Glycomics analyses of tear fluid for the diagnostic detection of ocular rosacea

A Glycomics approach to detect disease is illustrated in the analyses of human tear fluid for rosacea. The diagnosis of ocular rosacea is particularly challenging in a subgroup of patients that do not present with typical facial skin findings but have ocular signs and symptoms. Indeed, up to 90% of patients with ocular rosacea may have neither obvious roseatic skin changes nor a previous diagnosis of rosacea. Tear fluid was collected from 37 subjects (21 controls and 16 patients with ocular rosacea) after conjunctival stimulation with filter (Schirmer) paper. O-linked oligosaccharides were released from tear fluid by beta-elimination and then purified using solid-phase extraction. Mass spectra were recorded on an external source HiResMALDI with a 7.0 T magnet. Mass spectra were obtained in both the positive and negative modes. However, signals were stronger in the negative mode. Tear fluid samples from rosacea patients yielded distinctive clusters of peaks that extend to higher masses. Patients with rosacea presented several oligomeric series that were not found in the controls. To discriminate the ocular rosacea cases from the normal controls, the sum of absolute intensities of 13 series corresponding to nearly 50 identified mass spectrum peaks was used. Thirty-six out of the 37 samples were correctly classified. This yields a sensitivity of 100% (95% CI 79.5-100) and specificity of 95.2% (95% CI 76.2-99.9). The high abundance of oligosaccharides in the tear fluid of patients with rosacea may lead to an objective diagnostic marker for the disease.

[Red eye]

Author summarizes the causes of red eye: conjunctival hemorrhages and hyperemia of the eye, pointing out in which cases of red eye the patient should refer to an ophthalmologist and in which case can be treated by a non-ophthalmologist and by which drugs.

SUNCT syndrome. Diagnosis morbi. Shortlasting Unilateral Neuralgiform headache attacks, with Conjunctival injection, Tearing and rhinorrhoea

The present communication represents an updating of the clinical features of SUNCT. The characteristics of SUNCT have been weighed against other orbital/periorbital headache syndromes towards which differential diagnosis is mandatory. In this group, there are various headaches: cluster headache syndrome, first branch trigeminal neuralgia, and idiopathic stabbing headache (jabs and jolts syndrome). SUNCT emerges as a fairly clear-cut, clinical syndrome. A set of diagnostic criteria of SUNCT syndrome is also given.

Management of contact lens patients with pingueculae or pterygia

Diplomates in the Contact Lens Section of the American Academy of Optometry were surveyed to determine how they managed contact lens patients with pingueculae or pterygia. Responses indicated that many patients with these conditions can be successful contact lens wearers. Specific management techniques used by these practitioners are reported.

[Dengue fever with hemorrhagic manifestations after a stay in Thailand]

On returning from a 24-day long stay in Thailand a 30-year-old German woman fell ill with high fever and head and limb aches. Soon after a confluent petechial exanthem was noted, as well as conjunctival and gastrointestinal bleedings. Biochemical findings (fall in haemoglobin concentration and haematocrit, leucopenia and thrombocytopenia, rise in lactate dehydrogenase) and a rise in Dengue antibody titre to 1 : 320 (on the 13th day of illness) confirmed the diagnosis of Dengue fever with haemorrhagic manifestations. This mosquito-transmitted viral disease, while so far only rarely reported in tourists, should be considered in the differential diagnosis of fever of undetermined origin in travellers to the tropics.

Postoperative instillation of mitomycin C in the treatment of recurrent pterygium

We examined retrospectively 61 eyes of 61 patients with recurrent pterygia who had been treated with excision, with or without 0.02% mitomycin C instillation, 3 to 7 years after treatment. The rates of recurrence (5% to 9%) and complications in eyes that had undergone excision and mitomycin C instillation were less than those in eyes that had had excision only. These data suggest that the postoperative instillation of 0.02% mitomycin C, twice a day for five days, may be effective and safe in the treatment of recurrent pterygium.