Symptoms Of Conjunctivitis Research Articles

Survey of state conjunctivitis policies for school-age students

To examine state policies regarding school-age students with conjunctivitis. Analysis included the following evidence: publicly available policies for disposition of affected students; indications for exclusion and return to classroom; and completeness of information, including mention of different etiologies of conjunctivitis; signs and symptoms of viral versus bacterial conjunctivitis; student disposition and treatment based on etiology; internally consistent recommendations; reference to credible resources; and mention of the possibility of a conjunctivitis outbreak. Fifteen of 50 states have no policies. Ten states allow students to remain in school, 5 allow return 24 hours after initiation of antibiotic treatment, and 5 require physician approval. Seventeen states and Washington, DC, offer little detail or internally inconsistent recommendations, such as choice of antibiotic use or provider note. Twelve policies are thoroughly presented. Twenty-three states refer to sources like the Centers for Disease Control and Prevention and the American Academy of Pediatrics. No policy references the American Academy of Ophthalmology. State policies on conjunctivitis in students vary widely. Antibiotic use as a prerequisite for return to school has drawbacks of cost to parents, increasing antibiotic resistance, and lack of efficacy against nonbacterial etiologies, for example, viral conjunctivitis. Publicly available information and guidelines could be improved, aiming for fewer absentee days, reduced outbreak risk, and reduced risk of antibiotic resistance.

Experience in the use of antiviral drugs in the treatment of conjunctivitis in COVID–19

The study presents the effect of the drug Favipiravir in the complex therapy of conjunctivitis caused by COVID–19. The diagnosis of coronavirus infection was confirmed by positive PCR tests; the severity was assessed based on fluoroscopic examination of the lungs and computed tomography. To treat eye symptoms of conjunctivitis caused by SARS-CoV-2, antiviral drugs have been used: Acyclovir, Ophtalmoferon, and Favipiravir. The authors have shown that treatment with Favipiravir in combination with antiviral drugs reduces the duration of treatment by 1.86 times in patients of group 2 compared to patients of the first group who were treated with acyclovir and Оphthalmoferon. The high effectiveness of treatment of conjunctivitis with Favipiravir is due to the mechanism of its tropic action in relation to RNA-containing viruses, due to its ability to integrate into the RNA chain of the COVID-19, inhibiting its RNA-dependent RNA polymerase and disrupt the replication of the coronavirus. In addition, Favipiravir induces lethal RNA transversion mutations, leading to the death of the virus. The prolongation of the duration of treatment of conjunctivitis in patients of the first group can be explained by the effect of Аcyclovir, aimed at inhibiting viral DNA polymerase and blocking the synthesis of viral DNA, while the COVID-19 belongs to a single-stranded RNA-containing virus, despite the action of Оphthalmoferon, which can disrupt the reproduction of the virus by interacting with specific membrane receptors, the CD147 protein of the conjunctival epithelium.

Prevalence of Bacterial Conjunctivitis and Allergic Conjunctivitis in Pakistan

Objective: To find the prevalence of bacterial conjunctivitis and allergic conjunctivitis in Pakistan. Study Design: Prospective study Place and Duration of Study: Department of Ophthalmology, People Medical College Hospital Nawabshah from 1st January 2019 to 30th June 2019. Methodology: One hundred patients age between 8-15 years were enrolled depending upon their clinical symptoms of conjunctivitis. Each patient sample was then taken though conjunctival swab test and sent to laboratory for confirmation. Allergic conjunctivitis and bacterial conjunctivitis were identified with slit lamp examination, while Allergic conjunctivitis was confirmed through presence of the papillae in the upper portion of the tarsal conjunctiva correlating with the clinical symptoms of the patient. Results: The mean age of the patients was 13.3±3.4 years. The allergic conjunctivitis was observed in 18.18% of total examined cases while 12.72% had bacterial conjunctivitis. The odds ratio between boys and girls with 95% Confidence interval showed no significant variance between allergic conjunctivitis and bacterial conjunctivitis patients. Within the bacterial conjunctivitis positive cases majority of the patients suffered from staphylococcus aureus followed by hemophilic influenzae. Conclusion: Significant cases of allergic and bacterial conjunctivitis were found. Keywords: Allergic conjunctivitis; Bacterial conjunctivitis; Children; Vision Impairment

Therapeutic Efficacy of Topical Olopatadine 0.1% Versus Ketotifen Fumarate in Allergic Conjunctivitis

Objective: To compare the therapeutic efficacy of topical Olopatadine 0.1% versus Ketotifen Fumarate among the patients diagnosed with allergic conjunctivitis at Armed forces institute of ophthalmology.
 Study Design: Prospective comparative study.
 Place and Duration of Study: Armed forces Institute of Ophthalmology, Rawalpindi, from Jan 2020 to Jan 2021.
 Methodology: Patients diagnosed with allergic conjunctivitis by consultant ophthalmologist fulfilling the exclusion/inclusion criteria were included in the study. They were divided into two groups by block randomization with group A receiving Olopatadine 0.1%, while group B just received the Ketotifen Fumarate. Symptoms were assessed on a symptom severity score upon diagnosis before the start of medication and then after 72 hours of treatment by a different consultant ophthalmologist who was unaware of the group of patients.
 Results: A total of 100 patients were included in each group. The mean age of the study participants was 30.944 ± 3.349 years. 148 (74%) patients were males while 52 (26%) were females. The difference in mean score of symptoms in group A was 5.76 ± 1.39 while in group B was 3.33 ± 2.51. Application of t-test revealed that topical Olopatadine 0.1% was superior to Ketotifen Fumarate in reducing the symptoms of acute allergic conjunctivitis on the third day of treatment (p-value<0.001).
 Conclusion: Seasonal allergic conjunctivitis was the commonest type of allergic conjunctivitis seen in our study participants. Topical Olopatadine 0.1% emerged as a better treatment option when compared to Ketotifen Fumarate for immediate management of acute allergic conjunctivitis among patients managed at a tertiary...................

Comparison of efficacy of topical alcaftadine (0.25%) versus olopatadine (0.1%) in allergic conjunctivitis

The most common atopic ocular condition in clinical practice is allergic conjunctivitis. One of the preferred treatment options for allergic Conjunctivitis is anti histamines eye drops. The study purpose is to compare the clinical efficacy between topical alcaftadine 0.25% and olopatadine hydrochloride 0.1% in allergic conjunctivitis patients.A prospective, randomized, open label, parallel group, comparative study was conducted on 60 Patients with bilateral allergic conjunctivitis (30 in each group) after taking an informed written consentand was evaluated from May 2018 to November 2018. Patients were randomized into 2 groups of 30 each, group A received topical Alcaftadine 0.25% twice daily and patients in Group B received topical olopatadine hydrochloride 0.1% twice daily for 2 weeks. The patients were evaluated on first visit (baseline) followed by 7 and 14 day after starting the treatment. At each visit signs and symptoms were evaluated and rated using a scale from 0-3(0-Absent, 1- mild, 2 moderate and 3- severe). The change from baseline in the mean scores of itching, hyperemia, photophobia and tearing on day 14 is the primary outcome variable.: The signs and symptoms of allergic conjunctivitis were reduced by 2 weeks from baseline after using both the drugs. Relative significant efficacy was achieved in alcaftadine group for Itching, hyperemia and photophobia, but not for tearing (p=0.3). When compared to 0.1% olopatadine hydrochloride, 0.25% alcaftadine is more effective in reducing the symptoms of all types of allergic conjunctivitis except those mentioned in exclusion criteria.

Reproxalap Improves Signs and Symptoms of Allergic Conjunctivitis in an Allergen Chamber: A Real-World Model of Allergen Exposure

PurposeTo assess the prophylactic and treatment activity of reproxalap, a novel reactive aldehyde species inhibitor, in a real-world model of allergen exposure.MethodsIn a randomized, double-masked, vehicle-controlled, crossover Phase 2 trial, 70 adult patients with ≥2 years of moderate to severe allergic conjunctivitis history, a positive skin test to ragweed pollen, and allergen chamber-induced ocular itching and redness scores of ≥2.5 and ≥2 (both scales range from 0 to 4), respectively, were randomized 1:1:1 to one of three sequences: 0.25% reproxalap, 0.5% reproxalap, and placebo; 0.5% reproxalap, placebo, and 0.25% reproxalap; or placebo, 0.25% reproxalap, and 0.5% reproxalap. Symptoms and conjunctival redness were assessed over 3.5 hours in an allergen chamber of aerosolized ragweed pollen (3500 grains/m3). Test article was administered bilaterally just before chamber entry and at 90 minutes after chamber entry.ResultsReproxalap was safe and well tolerated; 66 of 70 enrolled patients completed all visits. Relative to vehicle, both concentrations of reproxalap demonstrated statistically significant and clinically relevant improvements in ocular itching, tearing, and redness over the duration of exposure in the chamber (P < 0.001 for all assessments). Prophylactic and treatment activity of drug were demonstrated.ConclusionIn an allergen chamber, reproxalap, a novel reactive aldehyde species inhibitor, was statistically superior to vehicle across the typical symptoms and signs of allergic conjunctivitis. These data are among the first rigorous clinical results demonstrating drug improvement in allergic conjunctivitis in an allergen chamber, a real-world model of allergen exposure.

Management of Vataja abhishyanda (Allergic conjunctivitis) with Gutika anjana and Punarnavadi eye drops: A comparative clinical study

Background: Vataja Abhishyanda is characterized by Toda (Pricking pain), Sangharsha (foreign body sensation), Achchasruta (watery discharge), Alpa Shopha (mild chemosis), Vishushka Bhava (feeling of dryness), Parushya (roughness) etc which are very similar to the most of signs and symptoms of the Allergic Conjunctivitis. It is one of the most common type of eye allergy and is widely experienced by global population. Aims and Objective: . To evaluate and compare the efficacy of Punarnavadi eye drops and Gutika Anjana in the management of Vataja Abhishyanda(Allergic conjunctivitis). Materials and methods: Total 104 patients diagnosed with symptoms and signs of Vataja Abhishyanda were selected from the outpatient department of Shalakya tantra. The selected patients were assigned randomly into two groups, group A (Punarnavadi eye drop) having 51 and group B (Gutika Anjana) having 50 patients. Duration of treatment was 8weeks with follow up for one month after the trial. Result: In Group A, 96.08% got complete relief after the completion of treatment, 03.92% got marked improvement. In Group B, 98% got complete relief after the completion of treatment, 2% got marked improvement. Conclusion: Gutika Anjana shows better relief in all sign and symptoms on the basis of percentage. The reason may be Anjana has maximum absorption due to more contact of time with the tissue which is responsible for better bioavailability.

Susceptibility of herons (family: Ardeidae) to clade 2.3.2.1 H5N1 subtype high pathogenicity avian influenza virus

ABSTRACT The pathogenicity of the H5 subtype high pathogenicity avian influenza viruses (HPAIVs) in Ardeidae bird species has not been investigated yet, despite the increasing infections reported. Therefore, the present study aimed to examine the susceptibility of the Ardeidae species, which had already been reported to be susceptible to HPAIVs, to a clade 2.3.2.1 H5N1 HPAIV. Juvenile herons (four grey herons, one intermediate egret, two little egrets, and three black-crowned night herons) were intranasally inoculated with 106 50% egg infectious dose of the virus and observed for 10 days. Two of the four grey herons showed lethargy and conjunctivitis; among them, one died at 6 days post-inoculation (dpi). The viruses were transmitted to the other two cohoused naïve grey herons. Some little egrets and black-crowned night herons showing neurological disorders died at 4–5 dpi; these birds mainly shed the virus via the oral route. The viruses predominantly replicated in the brains of birds that died of infection. Seroconversion was observed in most surviving birds, except some black-crowned night herons. These results demonstrate that most Ardeidae species are susceptible to H5 HPAIVs, sometimes with lethal effects. Herons are mostly colonial and often share habitats with Anseriformes, natural hosts of influenza A viruses; therefore, the risks of cluster infection and contribution to viral dissemination should be continuously evaluated. RESEARCH HIGHLIGHTS Clade 2.3.2.1 H5N1 HPAIV causes lethal infections in Ardeidae sp. Viruses are transmitted among grey herons. Some herons with HPAIV showed conjunctivitis or neurological symptoms. HPAIV systemically replicated in herons tissues.

Optimization of a histamine-induced allergic conjunctivitis model in Guinea pigs

Allergic conjunctivitis is one of the most common immune diseases in the field of ophthalmology. The number of patients suffering from allergic conjunctivitis has been increasing, and there is still a strong need for development of therapeutic agents for this disease. In drug development, the utmost important point to improve the success probability is to accurately single out good compounds in the early stage of drug development. Therefore, drug efficacy evaluations in the nonclinical stage should be conducted with high reliability and accuracy. However, there are no literatures investigating the preparation and evaluation methods of animal models of conjunctivitis in details nor the standardized criteria.In this study, we verified the reproducibility of an animal model in the previous report and made improvements in test methods focusing on a guinea pig model of histamine-induced allergic conjunctivitis. Furthermore, the drug efficacy evaluation was conducted using a commercially available antihistamine drug, levocabastine hydrochloride, to judge the suitability of the improved model.As a result, the dose level of histamine needed to be increased to use the existing model for drug efficacy evaluation, but allergic-like symptoms were induced very easily and stably in this model. For observations of symptoms of conjunctivitis, we eliminated ambiguity of evaluation by adopting the Draize scale and ensured a higher objectivity on the evaluation method. The drug efficacy evaluation of levocabastine hydrochloride in the prepared model revealed that drug efficacy of the antihistamine drug was captured according to the standardized test method and highly-reproducible results were obtained.

Diagnostic accuracy of clinical signs, symptoms and point-of-care testing for early adenoviral conjunctivitis

ABSTRACT Clinical relevance This study identifies key signs and symptoms of acute conjunctivitis, that when combined with a point-of-care test, can improve clinician accuracy of diagnosing adenoviral conjunctivitis. Background Adenoviral conjunctivitis is a common ocular infection with the potential for high economic impact due to widespread outbreaks and subsequent furloughs from work and school. In this report, we describe clinical signs and participant-reported symptoms that most accurately identify polymerase chain reaction (PCR)-confirmed adenoviral conjunctivitis. Methods Adults with ‘red eye’ symptoms of four days or less were enrolled. Participants rated 10 ocular symptoms from 0 (not bothersome) to 10 (very bothersome), and indicated the presence or absence of systemic flu-like symptoms. Clinicians determined the presence or absence of swollen lymph nodes and rated the severity of eight ocular signs using a 5-point scale. An immunoassay targeting adenovirus antigen was utilised for the point-of-care test, and conjunctival swab samples were obtained for subsequent adenovirus detection by PCR analyses. Univariate and multivariate logistic regression models were used to identify symptoms and signs associated with PCR-confirmed adenoviral conjunctivitis. The diagnostic accuracy of these clinical findings, and the potential benefit of incorporating point-of-care test results, was assessed by calculating areas under the receiver operating characteristic curves (AUC). Results Clinician-rated bulbar conjunctival redness, participant-rated eyelid swelling and overall ocular discomfort had the best predictive value in the multivariate logistic regression model with an AUC of 0.83. The addition of the point-of-care test results to these three clinical sign/symptom scores improved diagnostic accuracy, increasing the AUC to 0.94. Conclusions Conjunctival redness severity and participant-reported eyelid swelling and overall discomfort, along with adenoviral point-of-care test results, were highly predictive in identifying individuals with PCR-confirmed adenoviral conjunctivitis. Improved diagnostic accuracy by clinicians at the initial presenting visit could prevent unnecessary work furloughs and facilitate earlier treatment decisions.

Ayurveda Consideration of Abhishyanda and its Management: A Review

Abhishyanda is considered as Sarvagata Netraroga which is a dreadful disease and possess symptoms of conjunctivitis as per the modern science. The inflammation of conjunctiva mainly occurs in Abhishyanda which can spread through Rakta. Abhishyanda if not cured then it can causes Adhimanth associated with acute pain. The other complication may includes Sandhigat roga, Shuklagat roga, Krishnagat roga and Vartmagat roga, etc. Abhishyanda is put as disease amongst the seventeen Sarvagat rogas. Ayurveda classics mentioned various types of Abhishyanda including Vataja Abhishyanda, Pittaja Abhishyanda, Kaphaja Abhishyanda and Raktaja Abhishyanda. The disease involves Kledana in Doshas and Dhatu due to which profuse discharge comes out from the eye. Therefore excessive discharge from eye is the major feature of Abhishyanda. Ayurveda described different approaches such as Anjana, Pariseka, Pralepa, Aschyotana, Tarpana, Sweda and Putpaka for the management of various Netraroga. Some ayurveda formulations and herbs also offers relieves in the symptoms of Abhishyanda.

Symptoms and signs of conjunctivitis as predictors of disease course in COVID-19 syndrome

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can induce conjunctivitis signs and symptoms. However, limited information is available on their impact on COVID-19 disease phenotype. Quantification of ocular signs/symptoms can provide a rapid, non-invasive proxy for predicting clinical phenotype. Moreover, the existence and entity of conjunctival viral shedding is still debated. This has relevant implications to manage disease spread.The purpose of this study was to investigate conjunctivitis signs and symptoms and their correlation with clinical parameters, conjunctival viral shedding in patients with COVID-19.MethodsFifty-three patients hospitalized between February 25th and September 16th, 2020 at the San Raffaele Hospital, in Milan, Lombardy, Italy with a confirmed diagnosis of SARS-CoV-2 were evaluated. Presence of interstitial pneumonia was confirmed with computed tomography scan imaging. Ocular signs and symptoms, anosmia/ageusia, clinical/laboratory parameters, and reverse transcriptase–polymerase chain reaction (RT-PCR) from nasopharyngeal and conjunctival swabs for COVID-19 virus were analyzed.ResultsForty-six out of 53 patients showed a positive nasopharyngeal swab for SARS-CoV-2 infection at the time of conjunctival evaluation. All the conjunctival swabs were negative. Conjunctivitis symptoms were present in 37% of patients. Physician-assessed ocular signs were detected in 28% of patients.Patients with ocular symptoms or signs tended to be older: 76.8 years (62.4–83.3) vs 57.2 years (48.1–74.0), p = 0.062 and had a longer hospitalization: 38 days (18–49) vs. 14 days (11–21), p = 0.005. Plasma levels of Interleukin-6 were higher in patients with signs or symptoms in comparison with those without them: 43.5 pg/ml (19.7–49.4) vs. 8 pg/ml (3.6–20.7), p = 0.02. Red cell distribution width was also significantly higher: 15 (14.3–16.7) vs 13.2 (12.4–14.4), p = 0.001.ConclusionsWe found that over a third of the patients had ocular signs or symptoms. These had higher prevalence in patients with a more severe infection. No viral shedding was detected in the conjunctiva. Our results suggest that prompt detection of conjunctivitis signs/symptoms can serve as a helpful proxy to predict COVID-19 clinical phenotype.

44-Year-Old Woman With Fever, Sore Throat, and Polyarthralgia

In early 2019, a 44-year-old woman with no pertinent comorbidities presented to the clinic with a 4-day history of fever, chills, sore throat, joint and muscle pain, swelling on the right side of her neck, and odynophagia. She denied symptoms of hoarseness, conjunctivitis, coryza, cough, and urethritis. She denied smoking, alcohol use, and illicit drug use, was in a monogamous relationship, and took no medications. On physical examination, the patient was febrile to 38.1°C, with a heart rate of 100 beats/min and regular rhythm, a blood pressure of 108/68 mm Hg in the right arm sitting, a respiratory rate of 18 breaths/min, and a saturation level of 99% on room air.

Effects of omalizumab on allergic conjunctivitis.

To evaluate the effect of subcutaneous omalizumab therapy on the allergic conjunctivitis symptoms of patients being treated for asthma. A total of 84 eyes of 42 patients who were receiving subcutaneous omalizumab therapy for asthma and complained of allergic conjunctivitis symptoms underwent complete ophthalmic examination. All of the patients were graded according to signs and symptoms and duration of symptoms, evaluated using an ocular severity index (SI) and quality of life questionnaires. Immunoglobulin E (IgE) levels and both initial and final %FEV1 (forced expiratory volume in the first second) values were also evaluated. p values < 0.05 were accepted as statistically significant. The study included 36 women (85.7%) and 6 men (14.3%) with a mean age of 54.5 ± 10.8years. The mean duration of omalizumab therapy was 46 ± 30.9months. There were statistically significant changes between initial and final values for ocular SI, quality of life, subjective symptom frequency and severity and %FEV1. Final values of SI, quality of life, and symptom severity and frequency were statistically significantly lower compared to initial values, while final %FEV1 was statistically significantly higher compared to initial value (p < 0.001). Omalizumab therapy for asthma had a favorable effect on the patients' allergic conjunctivitis symptoms and decreased parameters related to ocular disease severity, improved quality of life and increased %FEV1values. 2019/5-5, Trial Registration Date: 28/03/2019, Retrospectively registered.

Ragweed pollen induces allergic conjunctivitis immune tolerance in mice via regulation of the NF-κB signal pathway.

To investigate the feasibility and mechanism of immune tolerance in allergic conjunctivitis. The allergic conjunctivitis immune tolerance mice model was established by ragweed pollen (RW) and the related cytokines were detected. The mice were divided into 9 groups and the maslinic acid (MA) or PBS were given for different group after modeling. The expression levels of chemokine ligand 5 (CCL5) and P-65 in the conjunctival tissue were analyzed by immunohistochemistry, quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blot. The percentage of interleukin-17 (IL-17) and CD4+CD25+ in the splenocyte supernatant was analyzed by flow cytometry. Furthermore, the serum and splenocyte supernatant concentration of total-IgE, interleukin-10 (IL-10), and IL-17 was analyzed by enzyme linked immune response (ELISA). After the model was established, symptoms of conjunctivitis were alleviated, the level of P-65, CCL5, IL-17, and total-IgE was raised, while the expression of IL-10, CD4+CD25+ was decreased. This result fully demonstrated that a typical IL-17/regulatory-T-cells (Treg cells) imbalance and NF-κB activation. When the NF-κB signal pathway was suppressed, it showed that there was a further relief of conjunctivitis in mice. At the same time, the expression of total-IgE, IL-17, and CCL5 was decreased and the expression of anti-inflammatory factor (IL-10, CD4+CD25+) was increased. In the state of immune tolerance, symptoms of conjunctivitis in mice are alleviated, the Th-17 cells of allergic conjunctivitis mice are inhibited, and Treg cells activity is enhanced.

Otorhinolaryngological manifestations of COVID-19

COVID-19 manifests itself in a wide spectrum of clinical symptoms, both in terms of their variety and severity. It can be asymptomatic or abortive, mild, moderate, severe and lightning, as septic with multiple organ failure and shock Typical leading symptoms of COVID-19 are: high fever poorly responding to drugs, severe loss of strength, chest pain, dyspnoea, pain headaches, bone and joint pain and muscle pain, until the onset of acute respiratory distress syndrome (ARDS). However, many publications mention among the possible symptoms also others, not related to the involvement of the lower respiratory tract. These are gastrointestinal disorders, damage to the central and peripheral nervous system, catarrh of the upper respiratory tract and dysfunctions of the sensory organs. The aim of this literature review was to determine the frequency of various head and neck dysfunctions that are part of COVID-19. Symptoms of conjunctivitis, nasal mucosa, pharynx and larynx are reported by about of patients, but they do not always occur at the same time, as in infections caused, for example, by rhinoviruses. Anosmi / hyposmia or ageusia / hypogeusia occur with a similar frequency. Symptoms of damage to the equilibrium system, such as dizziness, are reported by approx. 1/3, vertigo and hearing loss approx. 5-6%, tinnitus approx. 10% of patients. Reports of coexistence with COVID-19 of peripheral paresis of the facial nerve are so far relatively few and often included in the neurological disorders, the frequency of which is also about 1/3 of COVID-19 cases. Importantly, both catarrhal symptoms and the others listed here may precede, co-occur or follow the appearance of the leading symptoms of COVID-19. They can also be the only symptoms of this disease. This should prompt otorhinolaryngologists to be particularly vigilant in this regard

English

BACKGROUND Allergic conjunctivitis (AC) is a common eye condition that is frequent in childhood. The prevalence of allergic diseases in children aged 6 to 14 years varies significantly from 0.3 % to 20.5 %, and is gradually increasing.1 It is associated with several allergic diseases affecting the ocular surface and it is the most common ocular condition encountered in clinical practice. This study was conducted to determine the prevalence, ocular manifestations of allergic conjunctivitis, and associated comorbidities among school-going children in Western Odisha. METHODS A total of 1502 children from 10 schools of Burla, participated in this crosssectional observational study. Data collection started in September 2018 up to September 2019. All the children underwent meticulous history taking for symptoms of allergic conjunctivitis and any other associated comorbidities, a structured validated questionnaire was used to collect demographic and medical data. Visual assessment, and slit-lamp examination were done to look for signs of allergic conjunctivitis and any associated complications. Interpretation and data analysis was done using Epi Info Software and a chi-square test was used to analyse significant associations among categorical variables. RESULTS The prevalence of allergic conjunctivitis was found to be 29.16 % with a males to female ratio of 1.02: 1. Children aged 13 – 16 years recorded the highest number of cases which was 43.60 %. The commonest presenting symptom was itching (100 %), Papillae were the most frequent sign (97.71 %), Seasonal allergic conjunctivitis (SAC) was the most common type of AC reported (59.36 %), and allergic rhinitis (17.8 %) was the most common associated comorbidity. CONCLUSIONS The prevalence of Allergic conjunctivitis is high among children aged 5 - 16 yrs. There is a lack of treatment seeking behaviour inspite of such high frequency. Early identification &amp; treatment of patients would help curb complications, improve the child’s quality of life and thus the ophthalmic health of the community. KEYWORDS Allergic Conjunctivitis, Ocular Comorbidities, SAC

SARS-COV2 Virus in Tears and Conjunctival Secretions of COVID-19 Patients

Purpose: To determine the presence of SARS-COV 2 viruses in tears and conjunctival secretions of patients with diagnosed COVID-19.&#x0D; Study Design: Prospective interventional case series.&#x0D; Place and Duration of Study: Rawalpindi Institute of Urology, Department of infectious diseases, Holy Family Hospital, Rawalpindi Medical University, from September 2020 to October 2020.&#x0D; Methods: Samples of conjunctival and tear secretions were collected from 60 hospitalized patients of COVID-19 who were confirmed with nasopharyngeal swabs test. Disposable conjunctival swab sticks were used for sampling. Samples were taken within 3 days of admission. SARS-COV 2 virus evaluation in tears and conjunctival secretions was done by Qualitative RT-PCR (Reverse transcriptase polymerase chain reaction) analysis. Ocular features were documented. Regarding systemic course of illness, details were noted from their hospital records.&#x0D; Results: Mean age of the patients was 56.63 ± 16.373 years. Out of 60 patients, 42 were males and 18 were females. Twenty two (36.6%) patients had mild disease and moderate and severe disease was present in 19 patients (31.6%) each. Six (10%) patients had positive conjunctival and tear secretions for SARS-COV 2 viral RNA. All patients with positive ocular secretions for viral RNA were in first week of course of disease and 3 patients had severe COVID 19 disease signifying high viral load. Only one patient had conjunctivitis and ocular symptoms of redness and foreign body sensation.&#x0D; Conclusion: There is likelihood of SARS-COV 2 virus transmission via ocular secretions as frequency of patients with SARS-COV 2 viral RNA detected in tears was 10% in current study therapeutic services.&#x0D; Key Words: SARS-COV 2 Virus, COVID 19, Conjunctivitis, Qualitative RT-PCR, Ocular Manifestations

Quantitative Investigation of Viral Load in Acute to Subacute Human Adenovirus Type 54 Conjunctivitis.

To understand the clinical course of human adenoviral (HAdV) conjunctivitis and establish a better treatment regimen, 38 eyes of 19 patients with HAdV-54 conjunctivitis for less than one week from onset were evaluated for clinical signs and symptoms and DNA copy numbers. A viral load of 104-105 is required to develop symptoms of HAdV conjunctivitis, as symptoms were present in eyes with viral loads of ≥104 at least once during the course. Next, it was observed that asymptomatic infections in the contralateral eyes are common, as the virus was detected in most eyes that did not develop conjunctivitis. Furthermore, there was no rapid decrease in the viral load in healed eyes; on the contrary, the viral load in the healed eyes on day 15 was significantly higher than that in the unhealed eyes. This was likely due to corticosteroid instillation, which rapidly alleviated symptoms but prolonged the duration of viral shedding. Recently, combination treatment with iodine and corticosteroids has been recommended for HAdV conjunctivitis. Assessing changes in the viral load and clinical symptoms would be helpful to better understand the clinical course of this disease.

Larval Morphology and Molecular Identification of Ophthalmomyiasis Flies and its Incidence Rate in Referred Patients to an Ophthalmology Clinic, Shiraz, Iran

Background: Myiasis is the infestation of flies' larvae in living or dead tissues of the human body and animals. Ophthalmomyiasis is divided into internal and external types and thelarvae penetrate eyes in the internal type. This study aimed to examine larval morphology and molecular identification of flies causing ophthalmomyiasis and determine its incidence rate in referred patients to an ophthalmology clinic in Shiraz during 2019. Materials and Methods: During one year, all larvae were isolated from patients’ eyes. These larvae were identified using the morphological method according to the 1965 diagnostic key of Zumpt. Molecular confirmation was performed using a pair of specific primers for the Cytochrome Oxidase I (COI) gene in the next step. The expected amplicons were sequenced, and their results were aligned and analyzed using the nucleotide BLAST. Results: Overall, 224 fly larvae were isolated from 36 patients. According to the morphological analysis, all larvae were Oestrus ovis. Molecular analysis confirmed morphological results. Patients presenting acute conjunctivitis symptoms had a mean age of 34 ± 2 years, and there were four women (11%) and 32 men (89%). The highest incidence were recorded in the autumn season (55.8%). Morphological results of flies were confirmed by amplifying the expected size of the CO1 gene through conventional PCR. Conclusion: The cases of ophthalmomyiasis are higher than those mentioned in the published articles and this might be due to the absence of a regular monitoring program to care for the ophthalmomyiasis cases in the public health system. Therefore, due to the importance and potential incidence of this disease in Fars province, establishing a disease care program is necessary for the health surveillance system.