Eyewash Research Articles

Concerns of Teachers and Principals on Instructional Supervision in Three Asian Countries

This study discusses on the nature of instructional supervision carried out in schools in three Asian countries India, Malaysia and Thailand. This study followed the qualitative method involving questionnaire and interview. About hundred teachers and twenty five principals and other heads from three countries participated in this study. The questionnaire was sent trough post or email while interview was conducted either face to face or online using msn or Skype. The responding rate of participants was hundred percent. The discussion was focused on four themes that are related to the research questions namely supervision as a continuous, developmental and corporate process; supervision as a specialists' area, the role of principals and teachers in instructional supervision and benefits to the teachers through instructional supervision. Evidences of findings accounted for instructional supervision being just eye wash, a paper completion and punitive process and non beneficial to the teachers. The participants stressed for involving teachers, principals, subject teachers and subject specialist to make instructional supervision practices more meaningful. The findings advocated for supervision to be continuous development and corporate process.

Tear lipocalin and lysozyme concentrations in postmenopausal women

To investigate the potential relationship between subjective symptomatology, tear volume, and tear break up time with tear film lipocalin and lysozyme concentrations in a group of symptomatic dry-eyed postmenopausal (PM) women compared to age-matched controls. Eighty-five healthy PM females (>50 years of age) were categorized as mild or moderate dry eye (DE), or asymptomatic [non-dry eye (NDE)] based on their responses to the Ocular Surface Disease Index (OSDI) questionnaire. Non invasive tear breakup time (NITBUT) and tear secretion were measured. Tears were collected via capillary tube and an eye wash method. Tear lysozyme and lipocalin concentrations were determined via Western blotting. Ocular Surface Disease Index responses revealed 16 mild DE, 30 moderate DE, and 39 NDE. The OSDI total score and sub scores for the DE groups were significantly greater than for the NDE group (p < 0.001). The mild and moderate DE groups exhibited significantly shorter NITBUTs compared to NDE (p < 0.004). Tear secretion using the Phenol Red Thread (PRT) test was found to be significantly lower in the moderate DE group compared to NDE (p < 0.001). No difference in tear lysozyme or lipocalin concentration was found between DE and NDE groups, irrespective of tear collection method, although method of collection significantly influenced absolute concentrations (p < 0.008). Significant correlations were not found between symptoms or signs of DE compared to either lipocalin or lysozyme concentration. Within a PM population, lipocalin and lysozyme are invariant, irrespective of the presence and severity of DE symptoms. This is the first comprehensive study of lipocalin and lysozyme in dry-eyed PM women and our results suggest that neither protein would offer utility as a biomarker of DE.

Nasal-Associated Lymphoid Tissue Is Not an Absolute Requirement for the Induction of Rat Tear IgA Antibody Responses

Purpose/Aim of study: The purpose of this work was to determine whether rat nasal-associated lymphoid tissue is required for the induction of tear IgA responses.Materials and Methods: Particulate antigen in the form of DNP-BSA encapsulated in cationic microparticles was applied topically to the eyes (ocular topically) of rats that had the nasolacrimal ducts temporarily plugged with chromic gut suture material. Eye washes and serum were monitored for development of antigen specific IgA and IgG, respectively. To track the particulate uptake, fluorescent latex beads were applied topically to the eyes of plugged and unplugged animals. The nasal-associated lymphoid tissue and the draining lymph nodes were then examined for the presence of the fluorescent beads.Results: It was found that the chromic gut suture was effective in blocking the passage of antigen into the nasopharyngeal cavity for at least 24 hr. Tear antigen-specific IgA levels found in the eyes of plugged animals were not significantly lower from those of unplugged animals. Serum IgG antibody levels were also similar between the two groups. In animals with plugged nasolacrimal ducts, fluorescent beads were found predominately in the superficial cervical lymph nodes, which have been shown to drain the surface of the eye.Conclusions: These results indicate that particulate antigen can be taken up by the conjunctiva and transported to the draining lymph nodes, showing that antigen does not need to access nasal-associated lymphoid tissue to induce tear IgA antibody responses.

Tear Lipocalin and Lysozyme in Sjögren and Non-Sjogren Dry Eye

To evaluate the concentration of tear lipocalin, lysozyme, and total protein in Sjögren's Syndrome (SS), non-Sjögren's keratoconjunctivitis sicca (KCS), and non-dry-eyed (NDE) individuals. Seventy-six subjects were recruited for this study: 25 SS subjects; 25 KCS subjects, and 26 NDE individuals. Symptoms were measured with a visual analogue scale. Tear flow was measured by the Schirmer I test without anesthesia. Tears were collected using an eye wash technique. Total tear protein was quantified using the DC Protein Assay Kit. Tear lipocalin and lysozyme were quantified via Western blotting performed on a Phast System. By definition, the SS and KCS groups both had significantly lower mean Schirmer scores (5.12 +/- 5.96 mm and 7.84 +/- 7.35 mm) compared with the NDE group (23.83 +/- 7.85 mm; p < 0.0001). There was no difference in mean Schirmer scores between SS and KCS groups (p = 0.19). The tear film of the SS group was characterized by significantly reduced (p < 0.0001) total protein and lipocalin concentrations compared with both KCS and NDE groups. No difference between the KCS and NDE groups was found in total protein (p = 0.92) or lipocalin (p = 0.19) concentration. In contrast, the concentration of tear film lysozyme was found to be statistically similar in all three groups examined. No statistically significant correlation was found in any group between mean Schirmer values compared with total protein, lipocalin or lysozyme concentration. Our data demonstrate a biochemical distinction between the Sjögren's group compared with both KCS and control groups, in that both tear lipocalin and total tear protein were significantly reduced. Although correlations were not found between protein measurements and tear flow, a combination of tests including Schirmer I and quantitation of tear film biomarkers may allow for the identification of SS patients without the need for invasive testing.

Rinsing with isotonic saline solution for eye burns should be avoided

Background Recent approaches to emergency treatment of eye burns have given rise to many questions on the effectiveness of traditional rinsing solutions. This led us to study the use of isotonic saline solution and a recently introduced, highly effective solution, Cederroth Eye Wash, in the initial treatment of eye burns. Methods A central area (∅ 10 mm) of the cornea of isolated ex vivo rabbit eyes was burnt for 20 s with 25 ± 1.4 μL of 2N NaOH. The anterior chamber pH was measured continuously via microelectrode. The corneas were immediately rinsed for 15 min with flow rates of 50, 100, 200, 300, 400, and 500 mL/min. Results After 20 min measurement, no significant differences in intraocular pH were found between unrinsed eyes and eyes rinsed with isotonic saline solution at any flow rate. At all flow rates, Cederroth Eye Wash brought about a significant decrease ( p < 0.001; Tukey t-test). Conclusions Isotonic saline solution was ineffective in the emergency treatment of severe alkali eye burns in this ex vivo rabbit eye model. Cederroth Eye Wash, even at the lowest flow rate, significantly reduced intracameral pH. Thus a small amount of buffer solution effectively decontaminated the eye, whilst large amounts of saline solution did not.

SURTO DE CERATOCONJUNTIVITE INFECCIOSA EM OVINOS CAUSADA POR Moraxella spp. NO ESTADO DE GOIÁS, BRASIL

This article reports an infectious keratoconjuntivitis outbreak in sheeps (OKC) situated in Quirinopolis Goias, where raised 140 ovines for slaughter and from these 100 became ill. Moraxela bovis isolation was done in culture medium in the Food Analysis Center and Microbiological Latoratory of Veterinary Medicine Department, both from the Veterinary College of Goias Federal University. The disease focus control envolved the following protocol: 1. hygienics – animal quarantine in low luminosity ambient, rest and appropriate food; 2. medicamentous – eye washing with 0,9% sodium chloride solution followed by application oxytetracyclin chloridrate ophtalmic ointment and intramuscular injection of long-acting oxytetracyclin chloridrate in ill and healthy animals; 3. preventive – use of commercial vacine against OKC and fly control. Recovery of the great part of animals minimized the damages and avoid the disease spreading on this farm and others surrounding properties. In Brazil, there are few studies about OKC outbreaks. The incentive to carry out this study was the scarceness of data related to this serious ocular deasease caused by bacterium Moraxela spp. in ovines in state of Goias. KEY WORDS: Keratoconjuntivitis, Moraxella spp,.sheep.

Acute bacterial conjunctivitis – benefits versus risks with antibiotic treatment

Acute bacterial conjunctivitis – benefits versus risks with antibiotic treatment

Orbital Cellulitis and Endophthalmitis in Pseudomonas Septicemia

We report a case of concurrent orbital cellulitis and endophthalmitis that resulted from endogenous complications of community-acquired Pseudomonas aeruginosa bacteremia in an apparently healthy individual. Pseudomonas pneumonia and extensive focal skin lesions of ecthyma gangrenosum also complicated the condition. The presence of drug-induced neutropenia was a risk factor in this patient. Simultaneous orbital cellulitis and endophthalmitis developed and rapidly progressed. Intravenous, intravitreal, and topical antibiotics were administered along with frequent eye wash with normal saline to dilute copious purulent discharge from a deep subcutaneous abscess of lower eyelid. Because of the exocellular products of Pseudomonas aeruginosa, the sclera and corneal stroma were degraded, resulting in nearly perforated cornea. Tarsoconjunctival flap from the upper eyelid was performed to reconstruct the thinning areas. After the infection was controlled, the patient's ultimate visual acuity was light perception.

Assessment of bacterial contamination of three multidose ophthalmic solutions

To investigate the frequency of bacterial contamination of multidose proparacaine hydrochloride, tropicamide, and eyewash bottles used in veterinary ophthalmology examination rooms during normal operating procedures. Three representative bottles each of proparacaine hydrochloride, tropicamide, and purified water eye wash were opened at the same time, numbered, and placed into small animal examination rooms. Doctors, students and technicians who were using the solutions were blinded to the study. Aerobic cultures were obtained at the time of opening (time 0), at 1 week (time 1), and at 2 weeks after opening (time 2) the bottles. The sites cultured included a drop of each solution, the inside of the bottle cap, the tip of the bottle, and the bottle threads and medication residue found in these threads. Aerobic cultures of tropicamide and proparacaine had no growth of bacteria from any of the evaluated sites. Staphylococcus epidermidis was cultured from the tip of one bottle of eye wash after 1 week. We conclude that proparacaine, tropicamide, and eyewash solutions used in veterinary examination rooms are adequately preserved for use in ophthalmic examination. They have a low level of bacterial contamination 1 or 2 weeks after opening when used and stored according to the recommendations of the product manufacturers and previous studies.

Preliminary Study on Japanese Cedar Pollinosis in an Artificial Exposure Chamber (OHIO Chamber)

A pollen exposure chamber (OHIO Chamber) was built in central Tokyo, Japan, in order to study seasonal allergic rhinitis (SAR). Since satisfactory outcomes were obtained from the controlled pollen exposure at the chamber, we conducted preliminary studies in volunteers with SAR. Ten volunteers with SAR sensitive to Japanese cedar (JC) pollen were enrolled in this study. In order to investigate the intranasal and intraocular pollen number, volunteers were initially exposed to a low concentration of JC (2500 grains/m3) for at most 1 hour in this chamber. Before and after the exposure, nasal cavities and eyes were washed with 100ml and 25 ml of saline, respectively. Nasal and eye washing solutions were collected and the number of JC pollen was counted. After 3 hours the volunteers were subsequently exposed to a moderate concentration of JC (4500 grains/m3) for 2 hours. Subjective nasal and ocular symptoms were recorded and the amount of nasal secretion was measured during the allergen exposure periods. During the initial exposure, all volunteers except one stayed in the chamber for 1 hour without any nasal or ocular symptoms. The number of pollen in the nose and eyes was 249.2 +/- 120.9 and 13.6 +/- 13.6 grains, respectively. During the subsequent 2-hour exposure to JC pollen, nasal and ocular symptoms developed gradually in a time dependent manner in all the volunteers except one. This is the first clinical study using Japanese cedar pollen under well-controlled conditions in the OHIO chamber in which the induction of allergic symptoms was observed. The OHIO chamber will be useful for studying allergic rhinitis in Japan.

Changes in vitreous amino acid concentrations in a rabbit model of cataract surgery

We previously reported marked elevation of glutamate, gamma-aminobutyric acid (GABA) and alanine in the vitreous after combined cataract surgery and vitrectomy for macular disorder. Photo-stimulation by the operating microscope and increased intraocular pressure (IOP) are possible causes of postoperative increases in amino acids. An animal model was used to verify this hypothesis. Forty-five coloured rabbits were studied; stress was applied to simulate cataract surgery. Simultaneous photic and pressure stress, photic stress alone, or pressure stress alone were exerted for 20 mins. The vitreous was extracted at the end of the stress period, or 10 mins or 30 mins later. Levels of six amino acids (asparate, glutamate, glycine, taurine, alanine and GABA) in the vitreous were analysed quantitatively. Significant increases in vitreous glutamate concentrations in treated eyes were observed following simultaneous photic and pressure stress, as well as after pressure stress alone, whereas no difference was found after photic stress alone. The mean glutamate concentrations in treated eyes and fellow eyes, respectively, were 5.59 +/- 2.03 microM and 4.36 +/- 2.09 microM (p < or = 0.05) 10 mins after simultaneous photic and pressure stress, and 4.32 +/- 0.97 microM and 2.29 +/- 0.51 microM (p < 0.05) 10 mins after pressure stress alone. Taurine concentration was elevated by pressure stress alone at 0 min and at 10 mins post-stress. Alanine concentration was reduced by photic stress alone at 10 mins post-stress. In all protocols, no significant differences between treated and fellow eyes were observed at 30 mins after stress. Time-dependent changes were observed not only in the treated eyes, but also in untreated fellow eyes. Elevations of vitreous glutamate in cataract surgery may be caused by pressure stress due to irrigation. Photic stress caused by the operating microscope has little influence. Sympathetic response may be involved in amino acid changes due to stress in cataract surgery.

Photochemistry and Photocytotoxicity of Alkaloids from Goldenseal (Hydrastis canadensisL.). 2. Palmatine, Hydrastine, Canadine, and Hydrastinine

Goldenseal is an herb that is widely used in dietary supplements, eye washes, and skin lotions. The presence of Goldenseal root powder in dietary supplements and the topical application of Goldenseal preparations raise the possibility that an adverse phototoxic reaction may result from an interaction between its constituent alkaloids and light in exposed tissues. We have previously shown that berberine, the major alkaloid in Goldenseal powder, in combination with UVA causes DNA damage and cell death in HaCaT keratinocytes [(2001) Chem. Res. Toxicol. 14, 1529]. We have studied the photochemical and photobiological properties of four minor alkaloids found in Goldenseal, namely, hydrastine, palmatine, canadine, and hydrastinine. UVA radiation of palmatine in aqueous solutions generated no (1)O(2), but in CH(2)Cl(2), copious amounts of (1)O(2) were detected (Phi = 0.2). Palmatine also photogenerated oxygen-centered radicals, (*)OH and O(2)(*)(-) in aerated aqueous buffer and acetonitrile, respectively, as detected by the spin trap 5,5-dimethyl-1-pyrroline N-oxide (DMPO). In nitrogen-sparged acetonitrile containing DMPO, we observed the neutral palmatine radical formed by one-electron reduction. UVA irradiation (4 J/cm(2)) of HaCaT keratinocytes in the presence of palmatine (50 microM) resulted in a 50% decrease in cell viability but no DNA damage as measured by the comet assay. UVA irradiation of hydrastine, hydrastinine, or canadine (50 microM) did not cause DNA damage or cell death in keratinocytes. Although palmatine is photoactive, it is present in such small amounts in Goldenseal root powder that the phototoxicity of the herb is most likely due to berberine, the major constituent alkaloid.

MICROBIAL KERATITIS

Objective: To find out the incidence ofmicrobial keratitis in patients with red eyes. Design: randomized prospective study. Period: 07 months ranging from1st Jun 2001 to 31 Dec 2001. Place of study: Eye Department, Military H st ospital, Rawalpindi. Results: Out of 857patients with red eye 32 cases were found to have Microbial Keratitis (3%). Conclusion: Preventive aspects of ocularinfection should be taught to the people, like, proper washing of eyes, wearing of protective glasses. Patients comingwith ophthalmic problems, i.e., red eye, photophobia, irritation and watering to the general practitioner should bereferred as soon as possible to the ophthalmology department.

Emergency treatment of eye burns: which rinsing solution should we choose?

In the treatment of eye burns few data on the comparative application of rinsing solutions exist. We present experiments in vitro and ex vivo on the pH changes that can be achieved in alkali eye burns with currently distributed and propagated rinsing fluids like water, saline solution, Cederroth Eye Wash Solution (including borate buffer), Diphoterine, Ringers lactate solution and phosphate buffer. Titration curves in beakers are compared with ex vivo experiments on isolated rabbit eyes. We exposed eyes to burns from filter paper soaked in 2 mol NaOH, continuously measuring the anterior chamber pH by means of a micro pH electrode placed near the endothelium. In each experiment--repeated five times--the corneal burn of 20 s in 2 mol NaOH was followed by a period of 15 min of rinsing under a defined flow of 66 ml/min. We found highly significant differences in intracameral pH related to different types of rinsing solutions. The return of the intracameral pH to normal was not achieved by any of the rinsing fluids, but the best results were noted for of Cederroth Eye Wash Solution (Cederroth Industrial Products, Upplands Väasby, Sweden) and the Diphoterine- and Previn solutions (Prevor, Cologne, Germany). Water played an intermediate role whereas saline and phosphate buffer were not efficient at lowering intracameral pH after alkali burns. In alkali burns we recommend efficient buffering solutions. The tested isotonic phosphate buffer (PBS) was not effective at buffering the intraocular pH. Water was found to be much less efficient than Previn, Diphoterine or Cederroth Eye Wash solution in balancing intraocular pH.

In vitro and in vivo antiherpetic activity of three new synthetic brassinosteroid analogues

Brassinosteroids are a novel group of steroids that appear to be ubiquitous in plants and are essential for normal plant growth and development. It has been previously reported that brassinosteroid analogues exert an antiviral activity against herpes simplex virus type 1 (HSV-1) and arenaviruses. In the present study, we report the chemical synthesis of compounds (22 S,23 S)-3β-bromo-5α,22,23-trihydroxystigmastan-6-one ( 2), (22 S,23 S)-5α-fluoro-3β-22,23-trihydroxystigmastan-6-one ( 3), (22 S,23 S)-3β,5α,22,23-tetrahydroxy-stigmastan-6-one ( 4) as well as their antiherpetic activity both in a human conjunctive cell line (IOBA-NHC) and in the murine herpetic stromal keratitis (HSK) experimental model. All compounds prevented HSV-1 multiplication in NHC cells in a dose dependent manner when added after infection with no cytotoxicity. Administration of compounds 2, 3, and 4 to the eyes of mice at 1, 2, and 3 days post-infection delayed and reduced the incidence of HSK, consisting mainly of inflammation, vascularization, and necrosis, compared to untreated, infected mice. However, viral titers of eye washes showed no differences among samples from treated and untreated mice. Since the decrease in the percentage of mice with ocular lesions occurred 5 days after treatment had ended, we suggest that brassinosteroids 2, 3, and 4 did not exert a direct antiviral effect in vivo, but rather may play a role in immune-mediated stromal inflammation, which would explain the improvement of the clinical signs of HSK observed.

Corneal and conjunctival toxicity from hydrogen peroxide: A patient with chronic self-induced injury

Purpose To report a patient with severe corneal and conjunctival toxicity from long-term, habitual use of hydrogen peroxide as an eye wash. Design Observational case report. Intervention and testing Serial examinations of the cornea, conjunctiva, and ocular adnexa were done. Penetrating keratoplasty with amniotic membrane transplantation was performed. Main outcome measures Ocular inflammation, pain, and visual acuity outcome. Results Bilateral corneal and conjunctival inflammation and scarring mimicking ocular-cicatricial pemphigoid were noted. Formation of a descemetocele after starting treatment with low-dose topical steroids required emergent penetrating keratoplasty with amniotic membrane transplantation. Conclusions This is the first reported case of ocular surface toxicity in a patient after deliberate chronic use of high-dose hydrogen peroxide. It highlights the value of obtaining a thorough medical and social history and the importance of direct questioning about the use of any medications or agents on the eyes before making a diagnosis or initiating therapy.

Face washing promotion for preventing active trachoma.

Trachoma remains a major cause of avoidable blindness among underprivileged populations in many developing countries. It is estimated that about 146 million people have active trachoma and nearly six million people are blind due to complications associated with repeat infections. The objective of this review is to assess the effects of face washing on the prevalence of active trachoma in endemic communities. We searched the Cochrane Central Register of Controlled Trials - CENTRAL (which contains the Cochrane Eyes and Vision Group trials register) on The Cochrane Library (Issue 2, 2004), MEDLINE (1966 to February 2004), EMBASE (1980 to February 2004), the reference lists of identified trials and the Science Citation Index. We also contacted investigators and experts in the field to identify additional trials. We included randomised or quasi-randomised controlled trials, comparing face washing with no treatment or face washing combined with antibiotics against antibiotics alone. Participants in the trials were people normally resident in endemic trachoma communities. Two reviewers independently extracted data and assessed trial quality. Study authors were contacted for additional information. Two clinically heterogeneous trials are included, therefore a meta-analysis was considered inappropriate. This review includes two trials with data from a total of 2560 participants. Face washing combined with topical tetracycline was compared to topical tetracycline alone in three pairs of villages in one trial. The trial found a statistically significant effect for face washing combined with topical tetracycline in reducing 'severe' active trachoma compared to topical tetracycline alone. No statistically significant difference was observed between the intervention and control villages in reducing ('non-severe') active trachoma. The prevalence of clean faces was higher in the intervention villages than the control villages and this was statistically significant. Another trial compared eye washing to no treatment or to topical tetracycline alone or to a combination of eye washing and tetracycline drops in children with follicular trachoma. The trial found no statistically significant benefit of eye washing alone or in combination with tetracycline eye drops in reducing follicular trachoma amongst children with follicular trachoma. There is some evidence that face washing combined with topical tetracycline can be effective in reducing severe trachoma and in increasing the prevalence of clean faces. Current evidence does not however support a beneficial effect of face washing alone or in combination with topical tetracycline in reducing active trachoma.

General toxicologic hazards and risks for search-and-rescue dogs responding to urban disasters.

In large-scale disasters, it is not always possible to identify every potential toxic agent to which SAR dogs may be exposed. However, an understanding of the basic means by which dogs may be exposed to toxic agents can aid veterinarians in determining basic risks for particular SAR sites and allow veterinarians to institute general preventive measures (eg, frequent eye washes) to minimize exposure. Discussions with public health and other authorities on-site may aid in identifying site-specific risks for SAR dogs. Finally, ensuring that SAR dog handlers are aware of basic risks, precautions, and decontamination measures is essential, as handlers are the first line of defense in preventing illness or injury to SAR dogs as they work a disaster area.

０．６２５％洗眼用イソジン液の安定性に関する検討

０．６２５％洗眼用イソジン液の安定性に関する検討

The role of donor CD4(+) T cells in the reconstitution of oral immunity by herpes simplex virus type 1 in severe combined immunodeficiency mice.

Severe combined immunodeficiency (SCID) mice with ill-developed Peyer's patches develop neither antibodies nor protection against lethal herpes simplex virus type 1 (HSV-1) infection by oral immunization. However, SCID mice carrying spleen cells from immunocompetent BALB/c mice had serum anti--HSV-1 antibody; anti--HSV-1 IgA antibody was detected in eye wash samples, and the mice were protected against lethal HSV-1 infection (88% survival rate). Western blotting showed that antibodies in SCID mice carrying spleen cells from BALB/c mice recognized 60-kDa HSV-1. The effector cells in transferred spleen cells were CD4(+), not CD8(+), T cells. Donor T cells were detected in the submucosal layer of the gut in SCID mice 1 day after transfer. Rapid movement of donor T cells to the gut may have a role in mucosal immunity to HSV-1. Thus, the normal environment for mucosal immunity develops in SCID mice without prior presence of CD4(+) T cells.