Eye Ointment Research Articles

A 5-year Tracer Medicines Availability Trend in the Obstetrics Gynecology Department of a Teaching Hospital

Background Medications are indispensable in women’s healthcare. Yet, there are barriers to their availability. Tracer medicines (TMs), as a representative subset of Essential Medicines (EMs) was pioneered by the World Health Organization (WHO) with a 100% expected availability benchmark. Managing the availability of TMs is a determinant of pharmacy performance, access to medicines and healthcare quality. There is paucity of studies on the availability of TMs in an obstetrics and Gynecology unit of a hospital. Aim The aim of the study was to assess availability of TMs in in an Obstetrics Gynecology (O &G) Department of a Teaching Hospital. Methodology The study was conducted on the 31st of January each year from 2019 to 2023 at the O & G department of Korle-Bu Teaching Hospital. Data collected were analyzed using a modified WHO/ Health Action International (WHO/HAI) methodology to review TM availability only. The original WHO/HAI methodology reviews TM prices, availability and affordability. TM is available if physically existent and unexpired on the day of survey. Results At the O & G, there are 21 molecules that are classified as TM. For the years 2020, 2021 and 2023, all 21 molecules were 100% available on the day of the survey. In 2019 and 2022, 85.7% and 90.5% availability were recorded. Specific TMs that recorded some stock outs were Injections Ephedrine 30mg, Injection Magnesium sulphate 50%, Injection pethidine 100mg, Injection Vitamin K 1mg, as well as Tetracycline eye ointment. Conclusion Availability of TMs for women’s healthcare was less than 100% expected benchmark on some occasions. Policies are needed to improve availability, through an improved management of tracer medicines. A hospital-wide survey of more specialties is desirable for a wider view of access to TMs. Keywords: Tracer Medicine, Availability, expected benchmark,

Therapeutic applications of contact lens-based drug delivery systems in ophthalmic diseases

Traditional ophthalmic drugs, such as eye drops, gels and ointments, are accompanied by many problems, including low bioavailability and potential drug side effects. Innovative ophthalmic drug delivery systems have been proposed to overcome the limitations associated with traditional formulations. Recently, contact lens-based drug delivery systems have gained popularity owing to their advantages of sustained drug delivery, prolonged drug retention, improved bioavailability, and few drug side effects. Various methods have been successfully applied to drug-loaded contact lenses and prolonged the drug release time, such as chemical crosslinking, material embedding, molecular imprinting, colloidal nanoparticles, vitamin E modification, drug polymer film/coating, ion ligand polymerization systems, and supercritical fluid technology. Contact lens-based drug delivery systems play an important role in the treatment of multifarious ophthalmic diseases. This review discusses the latest developments in drug-loaded contact lenses for the treatment of ophthalmic diseases, including preparation methods, application in ophthalmic diseases and future prospects.

Comparative Evaluation of Tacrolimus 0.03% Eye Ointment Versus Standard Antiallergic Drugs in The Treatment of Vernal Keratoconjunctivitis

Comparative Evaluation of Tacrolimus 0.03% Eye Ointment Versus Standard Antiallergic Drugs in The Treatment of Vernal Keratoconjunctivitis

Occular manifestation of a case of lamellar ichthyosis

A baby full term born of LSCS to a otherwise healthy mother was referred for ophthalmology department. On ophthalmological torch light examination, the patient had equal upper and lower lid bilateral ectropion. There was missing eye lashes noted. The anterior segment evaluation was found to be within normal limit without evidence of corneal opacities. Lamellar ichthyosis otherwise termed as Collodion baby is a infrequent disease; and there is no well-known management protocol. The Patient was managed conservatively by the use of Hydroxy propyl methyl cellulose (2% w/v) eye ointment and lubricant (Carboxy methyl cellulose 0.5%) eye drops. Thus, surgical intervention was avoided and patient was managed medically on ointments and drops

Topical Betamethasone Treatment of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis with Ocular Involvement in the Acute Phase

To clarify the importance of administering topical steroids for the treatment of Stevens-Johnson syndrome (SJS) / toxic epidermal necrolysis (TEN) with ocular involvement in the acute phase. Retrospective case series. Using the medical records of acute SJS/TEN patients treated at the Kyoto Prefectural University of Medicine Hospital, Kyoto, Japan, between July 2006 and July 2017, the ocular findings, topical steroid dosage, systemic steroid dosage, and ocular sequelae were retrospectively examined. The level of cytokines in tear fluid and serum samples was also analyzed. This study involved 13 cases. In 10 cases in whom the clinical courses were recorded before the start of steroid therapy, the mean acute ocular severity score (AOSS: 3=very severe; 2=severe; 1=mild; 0=none) was 2.8 ± 0.4 points in the severest phase. The mean systemic steroid dose after steroid pulse therapy was 694 ± 386 mg and the mean topical steroid (0.1% betamethasone eye drop and ointment) dose was 13.4 ± 3.3 times daily in the severest phase. Analysis of cytokine levels of 4 cases showed that a cytokine storm occurred in the tear fluid after the steroid pulse therapy. At final follow-up, 16 eyes of 8 patients had a logMAR visual acuity of ≤0, and no serious ocular sequelae were observed. In patients with SJS/TEN, ocular surface inflammation remains strong even after systemic inflammation has improved post steroid pulse therapy, thus suggesting that both systemic and topical steroid therapy should be administered appropriately.

Collodion baby with ectropion in a Syrian newborn: a case report study.

The authors are reporting the first case in Syria, a 20-day-old white Syrian male newborn, vaginally delivered at 38 weeks of pregnancy, with normal conditions, and congenital lamellar ichthyosis was shown by physical examination, as parchment-like scales were covering the newborn's skin, which was starting to detach and showing the "collodion baby" appearance. Ophthalmologic examination revealed a bilateral ectropion of the upper eyelids with tarsal eversion. A treatment of Tobramycin 0.3% eye ointment was prescribed four times a day, with a viscotears liquid gel eye drops 4 times a day, and vaseline petroleum jelly to be applied three times daily. At 2-month follow-up, a significant improvement was noted. Ichthyosis have a wide range of disorders that involve the skin and have inherited and acquired forms. As a result, keratolytic and systemic retinoids can have significant benefits in restoring skin function.

First hepatitis B vaccine uptake in neonates prior to and during the COVID-19 pandemic.

Routine vaccination for hepatitis B is recommended at birth, and most infants should be vaccinated within 24h of life. Historically, vaccination rates have been less than ideal, and routine vaccination has been further complicated by the COVID-19 pandemic, with decreased uptake of many vaccines. This retrospective study assessed hepatitis B vaccination rates at birth before and after the start of the COVID-19 pandemic and explored the factors associated with lower vaccination rates. Infants born at a single academic medical center in Charleston, South Carolina from November 1, 2018 through June 30, 2021 were identified. Infants were excluded if they died or received≥7days of systemic steroid therapy within the first 37days of life. Maternal and infant baseline characteristics and uptake of the first hepatitis B vaccine during hospital admission were recorded. A total of 7808 infants were included in the final analysis, with an overall vaccine uptake of 91.6%. Of the 3880 neonates in the pre-pandemic group, 3583 (92.3%) were vaccinated, versus 3571 (90.9%) of 3928 neonates in the pandemic group (rate difference=1.4%; 95% confidence interval -2.8% to 5.7%, p=0.52). Factors independently associated with lower vaccine uptake included being of non-Hispanic white race, born to a married mother, birth weight<2kg, and parental refusal of erythromycin eye ointment at birth. The COVID-19 pandemic did not significantly affect the uptake of inpatient neonatal hepatitis B vaccination. Several patient-specific factors were associated with suboptimal vaccination rates in this population.

Unilateral conjunctival concretions associated with chronic inflammation and tear instability.

Conjunctival concretions are small yellow-white subconjunctival spots that can be asymptomatic for years and are an incidental finding on routine ophthalmic examination.[1,2] The etiologies are chronic vernal conjunctivitis, severe atopic keratoconjunctivitis, and post-trachomatous changes.[1–5] The concretions are located within the conjunctival recesses layered by epithelium and are made up of cell debris and phospholipids.[3,4] Case Report A 24-year-old-female presented with chronic irritation and redness in the right eye for 1 year. Systemic evaluation was unremarkable with no immunosuppressive disorders. Her symptoms were intermittently associated with discharge. Her vision was 20/20 in both eyes. Everted upper and lower eyelids of the right eye showed multiple concretions scattered beneath the tarsal conjunctiva, more in the upper eyelid, protruding through the conjunctiva at two focal points [Fig. 1]. There was diffuse congestion in the tarsal conjunctiva with a normal lid margin appearance. The left eyelid had neither congestion nor concretions. There was no ocular surface staining with fluorescein dye, but the exposed concretions showed fluorescein uptake. Dry eye workup revealed a tear break-up time of 7.8 s with normal tear secretion in the right eye, whereas tear breakup and secretion was normal in the left eye. She gave an antecedent history of a vegetative object falling into her right eye while driving a bike. The ocular symptoms developed 1 month after that trauma. She was using topical lubricants and antibiotic ointment over the eyelid margin for the meibomitis. Because of unilateral presentation and young age, two concretions were removed on slit lamp using a sterile 26-gauge needle under topical anesthesia and sent for tissue processing.Figure 1: (a) Everted right upper eyelid of the 24-year-old female shows scattered numerous concretions in the tarsal conjunctiva, fewer in the lower eyelid (d). (b) Gomori methenamine silver stain (100×) shows presence of fungal elements within the concretions (higher magnification in inset), which are also seen on gram stain (e, 400×) as empty round and vertical spaces. (c and f) Left upper and lower eyelids show normal tarsal conjunctivaThe histopathologic examination of concretions revealed eosinophilic homogenous amorphous material containing fungal elements, which were Gomori methenamine silver stain positive [Fig. 2]. The deepest sections (till the last tissue section) also contained numerous fungal hyphae, which ruled out contamination. Due to atypical histopathologic findings of concretions, a superficial conjunctival incision biopsy containing tarsal conjunctiva, concretions, and a thin sliver of tarsus was taken at 4 mm from the upper eyelid margin. The incision biopsy showed scattered amorphous, acellular eosinophilic hyaline-like material and diffuse lymphocytic infiltration in the substantia propria. The amorphous material had a rim of conjunctival epithelium suggestive of concretions embedded within the pseudoglands of Henle. The periphery of the concretions had a slight basophilic appearance. The concretions were negative for von Kossa stain, Alcian blue, and Congo red but were red on Masson trichrome stain, suggesting cell debris and keratin to be one of the constituents. Alcian blue was focally positive in the conjunctival epithelium at the location of goblet cells. She was started on tablet fluconazole 150 mg once a week for 3 weeks along with 1% itraconazole eye ointment into the eye twice a day. Her symptoms resolved with a reduction in the conjunctival concretions’ number and conjunctival congestion.Figure 2: (a) Everted right upper eyelid with highlighted biopsied part. (b and c) Incisional biopsy from the upper tarsal conjunctiva shows diffuse subepithelial lymphocytic infiltration along with eosinophilic hyaline-like material deposits (c, at 200×). Masson trichrome (d), Congo red (e), and Alcian blue (f) were negative for amyloid and mucopolysaccharide depositsTear film instability and reduced tear production have been reported in patients with conjunctival concretions, where 51% of asymptomatic patients with conjunctival concretions have reduced tear break-up time.[3] The current case had reduced tear break-up time in the eye with concretions. An interesting finding in the current case was the presence of fungal elements, which can be explained by the possible entrapment of organic body containing fungus 1 year back. The organic material dissolved away, but the fungal elements caused persistent chronic inflammation, which resulted in the formation of concretions. This case reports the possibility of having unilateral concretions secondary to chronic inflammation with degenerative changes. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Hyderabad Eye Research Foundation, Hyderabad. Conflicts of interest There are no conflicts of interest.

Novel Treatment Options for Corneal Edema

Introduction: The current treatment of corneal edema is limited to hyperosmotic saline mixtures. Usually the therapy consists of treatment with hypertonic 5% NaCl eye drops or 6% eye ointment. However, these only remain on the cornea for a short time because they are quickly removed by the tear film and blinking. This problem is partly addressed by adding hyaluronic acid to some pharmaceuticals. In this work, Sovermol as a carrier oil supplied with osmotically active substances, honey, icing sugar, Substance C188 and Prevor® substance X were investigated in an experimental setting as therapeutics for corneal edema. Material and Methods: In the Ex vivo Eye irritation Test (EVEIT), corneas can be examined under defined and stable biochemical conditions without blinking. Corneal edema can be simulated and examined using ultrasound pachymetry and Optical Coherence Tomography (OCT). Thus, we investigated the deswelling effect of the substances described above on 23 EVEIT corneas. Results: The mixtures, examined in this study, showed a significant reduction of corneal edema especially mixtures of Sovermol with Substance C188 were very promising as a new approach to treatment of corneal edema. As reference substance for corneal edema treatment ODM5® was used. Other mixtures, especially Honey and Prevor® substance X in DOL showed a sufficient reduction of corneal edema, while also damaging the corneal epithelium. While the mixture of DOL and powder sugar showed an increased corneal thickness and damaged Epithelium. Conclusion: The therapy of corneal edema with osmotically active substances as investigated here is a promising treatment for corneal edema. However, further pharmacological development is needed for application in patients.

Graves' Ophthalmopathy: A Comprehensive Review of Current Evidence and Management Approaches

Thyroid ophthalmopathy, also known as Graves' ophthalmopathy or thyroid eye disease, is an autoimmune condition that affects the eyes and is often associated with hyperthyroidism, an overactive thyroid gland. It is characterized by inflammation, swelling, and tissue changes in the muscles and tissues around the eyes, leading to a range of symptoms including bulging eyes, double vision, eye pain, redness, and sensitivity to light. The treatment of thyroid ophthalmopathy typically involves managing the underlying thyroid condition, relieving symptoms, and preventing complications. Corticosteroids, such as prednisone, are commonly used to reduce inflammation and swelling in the eye tissues. They can be administered orally or locally through eye drops or injections. Orbital radiotherapy, a form of radiation therapy, may also be used to reduce inflammation in the eye tissues, particularly in cases where corticosteroids are not effective or not well tolerated. In addition to medical treatments, eye protection measures are important in managing thyroid ophthalmopathy. This may include wearing sunglasses to protect the eyes from exposure to sunlight and using lubricating eye ointments at night to alleviate dryness. If eyelid retraction or swelling is present, eyelid management techniques such as lubricating ointments, taping the eyelids closed during sleep, or using moisture chamber glasses may be recommended to protect the cornea and relieve symptoms. Managing the underlying thyroid condition is also crucial in the treatment of thyroid ophthalmopathy. This may involve medications to regulate thyroid hormone levels, radioactive iodine therapy, or surgery to remove the thyroid gland, depending on the individual case. Surgical intervention may also be necessary in severe cases of eye-related complications, such as double vision or optic nerve compression. Surgical options may include decompression surgery, eyelid surgery, or strabismus surgery to realign the eyes. It's important to note that the management of thyroid ophthalmopathy is typically tailored to the specific needs of each patient and may involve a multidisciplinary approach involving endocrinologists, ophthalmologists, and sometimes surgeons. Regular follow-up and monitoring are necessary to assess the effectiveness of the treatment plan and make any necessary adjustments. In conclusion, thyroid ophthalmopathy is an autoimmune condition that affects the eyes and is often associated with hyperthyroidism. Treatment typically involves managing the underlying thyroid condition, relieving symptoms, and preventing complications. Corticosteroids, orbital radiotherapy, eye protection measures, and surgical intervention may be used as part of the management plan. It's important to work closely with a healthcare professional to determine the most appropriate treatment approach for each individual case.&#x0D; &#x0D; Received: 14 January 2023 / Accepted: 26 February 2023 / Published: 20 March 2023

Batch of Artificial Eye Ointment recalled in USA

Batch of Artificial Eye Ointment recalled in USA

Spectrophotometric Determination of Sulphacetamide Sodium Using 2,4-Dinitrophenylhydrazine as Coupling Reagent

A Sensitive, rapid and selective spectrophotometric method was developed for the determination of sulfacetamide sodium in an aqueous solution. The method is based on the oxidative coupling reaction with 2,4-dinitophenylhydrazine in the basic medium in the presence of potassium periodate to produce an intense orange colour product, soluble in water, stable and gives maximum absorbance at 484 nm. The linearity of Beer's law was in the range of 2.5-75 μg/ml of sulfacetamide. The molar absorptivity, Sandellʼs sensitivity, and detection limit were 3202.92 L/mol.cm, 0.07936 µg/cm2 and 0.50476 μg/ml respectively. This method is applied successfully to the determination of sulfacetamide in pharmaceutical preparation (eye drops and ointment).

Postoperative trachomatous trichiasis: a systematic review and meta-analysis study.

Trachomatous trichiasis is the potential stage of trachoma in which the eyelashes scratch the surface of the globe, ultimately causing corneal opacity, visual impairment and blindness. The aim of this systematic review and meta-analysis is to obtain the pooled prevalence and associated factors of postoperative trachomatous trichiasis (PTT) in World Health Organization (WHO) trachoma-endemic regions. An inclusive literature search was undertaken using PubMed, Cochrane Library, Science Direct and Google Scholar databases from 30 May 2022 to 28 June 2022. I2 statistics and funnel plots were used to determine heterogeneity and publication bias among included studies. A random effects model was used to estimate pooled prevalence, incidence and odds ratios (ORs) with the respective 95% confidence intervals (CIs) using RevMan 5.4 software. Eighteen articles were included in this meta-analysis and systematic review. The pooled prevalence of PTT was 19% (range 18-21). PTT was lower among young adults compared with old adults (OR 0.63 [95% CI 0.44 to 0.92]), single-dose oral azithromycin as compared with tetracycline eye ointment users (OR 0.82 [95% CI 0.69 to 0.99]) and minor trichiasis before surgery as compared with major trichiasis (OR 0.63 [95% CI 0.47 to 0.85]). The incidence of PTT was higher than the WHO's recommendation. Prescribing single-dose oral azithromycin after surgery, periodic training for trichiasis surgeons, close follow-up and health education after surgery are crucial to minimize the recurrence.Study protocol registration on PROSPERO: CRD42022336003.

Recent Progress in Chitosan-Based Nanomedicine for Its Ocular Application in Glaucoma.

Glaucoma is a degenerative, chronic ocular disease that causes irreversible vision loss. The major symptom of glaucoma is high intraocular pressure, which happens when the flow of aqueous humor between the front and back of the eye is blocked. Glaucoma therapy is challenging because of the low bioavailability of drugs from conventional ocular drug delivery systems such as eye drops, ointments, and gels. The low bioavailability of antiglaucoma agents could be due to the precorneal and corneal barriers as well as the low biopharmaceutical attributes of the drugs. These limitations can be overcome by employing nanoparticulate drug delivery systems. Over the last decade, there has been a lot of interest in chitosan-based nanoparticulate systems to overcome the limitations (such as poor residence time, low corneal permeability, etc.) associated with conventional ocular pharmaceutical products. Therefore, the main aim of the present manuscript is to review the recent research work involving the chitosan-based nanoparticulate system to treat glaucoma. It discusses the significance of the chitosan-based nanoparticulate system, which provides mucoadhesion to improve the residence time of drugs and their ocular bioavailability. Furthermore, different types of chitosan-based nanoparticulate systems are also discussed, namely nanoparticles of chitosan core only, nanoparticles coated with chitosan, and hybrid nanoparticles of chitosan. The manuscript also provides a critical analysis of contemporary research related to the impact of this chitosan-based nanomedicine on the corneal permeability, ocular bioavailability, and therapeutic performance of loaded antiglaucoma agents.

Bacterial contamination of multi-use antibiotic steroid eye ointments and drops.

This comprehensive prospective study aimed to investigate the bacterial contamination of antibiotic steroid eye ointments and drops frequently used by eye patients. In this comprehensive prospective study, a total of 410 multi-use topical eye medications containing 15 different ingredients from 22 pharmaceutical companies used by 185 patients were analyzed. Four groups were formed as follows: group 1: antibiotic ointments (n: 109); group 2: antibiotic drops (n: 103); group 3: steroid ointments (n: 67); and group 4: steroid drops (n: 131). Topical multi-use eye drops and ointments used by patients at home for at least 1week were randomly collected. The caps and contents were separately bacteriologically examined in a chocolate agar medium. Our study detected bacterial contamination in 23 containers (5.6%) of the total 410 topical drugs. According to the groups, bacterial contamination was detected in 10 of 67 (14.9%) steroid ointments, 6 of 109 (5.5%) antibiotic ointments, 4 of 131(3.1%) steroid drops, and 3 of 103 (2.9%) antibiotic drops. While the bacterial contamination rate in ointments was 9.1%, this rate was 3% in drops. The difference between them was statistically significant (p = 0.015). According to the post-hoc pairwise comparisons, the difference between steroid drops and steroid ointment (p = 0.0023) was statistically significant. Among all drugs, contamination was detected in 12 of the 93 (12.9%) containers used after keratitis, conjunctivitis, and inflammatory conditions. It was determined that preservatives statistically reduced bacterial growth on the cap. The preservatives did not have a statistically significant effect on the bacterial contamination of the contents compared to the caps. While all contaminations were detected in illiterate and primary school graduates, no contamination was seen in the drugs used by any secondary school or university graduate. Our study detected contamination in all topical ophthalmic drug groups. Contamination rates were found to be higher in ointments and steroids. Bacterial contamination was also seen in drugs containing preservatives. We should be careful in the use of topical medications. We do not recommend the bilateral use of ointments and drops in infected eyes, such as those with keratitis, or after intraocular surgeries, such as those for cataracts.

Anterior-segment optical coherence tomography for tacrolimus therapy response monitoring of vernal keratoconjunctivitis

Background: Vernal keratoconjunctivitis (VKC), a chronic bilateral eye disease, is a severe form of allergic conjunctivitis. Anterior-segment optical coherence tomography (AS-OCT) is a rapid, noninvasive, in vivo visualization modality for the anterior segment structures that has been used in diagnosing and staging diseases and assessing the treatment efficacy. We used anterior-segment optical coherence tomography (AS-OCT) to monitor the efficacy of the tacrolimus eye ointment in managing VKC.&#x0D; Methods: In this prospective follow-up study, we included patients with active symptomatic VKC. All patients were treated with the 0.03% tacrolimus ophthalmic ointment twice daily for 2 months and then once daily for 1 month. All patients underwent AS-OCT before and 3 months after treatment as an objective method to assess the treatment efficacy.&#x0D; Results: We included 20 eyes of ten patients (nine men and one woman) with active symptomatic VKC. The mean age was 17.3 (range: 11 – 36) years, with nine patients having a palpebral type and one patient having a mixed type of VKC. Substantial flattening and reduction in the papilla size were observed in all patients at the post-treatment follow-up. AS-OCT measurements revealed significant reductions in the vertical, horizontal, and total diameters of the palpebral papillae and limbal conjunctival thickness after 3 months of treatment compared to baseline measurements (all P &lt; 0.001). No serious adverse effects attributable to tacrolimus administration were observed in the study period.&#x0D; Conclusions: AS-OCT is a suitable objective method for evaluating the treatment efficacy of the 0.03% tacrolimus eye ointment in patients with VKC. Future large-scale studies including a wide range of age groups with longer follow-up periods and AS-OCT monitoring at multiple post-treatment visits are required to confirm our preliminary results. Moreover, the diagnostic accuracy of AS-OCT in monitoring patients with active VKC should be tested in comparison with objective scoring by an experienced corneal fellowship.

Two – Arm, Randomized, Open Labeled, Comparative, Prospective Clinical Study to Assess the Efficacy of Amalaki Ghrita Aashchyotana versus Hydroxypropyl Methylcellulose Eye Ointment in Dry Eye Syndrome with special reference to Shushkaakshipaka

Background: Increased computer work hours, reduced blinking and effect of light rays and radiation lead to raised number of cases of dry eye. Amalaki Ghrita Aashchyotana can be useful in the management of dry eye. Objectives: to compare the clinical efficacy of Amalaki Ghrita Aashchyotana with Hydroxypropyl Methylcellulose (HPMC) eye ointment as a surface lubricant in dry eye syndrome with special reference to Shushkaakshipaka. Methods: In an open labeled, comparative, randomized, prospective clinical study, 60 patients of Dry eye syndrome were randomly selected randomly and categorized into 2 groups, each comprising 30 patients each. Patients in trial group were given Amalaki Ghrita Aashchyotana while patients in the control group were given local application of HPMC eye ointment for consecutive 90 days. Patients were assessed on various clinical parameters before and after the treatment. The data generated through clinical study was subjected to appropriate statistical tests. Results: On treatment of Amalaki Ghrita Aashchyotana in trial group and HPMC eye ointment in control group for 90 days showed significant difference in all objectives as well as subjective parameters on intra-group comparison. The statistically insignificant inter-group comparison shows that both the treatments were equivalent. No adverse events during or after the completion of study in any of the groups. Conclusion: Amalaki Ghrita Aashchyotana is equally efficient as HPMC eye ointment in Dry eye syndrome and has more advantage over HPMC ointment, as it also can help to improve visual acuity.

Formulation development and evaluation of therapeutic contact lens loaded with ganciclovir.

In the present investigation ganciclovir (GAN) loaded microparticles dispersed in hydrogel-based contact lenses were fabricated, characterized and evaluated for eye irritation. GAN-Hydroxy Propyl Methyl Cellulose (HPMC) microparticles were prepared by solvent evaporation method and evaluated for entrapment efficiency, drug content and drug release. The Polyhydroxyethylmethacrylate (pHEMA) contact lenses were synthesized by free radical polymerization reaction using crosslinkers like ethylene glycoldimethacrylate and photoinitiator such as IRGACURE 1173®, in UVB light, λ 365nm. The GAN-HPMC microparticles when incorporated into the premonomer mixture and polymerized together give rise to a particle dispersion system in the hydrogel contact lenses. The contact lenses were studied for surface morphology, transmittance, swelling, drug release, Na+ion permeability and hens egg test chorioallantoic membrane assay (HETCAM). Hydrogel contact lens exhibited satisfactory surface morphology, transmittance, swelling, Na+ion permeability (3.72 × 106 mm2/min) and a release of 48h suggesting a potential for prolonged ocular drug delivery. Furthermore, HETCAM exhibited no signs of ocular irritation. The developed delivery platform is a promising alternative to conventional dosage forms like eye drops, suspensions and ointments due to its increase in the residence time attributed to its prolonged release profile.

Evaluation of tacrolimus and cyclosporine in the treatment of vernal keratoconjunctivitis in children

Aims: To compare the efficacy and safety of 0.03% tacrolimus eye ointment with 2% cyclosporine eye drops in the treatment of vernal keratoconjunctivitis. Settings and Design: Comparative, Hospital-based, Prospective, Randomized, Clinical study. Methods and Material: About 56 children diagnosed with Vernal keratoconjunctivitis (VKC) were enrolled in the study. All the subjects underwent a comprehensive ophthalmic evaluation. Total subjective symptom scoring (TSSS) and Total objective sign scoring (TOSS) were done for each patient based on their history and clinical examination. They were divided into two groups. One group was treated with 0.03% tacrolimus ointment bd and the other with 2% cyclosporine eye drops tid. Both groups were also put on carboxymethylcellulose eye drops four times a day. Steroids were never used during the study. The patients were followed up at intervals of two weeks, four weeks, and eight weeks. At each follow-up, the TSSS and TOSS were done for each patient. Patients were also questioned about any adverse effects encountered by them during the treatment. A comparison was done between both groups based on the above scoring. Results: There was progressive reduction which was statistically significant (P &lt; 0.05) in the TSSS and TOSS in both the groups throughout treatment. Reduction in TSSS The only adverse effect reported by a few patients was a burning sensation that was not severe enough to discontinue treatment. Conclusions: Both tacrolimus 0.03% eye ointment and cyclosporine 2% eye drops are effective in the treatment of VKC without any significant severe side effects. Tacrolimus eye ointment was more effective than cyclosporine drops.

Comparision of efficacy and safety of 0.03% and 0.1% tacrolimus ointment in children with vernal keratoconjunctivitis.

Topical immunosuppressants such as tacrolimus in different concentrations are a breakthrough in the management of recalcitrant vernal keratoconjunctivitis (VKC); however, there is a lacks of comparative studies to guide their use in VKC management. To compare the efficacy and safety of tacrolimus 0.03% and 0.1% eye ointment in the treatment of recalcitrant VKC. A retrospective comparative single-centre observational study. We reviewed records of a total of 48 recalcitrant VKC patients treated with two different strengths of tacrolimus ointment between April 2016 and March 2017. Of these, 39 fulfilled the inclusion criteria and were categorized into two groups, A and B, depending on the use of strength of tacrolimus (0.03% and 0.1%) used, respectively. Group A had 18 patients, while group B had 21 patients. Thirty-six patients, 18 from each group, were finally analysed and compared. Records of patients were explored for the subjective symptoms and objective sign score of the patient at baseline and at each time point. The main outcome measures were composite scoring and comparison of total subjective symptom scores (TSSSs) and total objective sign scores (TOSSs) within and between the groups at each follow-up. Percentage of patient with significant reduction in symptom and sign scores as compared with baseline was considered success of treatment. Chi-square and t-tests were used for comparison of outcomes between both groups. Mixed variety was most commonly encountered type of VKC. The signs and symptoms were significantly reduced in patients with treatment in both groups (p = 0.001) in all types of VKC. However, in group B, there was significant improvement in the size of papillae (p = 0.04) as compared baseline in contrast to group A. Side effects like burning and stinging in group B were significantly higher as compared with group A. Both strengths of tacrolimus (0.03% and 0.1%) are effective in all forms of recalcitrant VKC. Papillary component of VKC responds better with higher strength (0.1%) but is associated with more significant side effects. Different strengths of tacrolimus can be used strategically depending upon the severity and clinical type of VKC to intensify outcome and minimize side effects.