined, yielding information on patients examined during the period of study. Results: Glaucoma was the most common eye condition to be diagnosed. Cataracts were the second most common eye condition accounting for 20.8%. Other common eye illnesses were refractive error (9%), pterygium (7%), and allergic eye disease (6%) with 129, 101, and 95 cases, respectively. Retinal detachment (51 cases), prebyopia (47 cases), corneal lesion (58 cases), and dry eye condition (47 cases) were less common. Conclusion: The results show the burden of eye disorders in the Nenwe rural community and the importance of community-based eye care services.

Effect of Exposure to Particulate Matter on the Ocular Surface in an Experimental Allergic Eye Disease Mouse Model.

In response to the escalating concern over the effect of environmental factors on ocular health, this study aimed to investigate the impact of air pollution-associated particulate matter (PM) on ocular allergy and inflammation. C57BL/6 mice were sensitized with ovalbumin (OVA) topically and aluminum hydroxide via intraperitoneal injection. Two weeks later, the mice were challenged with OVA and exposed to PM. Three groups-naive, OVA, and OVA-sensitized with PM exposure (OVA + PM) groups-were induced to an Allergic Eye disease (AED) model. Parameters including clinical signs, histological changes, inflammatory cell infiltration, serum OVA-specific immunoglobulins E (IgE) levels, mast cells degranulation, cellular apoptosis and T-cell cytokines were studied. The results demonstrate that exposure with PM significantly exacerbates ocular allergy, evidenced by increased eye-lid edema, mast cell degranulation, inflammatory cytokines (IL-4, IL-5 and TNF-α), cell proliferation (Ki67), and serum IgE, polymorphonuclear leukocytes (PMN), and apoptosis and reduced goblet cells. These findings elucidate the detrimental impact of PM exposure on exacerbating the severity of AED. Noticeably, diminished goblet cells highlight disruptions in ocular surface integrity, while increased PMN infiltration with an elevated production of IgE signifies a systemic allergic response with inflammation. In conclusion, this study not only scientifically substantiates the association between air pollution, specifically PM, and ocular health, but also underscores the urgency for further exploration and targeted interventions to mitigate the detrimental effects of environmental pollutants on ocular surfaces.

Ocular disorders in a tertiary Hospital in South East Nigeria

The object of this study was to determine the pattern of ocular disease patients that presented to the Enugu State University of Science and Technology Teaching Hospital, Park Lane, Enugu, Nigeria. A retrospective study was conducted, where the medical case notes of patients who had ocular examinations, other clinical examinations, and investigations from April 2022 through December 2022 were retrieved. There were a total of 1145 patients, with a male population of 476 (41.6%), while females were 669 (58.4%). The mean age of the study population was 40.8 years, with a Standard Deviation (SD) of 22.4. A total of 924 (80.7%) participants were adults while children (aged 16 years and below) were 221 in number and constituted 19.3% of the study population. The most common eye disease was refractive error, which occurred in 266 (23.2%) of the participants; it was followed by allergic eye diseases, 201 (17.6%), cataract, 170 (14.9%), glaucoma, 111 (9.7%), and trauma to the eye, 94 (8.2%). Among the children, the most common eye disease seen were allergic eye diseases, 78 (35.3%), followed by refractive error, 70 (31.7%), trauma, 21 (9.5%), cataract, 11 (5.0%), while infections of the eye were 10 (4.5%). The most common eye disease among the adult participants was refractive error, 196 (21.1%), and then cataract, 159 (17.2%), allergic eye diseases, 123 (13.3%), glaucoma, 105 (11.4%), and retinal pathologies, 82 (8.9%). The most common causes of eye diseases in this study were refractive error, allergic eye diseases, cataracts, glaucoma, and trauma. Health education at community and primary health care level could help to reduce the number of people with avoidable causes of visual impairment.

Ocular Cicatricial Pemphigoid in Young Patients.

The purpose of this study is to report ocular cicatricial pemphigoid (OCP) occurring in young patients. Relevant literature is also reviewed. Medical records of patients aged 30 years or younger who were treated for OCP between August 2021 and May 2023 at a tertiary care eye institute were reviewed. The most common differential diagnoses of cicatrizing conjunctivitis, such as Stevens-Johnson syndrome sequelae, chemical injury, chronic topical/systemic drug use, autoimmune connective tissue disorders, or allergic eye diseases, were ruled out based on clinical history, examination, and the Cicatrizing Conjunctivitis Score described by Shanbhag et al. The diagnosis of OCP was confirmed by positive direct immunofluorescence of oral mucosal and/or conjunctival biopsy in a majority of the patients. Seven patients fulfilled the criteria for a diagnosis of OCP. The mean age at presentation was 21.86 ± 5.25 years (13-28 years). Some of the patients presented with relatively atypical features for OCP such as corneal immune ring infiltrate and bilateral corneal perforation. Six patients exhibited systemic mucosal lesions, and the direct immunofluorescence yield was 85.71%. All patients required aggressive immunosuppressive treatment. OCP is classically described as a rare disease that occurs in old age. This case series highlights the importance of a higher index of suspicion for diagnosing OCP at a younger age. Early administration of immunosuppressive agents can potentially control severe ocular surface inflammation and its sequelae.

The new preservative-free ophthalmic formulation of bilastine 0.6% preserves the ocular surface epithelial integrity in a comparative in vitro study

Allergic conjunctivitis (AC) is the most common form of allergic eye disease and an increasingly prevalent condition. Topical eye drop treatments are the usual approach for managing AC, although their impact on the ocular surface is not frequently investigated. The aim of this study was to perform a comparative physicochemical characterization, and in vitro biological evaluations in primary conjunctival and corneal epithelial cells of the new multidose preservative-free bilastine 0.6% and main commercially available eye drops. MTT assay was used to measure cell viability; oxidative stress was analyzed with a ROS-sensitive probe; and apoptosis was evaluated monitoring caspase 3/7 activation. Differences in pH value, osmolarity, viscosity and phosphate levels were identified. Among all formulations, bilastine exhibited pH, osmolarity and viscosity values closer to tear film (7.4, 300 mOsm/l and ~ 1.5–10 mPa·s, respectively), and was the only phosphates-free solution. Single-dose ketotifen did not induce ROS production, and single-dose azelastine and bilastine only induced a mild increase. Bilastine and single-dose ketotifen and azelastine showed high survival rates attributable to the absence of preservative in its formulation, not inducing caspase-3/7-mediated apoptosis after 24 h. Our findings support the use of the new bilastine 0.6% for treating patients with AC to preserve and maintain the integrity of the ocular surface.

Applications of topical immunomodulators enhance clinical signs of vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC): a meta-analysis.

This meta-analysis aimed to review the safety and efficacy of topical cyclosporine A (CsA) and topical tacrolimus in allergic eye disease. A systematic search identified thirteen studies and a total of 445 patients for inclusion, making this the largest meta-analysis published on the subject. The current review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Thirteen randomized control trials were included in the meta-analysis. Eleven studies used CsA as the treatment, and two used Tacrolimus. In total, 445 participants were included, of whom 76.6% were male. The mean age of participants across the included studies was 14years. All studies reported clinical signs as evaluated by an examining clinician. Signs were usually assessed by anatomical region, with the most common regions being the conjunctiva and the cornea, and the most common signs assessed were hyperemia and papillae. Three studies accounted for more than 50% of the meta-analysis's weight. Effect size (d) ranged from - 2.37 to - 0.03, negative values favoring immunomodulators. Fixed Effect Meta-Analysis returned an SMD of - 0.81 (95% CI [- 0.98, - 0.65]). However, there was significant heterogeneity (I2 = 61%, Qw = 30.76) in the outcome measure (P = 0.0021); therefore, a random-effect meta-analysis was also completed in which the pooled SMD was - 0.98 (95% CI [- 1.26, - 0.69], τ2 = 0.16). This study affirms the current scientific community's stance that immunomodulators effectively treat clinical signs, including blepharitis, conjunctival hyperemia, edema, papillae, and corneal damage in severe ocular allergic disease.

Prevalence and Pattern of Eye Disorders Among Primary Schoolchildren in Abakaliki, Nigeria: A Cross-Sectional Study.

Background A child's learning ability depends on vision, and visual impairment negatively affects neurological, intellectual, and emotional development by limiting children's exposure to a range of experiences and information. This study aims to determine the prevalence and pattern of ocular morbidity among primary schoolchildren in Abakaliki and provide evidence that can be used in planning a school eye health program for the state. Methodology A school-based, cross-sectional study was conducted within the Abakaliki metropolis between January and April 2018 to determine the ocular health status of schoolchildren recruited using stratified random sampling. Data were analyzed using SPSS version 22 (IBM Corp., Armonk, NY, USA) and presented using descriptive statistics. Univariate analysis was performed to determine the association between dependent and independent variables, with the level of significance determined by a p-value <0.05 (95% confidence interval (CI)). Results A total of 553 schoolchildren aged 6-16 years were examined. The prevalence of eye disorders was 23.5%. Common disorders included refractive error (12.7%) and allergic eye disease (7.1%). Other findings included glaucoma suspect (15, 2.7%), infective conjunctivitis (1, 0.2%), amblyopia (3, 0.5%), cataract (1, 0.2%), and squint (1, 0.2%). The prevalence of visual impairment was 3.1%. Univariate analysis showed a significant association between ocular morbidity and attending private schools (95% CI = 6.5-11.1, p = 0.003). Conclusions Eye disorders such as uncorrected refractive error and allergic conjunctivitis were common among schoolchildren. School eye health programs can ensure that eyescreening is done periodically, allowing for early detection, referral, and prompt treatment of eye diseases that can potentially cause visual impairment.

Para‐phenylenediamine hair dye and dry eye symptoms: A cross‐sectional study

Aims/Purpose: Para‐phenylenediamine is a common constituent in black hair dye which is well‐associated with irritant dermatitis. Ocular complications include blepharoconjunctivitis, dry eye disease and allergic eye disease (1), mostly reported in case studies. We conducted a cross‐sectional study to establish the prevalence of dry eye symptoms in black hair dye users, and its association with irritant dermatitis, sleeping position and frequency of hair dye use.Methods: This cross‐sectional study was conducted online among Facebook followers of an ophthalmology clinic based in Mauritius. 100 responses were gathered between November 2020 and May 2022. Participants included in the study were all users of black hair dye, over the age of 18 and of either sex. Patients with potential confounding causes of dry eye disease symptoms were not excluded from the study, but a separate analysis was conducted excluding them. Data was subsequently analysed using R statistical software.Results: Most participants were female (88%) and excluding those with confounding causes of dry eye disease, 57% of participants reported ocular symptoms, such as grittiness, blurry vision and red eyes. 34% of these patients also reported scalp dermatitis. Prevalence of ocular symptoms increased with duration of hair dye use. However, no association was found between either rates of irritant scalp dermatitis, sleeping position or frequency of hair dye use and ocular symptoms.Conclusions: We have found a high prevalence of dry eye symptoms among black hair dye users, compared to the prevalence previously described in the literature (28.2% by Golińska‐Zach et al.) (1), with a prolonged duration of hair dye use being a risk factor. Larger scale studies are needed to characterize the influence of para‐phenylenediamine hair dye on ocular surface disease, including assessment of tear film properties and meibomian gland dysfunction.Reference1. Golińska‐Zach A, Krawczyk‐Szulc P, Wiszniewska M, Nowakowska‐Świrta E, Świerczyńska‐Machura D, Tymoszuk D, et al. Sensitization to occupational allergens in hairdressing apprentices diagnosed already before entering vocational training. Med Pr [Internet]. 2016 [cited 2022 Apr 25]; 67(5): 567–75. Available from: https://pubmed.ncbi.nlm.nih.gov/27819696/

Ocular surface pseudoepitheliomatous hyperplasia secondary to allergic eye disease: clinical features and management.

To study the clinical characteristics and treatment outcomes of ocular surface pseudoepitheliomatous hyperplasia (PEH) associated with chronic vernal keratoconjunctivitis (VKC). This retrospective study includes 39 eyes of 32 patients with VKC induced PEH who presented from 2016-2022. A database search was conducted for diagnosis of PEH, and data on clinical features, imaging characteristics, and treatment were analyzed. Of the 32 patients, 11 (34%) were children and adolescents, 21 (66%) were adults. PEH was common in males (72%) and ocular surface squamous neoplasia (OSSN) was the commonest referral diagnosis (43.7%). Mean age at presentation was 26.62 ± 10.18 (range: 6-52) years. While history of VKC was present in 21 patients, 11 were diagnosed with VKC at the time of diagnosis of PEH. The mean base/largest diameter was 5.2 ± 1.67 mm. Anterior segment optical coherence tomography (AS-OCT) showed irregular hyper-reflective epithelium, epithelial dipping, and sub-epithelial hyper-reflective lesion with shadowing in all lesions. Of the 31 eyes that received medical therapy, 21 (67%) and 10 (32%) eyes showed complete and partial resolution respectively with median time to resolution of 3(IQR:2-4) months. Eight eyes that underwent surgical excision showed complete resolution and one developed partial limbal stem cell deficiency. Ocular surface PEH is a manifestation of chronic VKC which closely mimics OSSN. Detailed history-taking, examination for signs of allergy, and AS-OCT imaging can distinguish it from OSSN. It responds well to medical therapy and should be considered first-line therapy before planning any surgical intervention.

A Randomised Control Trial on Shigrupatra Arka Ashchyotana in Kaphaja Abhishyanda

Eyes are the most essential and delicate organ of the human body and they need special care. Vernal Keratoconjunctivitis (VKC) is recurrent, bilateral, interstitial, self-limiting allergic inflammation of the conjunctiva having periodic seasonal incidence, also known as Warm weather conjunctivitis or Spring Catarrh. Vernal Keratoconjunctivitis (VKC) is an allergic eye disease that especially affects young boys. Aim: To study the role and efficacy of Shigrupatra Arka Ashchyotana in Kaphaja Abhishyanda. Objectives: 1. To compare the efficacy between Shigrupatra Arka Ashchyotana and olopatadine eye drop (0.1%). 2. To establish a relation between Kaphaja Abhishyanda and Vernal Kerato-Conjunctivitis (VKC). Material and Methods: 40 patients of Kaphaja Abhishyanda were randomly assigned to two groups for a clinical trial. Result: The clinical data shows that the effect of therapy on Kaphaja Abhishyanda is 73.36% in Group A and 71.79% in Group B. Conclusion: It can be concluded that clinically Shigru Patra arka Aschyotana is effective in managing the symptoms of Kaphaja Abhishyanda.

Prevalence of Keratopathy in Vernal Keratoconjunctivitis

Background: Vernal keratoconjunctivitis is a chronic allergic eye disease that primarily affects young individuals and can lead to significant discomfort and visual impairment. Keratopathy, in the context of Vernal Keratoconjunctivitis (VKC), refers to corneal changes and complications that can occur as a result of this chronic allergic eye condition. VKC primarily affects the conjunctiva and the cornea, and keratopathy is a significant concern due to its potential to cause visual impairment. Objective: To determine the frequency of keratopathy in vernal keratoconjunctivitis. Study Design: Cross-sectional. Settings: Sindh Institute of Ophthalmology and visual sciences at LUMHS Eye Hospital Hyderabad Pakistan. Duration: From February 16, to August 15, 2019. Methods: All the patients with VKC, aged 5-15 years and both genders were included. History was taken from patient or parent about presenting complains and duration of disease. Clinical (slit lamp) examination was performed to look for corneal lesions. Both eyes of each patient were examined for corneal involvement, including SPEE (positive Florescence staining), corneal epithelial defects, corneal shield ulcer and corneal subepithelial scars. Florescence staining with blue filter was used where indicated. All the data was entered in the proforma and analyzed by SPSS version 20. Results: Total 232 patients were studied, most of the patients 84.1%, belonged to age group of 5-10 years, while 15.9% presented with age range of 11-15 years. Males were most common 78.0%. Frequency of keratopathy was 22.0%. Most of the cases 51.3%, had &gt;1 years duration. According to type of keratopathy, superior punctate epithelial erosions was most common type among 35.3% patients out of 51, scarring was among 24.5% patients, shield ulcer was among 9.8% patients and macro erosion was in 2 patients. No significant impact was found of age on Prevalence of keratopathy, (p-0.419). Male gender, duration of VKC and bilateral eyes were significantly associated with Prevalence of keratopathy, (p-0.001). Conclusion: It was concluded that frequency of keratopathy in vernal keratoconjunctivitis is 22.0%.

Targeted Therapies for Allergic Conjunctivitis

Allergic eye disease is extremely common as the eye is sensitive to irritants due to its constant exposure to the external environment. Approximately 40% of the general population is affected by ocular allergies. The majority of patients may also suffer with additional associated symptoms of allergic rhinitis, such as nasal congestion, sneeze, etc.; however, 6% may have isolated ocular symptoms. In addition, there are links between ocular allergies and other allergic conditions such as asthma, food allergy and atopic dermatitis. The challenge is that in addition to ocular symptoms, patients experience a substantial negative influence on their quality of life (QOL). The most common symptoms are watery and itchy eyes; redness; soreness; stinging; burning sensations; and swelling. Unfortunately, as these symptoms are quite common, most patients may choose to self-medicate and many cases are undiagnosed or underdiagnosed. As a result of this, patients may not utilize the correct management strategy; this can lead to a further propagation of symptoms and a greater reduction in patients’ QOL. Hence, it is crucial for patients to seek professional medical attention, while physicians must gather a comprehensive medical history and conduct relevant investigations. Additionally, the physician ought to propose the correct diagnosis and suitable treatment plan.

The Burden of Pediatric Visual Impairment and Ocular Diagnoses in Barbados.

Visual impairment (VI) negatively affects a child's quality of life. The prevalence of VI in the Caribbean is nearly three times higher than in the United States, but the causes remain uncertain. This study leverages Barbados' unique eye care system to survey the eye diseases and VI prevalence in Barbadian children. Medical records of all patients aged <19 years who received ophthalmic care in Barbados' two public eye care centers between January and December 2019 were reviewed, capturing the entirety of public pediatric eye care within the study period. Age at the first visit to the clinic and at the final visit in 2019, sex, best-corrected visual acuity (BCVA), past medical history, and clinical diagnoses were extracted and analyzed. VI was defined as a BCVA of 6/12 or worse in the better-seeing eye. There were 3278 patient records with a mean age at the first visit of 7.8 ± 3.9 years. There were 80 (2.4%) children with VI, 62.5% of which were attributed to amblyopia. A total of 94% of VI was preventable or treatable. The most common diagnoses were refractive error (87.5%), strabismus (27.5%), and allergic eye disease (20.0%). Amblyopia is the major cause of pediatric VI in Barbados and is largely avoidable.

Clinical Profile of Vernal Keratoconjunctivitis (VKC) Patients: A Retrospective Study at a Peripheral Combined Military Hospital in Bangladesh

Background: Vernal keratoconjunctivitis (VKC) is an allergic eye disease that especially affects young boys. The most common symptoms are itching, photophobia, burning, and redness. This study was conducted to assess the clinical profile of vernal keratoconjunctivitis (VKC) among the local population reported at a peripheral combined military hospital over 1 year. This study aimed to analyze the cases of vernal keratoconjunctivitis at a peripheral combined military hospital. Material &amp; Methods: This is a retrospective study carried out in the Department of Ophthalmology at Combined Military Hospital, Saidpur. A total number of 110 patients with VKC were diagnosed based on their history, clinical features, and characteristic symptoms and sign over a period of 1 year from Jan 2021 to Dec 2021. Best-corrected visual acuity (VCVA) was assessed and each patient was thoroughly examined with a Slit Lamp Bi microscope, Fluorescein staining, and Tear film break-up time. Follow-up was done every 4 weeks, 3 months, and 6 months for 01 year. A purposive sampling technique was used in this study. Data was collected by a pre-designed questionnaire. All data were analyzed using SPSS version 20 (IBM Corp, Armonk, NY, USA) results were compiled in the frequency distribution table. Informed written consent was taken from all participants. Ethical clearance was obtained by the ethical committee of CMH. Results: Out of 110 patients, 80 (72.72%) were male and 30 (27.27%) were female. The highest incidence of VKC occurred in the age group of 11–15 years. In maximum cases 70 (63.63%) had palpebral form followed by mixed form 25 (22.72%) and then bulbar form 15 (13.63%). Corneal complications occurred in 27 (24.54%) patients; Out of 27, 25 patients had minor complications and 2 had major complications. The minor complications were usually superficial punctate keratopathy (SPK) or other epithelial disturbance. Major complications were superior pannus and pseudogerontoxon. Although patients with VKC often give a history of allergies or atopic diseases such as allergic rhinitis, asthma, or hay fever, in the present study, coexisting allergic conditions could be detected only 40 (36.36%) patients. Conclusion: VKC is a common form of allergic conjunctivitis among the age group of 11–15 years of male patients. The most common is the palpebral form followed by mixed and then bulbar forms. Some cases showed a history of atopy and other allergic conditions.

AYURVEDIC MANAGEMENT OF VERNAL KERATOCONJUNCTIVITIS / KAPHAJA ABHISHYANDA: A CASE STUDY

Vernal keratoconjunctivitis (VKC) is the commonest allergic eye disease in childhood. The major complaints of VKS patients are intense itching, tearing, photophobia and mucous discharge. This condition can be correlated with Kaphaja Abhishyanda (Kapha dominant conjunctivitis) in Ayurvedic texts. Kriyakalpa (ocular therapeutic procedures) procedure, along with oral medications, successfully manages symptoms and reduces the recurrence rate. A nine-year-old female patient consulted the eye OPD of the National Institute of Ayurveda, Jaipur, with chief complaints of atikandu (excessive itching), akshiraga (redness in the eyes) and jalsrava (watery secretion) in both eyes since three months. Slit lamp examination revealed the presence of gelatinous opacification (approx. 2 mm in size) at the limbus, hyperaemia in the palpebral conjunctiva and triangular congestion in the bulbar conjunctiva. The rest of the eye assessment was normal. Owing to the symptoms and signs, the case was diagnosed as VKC, which can be correlated with Kaphaja Abhishyanda. Hence this patient was treated with Kriyakalpa (ocular therapeutic procedures) like Ashchyotana (eye drops), Nasyam (medications through nasal route), Vidalaka (Application of medicated paste on the outer part of the eye), etc., along with oral medications. Kriyakalpas (ocular therapeutic procedures), as well as internal medications, give significant results in the management of vernal keratoconjunctivitis.

Corneal topographic changes in young patients with chronic allergic eye disease

Corneal topographic changes in young patients with chronic allergic eye disease

Pattern of Ocular Morbidity in Patients Attending Urban Specialist Eye Clinic in South East, Nigeria

Background: The pattern of eye diseases varies across the world. Racial, ethnic, socio-cultural and socio-demographic characteristics are known to exert some influence on the pattern of these eye diseases. Knowledge of these patterns is important in planning for adequate eye care services.&#x0D; Aim: To determine the pattern of ocular morbidity in an urban Specialist Eye Clinic in Awka, South-East Nigeria.&#x0D; Setting and Design: A two-year descriptive retrospective study of patients seen in an urban Specialist Eye Clinic in South-East Nigeria.&#x0D; Materials and Methods: The needed information, which included socio-demographics and diagnosis, were extracted from patients’ case files and entered into a proforma. The data were analyzed using SPSS version 20. Ninety five percent Confidence Interval was given for percentages and p ≤ .05 was accepted as statistically significant.&#x0D; Results: Five hundred and twenty seven patients comprising 277 (52.6%) females and 250 (47.4%) males with a mean age of 43.2 ± 21.7 years seen within the two year period were reviewed. Refractive error, glaucoma, allergic eye diseases, and cataract in that order were the commonest ocular morbidities in these patients. Spherical errors were commoner than cylindrical errors. Hypermetropia was the commonest refractive error while hypermetropic astigmatism was the commonest astigmatic error. All the refractive errors were commoner in females than in males. Although 185 (35.1%) patients were presbyopic on clinical examination, only 41(7.7%) patients had presbyopia as their main diagnosis.&#x0D; Conclusion: Most of the common reasons for ophthalmic consultations were refractive error, glaucoma, allergic eye diseases, and cataract. Adequate provision for the management of these conditions will help in reducing the burden of visual impairment and blindness.