Conjunctivitis Patients Research Articles

Prevalence, Clinical Characteristics, and Relative Factors of Acquired Punctal Stenosis in Adult Allergic Conjunctivitis Patients

Plain Language SummaryThis study aimed to examine the prevalence of acquired punctal stenosis (APS) among adults with allergic conjunctivitis (AC), describe its characteristics, and identify associated risk factors. We reviewed the medical data of 210 adult patients with AC at Zhongshan Ophthalmic Center. We gathered demographic data and evaluated ocular symptoms. Using slit-lamp microscopy, we assessed and graded the morphology of the lacrimal puncta (lacrimal duct openings) according to a modified grading system. The study results revealed that 69% of the adult patients with AC had APS. Stenotic lacrimal puncta were present in 49.3%, with grade IIa being the most common. The narrowing was most frequently observed in the upper lacrimal puncta compared to the lower ones. Older age and a higher tear meniscus height (TMH) were significantly associated with the presence of APS. Therefore, this study demonstrates that APS is commonly observed in adults with AC, which is associated with the increased age and widened TMH, indicating a possible link between chronic and recurrent AC and the development of APS.

Bacterial Etiology and Antibiotic Susceptibility in Isolates from Conjunctivitis Patients in Tripoli, Libya

Acute conjunctivitis is described as inflammation of the conjunctiva that lasts less than 3 to 4 weeks, showing cellular infiltration and exudation. Conjunctivitis can cause significant and lasting harm to the eye, resulting in severe inflammation in the corneal lid. This study seeks to isolate and identify the particular bacterial pathogens responsible for conjunctivitis in patients at Tripoli Eye Hospital. Collection of bacterial samples from patients with conjunctivitis was conducted at the ophthalmic consultative clinic within Tripoli Eye Hospital, Libya between September 2021 and January 2022. Tests were done to separate bacterial pathogens causing conjunctivitis and to test their resistance to antibiotics. Among 140 samples, bacterial infection was detected in 86% of cases while 14% yielded negative results. Males had a higher prevalence of bacterial infections at 63% in comparison to females. Both male and female individuals aged 60-79 years had the highest percentage of bacterial conjunctivitis cases at 51%. Segregation tests showed that the majority (82%) were Gram-positive, while a minority (18%) were Gram-negative, with Staphylococcus aureus being the most prevalent bacteria (35%), closely followed by Staphylococcus epidermidis (32%). Streptococcal pneumoniae and Enterobacter spp had rates of 2% which were lower. The majority of organisms showed sensitivity to levofloxacin (43%), while there was only a small amount of resistance to polymyxin B (4%). Professional attention and microbiological research are crucial for verifying clinical diagnoses and carrying out suitable and efficient treatments.

Correlation between forkhead box P3 (rs3761548) gene polymorphism and serum interleukin13 as biomarkers of severity in Egyptian allergic conjunctivitis: a retrospective study.

The genetic variants that alter human Forkhead Box P3 (FOXP3) function may have a part in the establishment of allergic conjunctivitis. Our study aimed to evaluate the FOXP3 polymorphism, serum interleukin13 (IL13) and total immunoglobulin E (IgE) levels in allergic conjunctivitis and assess their role as biomarkers for allergic conjunctivitis risk and severity. This study included 52 cases and 52 controls. Blood samples were taken from allergic conjunctivitis patients and controls for total IgE, IL13 measurement and detection of FOXP3 (rs3761548) gene polymorphism. There was a statistically significant difference between the allergic conjunctivitis group and healthy control group regarding FOXP3 (rs3761548) polymorphism with those have AA genotype are 12 times at risk for allergic conjunctivitis and A allele increases the risk of allergic conjunctivitis by about 4 times. There was statistically significant difference between mild/moderate and severe allergic conjunctivitis regarding FOXP3 (rs3761548) polymorphism with those have AA genotype are 53 times at risk for severe allergic conjunctivitis and A allele increases the risk of severe allergic conjunctivitis by about 6 times. Also, there was a significantly higher value of total IgE IU/ml, IL13 Pg/ml value in severe allergic conjunctivitis compared to moderate/mild allergic conjunctivitis. The best cutoff values of total IgE and serum IL13 for detecting the severity of allergic conjunctivitis were ≥320 IU/ml and ≥40 Pg/ml and the area under the curve were 0.89 and 0.95 respectively. The research significantly contributes to find correlation of FOXP3 polymorphism, total IgE and IL13 with risk and severity of allergic conjunctivitis which are limited in the literature on the perceived value relevance of FOXP3 polymorphism in allergic conjunctivitis risk and severity.

Evaluating the effectiveness of large language models in patient education for conjunctivitis

AimsTo evaluate the quality of responses from large language models (LLMs) to patient-generated conjunctivitis questions.MethodsA two-phase, cross-sectional study was conducted at the Eye and ENT Hospital of Fudan University. In...

The Clinical Features of Vernal Conjunctivitis in Cicendo National Eye Hospital

Introduction: Vernal conjunctivitis is a chronic, recurrent form of allergic conjunctivitis that occurs mainly in children and is commonly found in warm and humid climates or tropical countries, including Indonesia. Although vernal conjunctivitis is a self-limiting disease, it often leads to visual impairment and significantly affects the patient's quality of life. Methods: This retrospective descriptive study was conducted in Cicendo National Eye Hospital from March to April 2023 using the total sampling method to obtain the clinical features of vernal conjunctivitis patients. Result: This study took 117 patients (234 eyes) registered in electronic medical records from January to December 2022 with an age range of 7-18 years. The mean age of the patients was 10.73 ± 3.02 years, with total of 78 patients (66.67%) being male. A total of 30 patients (25.64%) had a history of atopic allergies. All patients in this study had a bilateral condition. The palpebral type was diagnosed in 85 patients (72.64%). Red eyes were the most prominent symptom experienced in 89 eyes (76.06%). Papillary signs were seen in 203 eyes (86.75%), with an uncorrected visual acuity of 6/6 to 6/18 were found in 163 eyes (69.66%). A small proportion of patients experienced complications in 93 eyes (39.74%). Conclusion: The clinical features of vernal conjunctivitis patients in Cicendo National Eye Hospital are similar to those in other tropical countries. Most patients were male and complained of itching and red eyes. The palpebral type is the most common type. Few distinct features were noted indicating a low association with atopy.

Evolution of dupilumab-associated conjunctivitis in patients with atopic dermatitis after switching dupilumab to tralokinumab or Janus kinase inhibitors (RESO-ADOC study).

Clinical trials and real-life data have reported an increased incidence of conjunctivitis in patients treated with dupilumab for their atopic dermatitis (AD). Although mostly mild in severity, in some cases conjunctivitis will appear or increase after dupilumab initiation, which can lead to dupilumab discontinuation. (1) To describe the characteristics of patients developing conjunctivitis requiring discontinuation of dupilumab; and (2) to analyse the factors associated with a complete conjunctivitis improvement after dupilumab discontinuation and a switch to tralokinumab or Janus kinase inhibitors. This was a multicentre retrospective cohort study that included all patients with AD treated with dupilumab who developed conjunctivitis leading to dupilumab discontinuation and switching to tralokinumab or Janus kinase inhibitors in daily practice. Data on patients, their AD and conjunctivitis were analysed at the inclusion visit (corresponding to discontinuation of dupilumab and the institution of new AD treatment), at visit 2 (3-6 months after inclusion) and at visit 3 (corresponding to the last medical visit). After multivariate analysis, the only factors associated with a complete resolution of dupilumab-associated conjunctivitis at visit 2 and/or visit 3 were conjunctivitis duration (OR 8.98, 95% CI 1.47-55) (p = 0.018), personal history of asthma (OR 10.66, 95% CI 1.82-62.63) (p = 0.009) and switching from dupilumab to Janus kinase inhibitors (OR 17.11, 95% CI 2.94-99.66) (p = 0.002). Although uncommon, severe dupilumab-associated conjunctivitis is more frequent in daily life compared to its incidence in the dupilumab pivotal trials. In these cases, our study suggests that a rapid switch to another molecule, particularly a Janus kinase inhibitor, should be considered.

Molecular characterization of coxsackievirus A24 variants isolated from an outbreak of acute hemorrhagic conjunctivitis

PurposeAcute Hemorrhagic conjunctivitis (AHC) is associated with CVA24v. Recently there was a severe outbreak of conjunctivitis in months of July and August 2023 in India. This study emphasizes the identification of the distinct mutations in the CVA24v strains, which were isolated during the AHC outbreak and could have potentially played a role in the high transmission of AHC in India during the 2023 outbreak. MethodsA total of 71 conjunctivitis patients aged 1–75 years comprising 47 males and 24 females who attended Ophthalmology department of a tertiary care hospital of easternIndia were studied.RNA was extracted from all conjunctival swab samples and converted into cDNA. Subsequently, the viral 5′ UTR was amplified and the PCR positive samples were subjected to sequencing. The newly isolated viral 5′ UTR sequences were aligned with other worldwide sequences using the Clustal W tool to conduct mutational analysis. A phylogenetic tree was built using the MEGA software for viral genotype identification. ResultsAll of the current outbreak strains belonged to genotype IV of CVA24v. The present outbreak strains formed a distinct clade in the phylogenetic tree and were different from previously reported Indian strains. Two persistent mutations, specifically in domain IV (T213C) and domain V (C475T), were exclusively detected within the internal ribosome entry site (IRES) of the 5′ UTR of the current strains causing the outbreak. These two alterations have previously been shown to impact the virulence of another enterovirus (CV B3), but they have not been described in CVA24v until now. ConclusionFinding of the present study highlights the possibility and the significance of the aforementioned two mutations in enhancing the transmissibility of the newer CVA24v strains. Hence, these two distinct mutations should be investigated further for developing antiviral therapies to combat future AHC outbreaks associated with CVA24v.

NLRP3 inflammasome-a likely target for the treatment of immunologic conjunctivitis: A protocol for systematic review and meta-analysis.

Immune-mediated conjunctivitis is a prevalent ocular ailment characterized by inflammation and immune reactions in the conjunctiva. However, the precise causes and therapeutic approaches for this condition remain the main focus for numerous ophthalmological specialists. Recently, accumulating evidence from human and mouse experiments has demonstrated the critical involvement of the NLRP3 inflammasome, IL-1β, and IL-18 in the development of allergic diseases. Targeting specific NLRP3 inflammasome and its related inhibitors may hold potential as therapeutic agents for immunologic conjunctivitis. Despite this, there has been no systematic review specifically addressing the treatment of immunologic conjunctivitis related to NLRP3. Therefore, this study aims to conduct a systematic review and meta-analysis of currently published randomized controlled trials (RCTs) on NLRP3-related treatments for immunologic conjunctivitis patients, with the goal of evaluating their efficacy and safety. We will conduct a comprehensive search for relevant studies on NLRP3 inflammasome inhibitors or NLRP3-related treatments for immunologic conjunctivitis in various databases including PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang. The search will encompass studies from their respective inception dates to July 2023. A meta-analysis will be performed using data extracted from eligible randomized controlled trials (RCTs), focusing on the clinical manifestations of immunologic conjunctivitis, levels of NLRP3-related factors in serum or tear samples, quality of life outcomes, and adverse events. Review Manager 5.4.1 software will be employed for the meta-analysis, and the results will be analyzed using either random-effects or fixed-effects models, depending on the presence of heterogeneity. The reliability and quality of evidence will be evaluated using the Grading of Recommendations, Development, and Evaluation (GRADE) system. The findings of this study will yield robust and high-quality evidence regarding the efficacy and safety of NLRP3-related treatments for immunologic conjunctivitis. This evidence will contribute significantly to our understanding of the potential benefits and risks associated with such treatments and will assist healthcare professionals in making informed decisions regarding the management of immunologic conjunctivitis. This study represents the first comprehensive meta-analysis aiming to evaluate the efficacy and safety of NLRP3-related treatments for immunologic conjunctivitis. The findings from this study will provide valuable evidence to guide clinical management strategies for this disease. The results are anticipated to significantly contribute to the understanding of the therapeutic potential and safety profile of NLRP3-related treatments, offering valuable insights for healthcare professionals involved in the care of patients with immunologic conjunctivitis. Systematic review registration: PROSPERO with registration number CRD42023437076.

Keratometric Study of Cornea in Allergic Conjunctivitis Patients

Background: To explore corneal biomechanical changes, identify related factors and determine early indicators of keratoconus (KC) development risk in allergic conjunctivitis (AC) patients. Methods: A total of 50 patients, including 20 eyes without AC and 30 eyes with AC were enrolled in this study. All patients underwent a complete ocular examination, including evaluations of clinical manifestations of AC, corneal tomography and densitometry by Pentacam, corneal biomechanics by Corvis ST, and corneal and epithelial thickness mapping by RTvue optical coherence tomography (OCT). Results: The index of surface variance (ISV), index of vertical asymmetry (IVA), keratoconus index (KI), index of height decentration (IHD) and Belin/Ambrosio enhanced ectasia total deviation index (BAD-D) were significantly higher in the AC group than in the non-allergic conjunctivitis (NAC) group (P < 0.05). The tomography and biomechanical index (TBI) was also significantly higher in the AC group (P =?0.04). The average epithelial thickness in the 2–7?mm annulus was significantly thinner in the AC group than in the NAC group (P < 0.05). The average densitometry of the total cornea and the anterior layer were higher in the AC group than in the NAC group (P < 0.001). The ISV, IVA, KI, IHD and BAD-D were significantly correlated with the TBI and changes in corneal epithelial thickness in AC patients (P < 0.05). The changes in epithelial thickness were closely related to the eye rubbing frequency and allergic sign scores (P < 0.05). CONCLUSIONS: AC patients should be advised to routinely undergo corneal tomographic and biochemical measurements and the TBI could be used an indicator of KC devolopment risk in AC patients.

Persistent Neutrophil Infiltration and Unique Ocular Surface Microbiome Typify Dupilumab–Associated Conjunctivitis in Patients with Atopic Dermatitis

To elucidate the pathogenesis of dupilumab (Dupixent®)-associated ocular surface disease (DAOSD). Prospective single-center cohort study. Twenty patients with moderate-to-severe atopic dermatitis (AD) who received dupilumab and 10 age- and sex-matched healthy controls were enrolled in the study. The study cohort underwent a thorough slit-lamp and entire-body dermatologic examination. Conjunctival swabs and smears were collected at baseline, 4 and 16 weeks after treatment initiation, and during the conjunctivitis episode. To analyse the ocular surface microbiome, 16S ribosomal RNA sequencing was performed, smears were hematoxylin and eosin stained, and serum cytokines were measured by using a multiplex immunobead assay. Composition of ocular surface microbiome and cellular component as well as serum cytokine levels. Six of the 20 patients with AD developed DAOSD after dupilumab initiation; these patients responded after a delay to treatment as quantified by Eczema Area and Severity Index and Investigator's Global Assessment score. Conjunctival smears showed massive neutrophilic infiltration and serum analysis revealed increased systemic levels of neutrophil-priming proinflammatory cytokines, in particular interleukin-1β and tumor necrosis factor α, in patients with DAOSD compared with those without it. The ocular surface microbiome of patients with DAOSD was characterized by a diverse and persistent microbial colonization, particularly by Acetobacter aceti. In contrast, microbial diversity decreased in patients with AD without DAOSD after the initiation of dupilumab treatment, especially the abundance of Staphylococcus aureus. Invitro experiments substantiated the potential role of the microbiome, showing increased growth of A.aceti and decreased growth of S.aureus in presence of dupilumab. Persistent neutrophilic infiltration and a unique microbial landscape on the ocular surface associated with elevated levels of systemic proinflammatory cytokines typify DAOSD. Proprietary or commercial disclosure may be found after the references.

Isolation and identification Streptococcus pneumonia from contact lenses of conjunctivitis and keratitis patients with bacteria resistance to antibiotics

There are different methods for identification bacteria,we used culture methods,biochemical tests and molecular method,the aim of this study to decide the measure of efficient select gene for the recognition of the S. pneumonia by molecular tests -specific polymerase chain reaction(PCR),the assay targeting lytA gene from keratitis and conjunctivitis in patients and clients wearing contact lenses in several centers in Erbil city, the results showed that out of 12 investigated S.pneumoniae isolates by culture methods and biochemical testes ,lytA gene is found in 6(50%).all 6 of the positive lytA isolates encapsulated ,Norfloxacin and Seftazidime were the best antibiotics (100% ,83.3%) respectively, most infections was keratitis(cornal infections),in addition the majority of patients and clients were among females 78(60%),32(24.6)of patients and clients in the average age ranging from(15-20)years ,80(61.5%) of infections recoded of those who are putting cosmetic lens

Conjunctivitis Patients in the Ophthalmology Outpatient Clinic Dr. Soetomo General Academic Hospital, Surabaya, in 2017

Highlights:1. Ginger (Zingiber officinale) has antimicrobial activity against UPEC which commonly causes UTI in women.2. The MIC and MBC of ginger against UPEC in this study was 1000 mg/ml. AbstractIntroduction: Conjunctivitis is a self-limiting disease. It can be diagnosed through clinical signs found in the eye examination. The purpose of this study was to define the characteristics of conjunctivitis patients in the ophthalmology outpatient clinic Dr. Soetomo General Academic Hospital, Surabaya, in 2017.Methods: This was a retrospective descriptive observational study of all conjunctivitis patients from the medical history in the ophthalmology outpatient clinic Dr. Soetomo General Academic Hospital, Surabaya, in 2017.Results: There were 497 patients included in this study. Most patients with conjunctivitis were 0-9 years old (19.32%). The most common sign of conjunctivitis was conjunctival hyperemia (80.89%), followed by eye discharge (24.14%), eyelid edema (8.05%), blepharospasm (5.63%), and papillary hypertrophy (5.03%). Most cases of conjunctivitis were bilateral (58.75%). Conclusion: The majority of conjunctivitis was bilateral conjunctivitis. It commonly affects children under ten years old. The most typical finding was conjunctival hyperemia.

Investigating the Role of Adenovirus, Herpes Simplex 1, 2, and Varicella Zoster Virus in Incidence of Conjunctivitis in Tehran, Iran

"Conjunctivitis is one of the most common ocular diseases across the world. In this study, the prevalence of viral Conjunctivitis in patients who were referred to the Eye specialized Hospitals was evaluated. Some of the most important viruses that cause conjunctivitis are Human Adenoviruses (HAdV), Herpes Simplex 1, 2 (HSV-1, HSV-2), and Varicella Zoster Virus (VZV). The clinical diagnosis of eye viral infections is difficult and often controversial. Thus, research to experiment with these causative factors is of pivotal importance. In this cross-sectional study, 200 conjunctival swab samples were collected from symptomatic patients with signs of conjunctivitis who had been referred to two hospitals. After DNA extraction, Multiplex Real-Time PCR was carried out in two separate reactions for each sample. Among 200 collected samples, 34 (17%) and 8 (4%) were positive for Adenovirus and HSV-1 DNA, respectively. There were no HSV-2 and VZV conjunctivitis. No significant correlation was identified between gender and conjunctivitis (P-value: 0.845); however, there was a close correlation between age and conjunctivitis (Pvalue: 0.05). In this study, 66.3% of Adenoviral conjunctivitis occurs in the summer compared to 33.7% in spring. No significant seasonal variation was observed for HSV-1. Our results showed that adenovirus has a key role in causing viral conjunctivitis. "

Effect of Rosmarinus officinalis L. extracts on bacteria isolated from conjunctivitis in Kirkuk City, Iraq

Conjunctivitis is an eye disease that causes swelling or Conjunctival inflammation. It is one of the most common ocular diseases worldwide. This work aimed to study the effect of Rosmarinus officinalis (alcoholic and aqueous) extracts against isolated bacteria from conjunctivitis persons, further evaluation of the phytochemical test, antioxidant activity test, and sensitivity test for bacterial isolates. 50 samples were collected from conjunctivitis patients were visited private medical laboratories in Kirkuk city from 15 July to 1 December 2022 by using sterile transport swabs, planted into several culture media incubated under aerobic and anaerobic conditions at 37 ° C for 24-48 hr. diagnosed with biochemical tests and confirmed with the API system. Alcoholic and aqueous rosemary extracts were prepared with three concentrations 10%, 20%, and 30%. Three tests were conducted: sensitivity test, a phytochemical test, and an antioxidant activity test. Out of 50 samples, 31 (62%) were positive culture. While 19 cases gave a negative result to the culture. Staphylococcus aureus was the most prevalent (11 isolates). Then Streptococcus viridance (8 isolates), Pseudomonas aeroginosa was prevalent (7 isolates), (3 isolates) of E. coli and Klebsiella pneumonia was (2 isolates). Regarding the extracts' inhibitory effect, the alcoholic extract was effective in strains than aqueous extract, and the inhibitory activity increased with increasing concentrations. Gram-positive bacteria were more susceptible to extracts of rosemary than Gram-negative bacteria. Staphylococcus aureus was shown to be the most sensitive to rosemary extracts, while Pseudomonas aeroginosa was found to be the least sensitive. The phytochemical reaction in alcohol extract revealed 8 phytochemical components, whereas revealed 5 phytochemical components in aqueous extract. In addition, alcohol extract had higher antioxidant activity than aqueous extract.

A clinical pharmacological experimental research analysis of the evidence-based rational pharmacotherapeutics of pefloxacin and newer quinolones

Background: Pefloxacin is a newer broad-spectrum bactericidal fluoroquinolone antibiotic, with superior antibacterial activity in vivo against pathogenic ocular gram-negative and anaerobic microorganisms and better pharmacokinetic properties.Methods: 100 bacterial conjunctivitis patients were prescribed topical pefloxacin 0.3% ophthalmological drops monotherapy, 2 drops in each eye after every 3 hours for 2 days, and 2 drops in each eye after every 6 hours for next 5 days. The overall recovery of the patients was clinically examined and assessed. The patients who did not recover completely with 0.3% pefloxacin monotherapy ophthalmological drops, were administered topical pefloxacin 0.3% ophthalmological drops, 2 drops in each eye after every 6 hours for the next 3 days, as combination therapy, with other required ophthalmological eye drops, depending on the prognostic follow-up, on days 0, 3, 5, 7, 10, 15, 30, and on further follow-ups. The evidence-based rational pharmacotherapeutic patient percentage topical application requirements of 0.3% pefloxacin ophthalmological drops monotherapy and subsequent combination therapy for complete recovery from bacterial conjunctivitis was thoroughly analysed and assessed.Results: In this study, the patient percentage topical application requirements of pefloxacin 0.3% ophthalmological drops monotherapy and combination therapy in bacterial conjunctivitis patients showed that 93% patients had completely recovered with pefloxacin monotherapy, and 7% patients required pefloxacin combination therapy for complete recovery. The evidence-based rational pharmacotherapeutics of newer quinolones, in global multi-centre tertiary care hospitals, was also well characterized and analytically described.Conclusions: Therefore, 93% patients had completely recovered with the ocular antibiotic pefloxacin 0.3% ophthalmological drops monotherapy, and 7% patients required pefloxacin combination therapy for complete recovery. The evidence-based rational pharmacotherapeutics of newer quinolones was also distinctly delineated.

Neuropathic pain and itch: mechanisms in allergic conjunctivitis.

Allergic conjunctivitis is highly prevalent and affects up to one third of the general population. The current understanding of the pathophysiology and therapeutic strategies center around the type 2 inflammatory pathway. However, there is an increasing body of evidence that suggests neurogenic mechanisms also play a role in allergic inflammation, with a substantial proportion of allergic conjunctivitis patients experiencing both ocular itch and pain. Unmyelinated C fibres on the ocular surface transmit histaminergic itch and can be directly activated by mast cell mediators. The conjunctival mucosa also contains TRPV1+ (histamine-dependent) and TRPA1+ (histamine-independent) neurons that enhance ocular pain and itch in allergic conjunctivitis. Allergen-complexed IgE also binds directly to FcεRI expressed on peripheral neurons. Environmental aeroallergens can also directly stimulate neuronal nociceptors to release inflammatory substances. Allergic inflammation thus stimulates nerve terminals to release vasoactive and inflammatory neuropeptides, leading to a cyclical neuronal dysregulation that augments mast cell activity. These repetitive cycles lead to both peripheral and central sensitization and neuronal plasticity, resulting in decreased itch/pain thresholds and a heightened itch/pain response. Neurogenic mechanisms including peripheral and central sensitization may drive chronic ocular itch and pain secondary to allergic inflammation. Research into these pathways may help to identify therapeutic targets in allergic conjunctivitis patients with refractory symptoms.

A rational pharmacovigilance safety appraisal of topical pefloxacin 0.3% ophthalmological drops in bacterial conjunctivitis, in global multi-centre tertiary care hospitals

Background: Pefloxacin is a newer broad-spectrum bactericidal fluoroquinolone antibiotic, with superior antibacterial activity in vivo against pathogenic ocular gram-negative and anaerobic microorganisms and better pharmacokinetic properties. The objective of this clinical research study was the rational pharmacovigilance safety appraisal of topical pefloxacin 0.3% ophthalmological drops in bacterial conjunctivitis, in global multi-centre tertiary care hospitals.Methods: The 43 bacterial conjunctivitis patients were prescribed topical pefloxacin 0.3% ophthalmological drops, 2 drops in each eye after every 3 hours for 2 days, and 2 drops in each eye after every 6 hours for next 5 days. The pharmacovigilance safety appraisal was performed by monitoring the occurrence of adverse drug reactions, like, transient ocular burning or discomfort, ocular irritation, redness, stinging, pruritis, photophobia, ocular watering and dryness, and recording in Adverse Event Case Report Forms, on days 0, 3, 5, 7, 10, 15, 30, and on further follow-ups.Results: In this study, the safety assessment showed that only 1 patient had ocular discomfort in the eye. The occurrence of adverse effects was statistically non-significant. Thus, 0.3% pefloxacin ophthalmological drops treatment was safe and tolerable, among all 43 patients.Conclusions: Therefore, pefloxacin is a safe ocular antibiotic for treating bacterial conjunctivitis, with adequate drug tolerability exhibited by the patients.

Effect of allergic conjunctivitis on central corneal thickness and intra ocular pressure

To study effect of allergic conjunctivitis on central corneal thickness and intra ocular pressure. This was a case control study which included 35 eyes of 20 patients with allergic conjunctivitis compared with 35 eyes of 35 patients of age and sex matched controls. Participants were subjected to complete ophthalmic examination including central corneal thickness(CCT) and intra ocular pressure(IOP) which were measured using ultrasound pachymeter and goldmann’s applanation tonometer respectively.Comparision of the data between the two groups was done using t test. The mean age in the study group was 25.23±9.2 years with 60% of the study group constituting male patients indicating male preponderance. Best corrected visual acuity (BCVA) in both groups was 6/24 or better which did not show any statistically significant difference (p>0.05). Mean CCT in the study group was 521.77±5.9µm whereas in the control group was 542.62 ± 5.42 µm which showed statistically significant difference between the two groups (t = 15.396, p < 0.0001). The mean IOP in the study group was 17.08 ± 1.8 mm of hg and the in the control group was found to be 11.79 ± 1.79 mm of hg which did not show any statistically significant difference(p>0.05). Central corneal thickness was significantly reduced in the allergic conjunctivitis patients compared to controls and IOP did not show any statistically significant difference.

Occurrence of Bacterial Conjunctivitis and Viral Conjunctivitis in Pakistan

Aim: To identify the prevalence of bacterial and viral conjunctivitis. Study design: Prospective study. Place and Duration of Study: Department of Ophthalmology, Pakistan Railways Hospital, Islamic International Medical College, Rawalpindi from 1st April 2021 to 30th September 2021. Methodology: Fifty conjunctivitis patients enrolled within age of 14-29 years. Clinical examination, slit lamp test and lab testing separated cases as viral or bacterial conjunctivitis. Polymerase chain reaction post culturing was sued in viral conjunctivitis cases while Kirby-Baur disc diffusion assay was sued in bacterial conjunctivitis confirmation. Results: There were 91.17% patients with viral conjunctivitis in age of 24-29 years and 62.5% patients with bacterial conjunctivitis within 14-18 years. The odds ratio value between the male and female gender showed a significant difference between both genders with 95% confidence interval with higher female frequency in both. Coronavirus cases were highest with 52.9% while cases of Micrococciwere highest as 37.5% with conjunctivitis. Conclusion: Viral conjunctivitis was more common in general cases due to recent covid-19 infection followed by Micrococci bacterial conjunctivitis. Keywords: Allergic conjunctivitis; Bacterial conjunctivitis; Children; Vision Impairment

Clinical Efficacy and Safety of Artesimia annua-Sublingual Immunotherapy in Seasonal Allergic Rhinitis Patients Based on Different Intervention Time

Introduction: Artemisia is a major kind of grass pollen in Northern China that can cause multiple kinds of common allergic diseases, such as allergic rhinitis (AR), conjunctivitis, or asthma. Recently, Artemisia annua Allergens Sublingual Immunotherapy Drops have been proved effective and safe for treating seasonal AR (SAR) with or without allergic conjunctivitis patients and were available in China. We sought to further investigate the different intervention times of A. annua-sublingual immunotherapy (SLIT) for evaluating efficacy and safety in patients with SAR. Methods: A total of 88 subjects aged 18–52 years with SAR were enrolled and randomized into the SLIT group and control group. Forty-five patients received a course of SLIT with A. annua extracts along with pharmacotherapy as SLIT group and 43 patients only used symptomatic drugs as control group. Furthermore, SLIT group was randomly divided into 12–13 weeks’ pre-seasonal treatment group and 8–9 weeks’ pre-seasonal treatment group to receive different duration of SLIT before pollen season. Monosensitized and polysensitized groups were also the subgroups of SLIT group according to the sensitization status of patients. The combined symptom and medication score (CSMS), total nasal symptom score (TNSS), total medication score (TMS), visual analog score (VAS) were evaluated during the peak pollen phase in 2020 and 2021, respectively. Safety was assessed according to adverse events (AEs) reported. Results: Compared to control group, CSMS, TNSS, TMS, VAS were significantly improved during the course of SLIT (p < 0.001). Besides, clinical improvement in nasal symptoms and reduction of medication use was also observed in SLIT group, compared to the baseline value (p < 0.001). Meanwhile, we observed that there was no significant difference between monosensitized group (n = 8) and polysensitized group (n = 29), as well as 12–13 weeks’ preseasonal treatment group (n = 20) and 8–9 weeks’ pre-seasonal treatment group (n = 17) belonging to the SLIT group in clinical efficacy (p > 0.05). No severe systemic AEs were reported. Conclusions: This study proved that A. annua-SLIT can provide equivalent efficacy and safety for SAR patients under the circumstance of accepting the pre-seasonal treatment of 8–9 or 12–13 weeks, regardless of monosensitization or polysensitization.