1
|
Chan VF, Yong AC, Azuara-Blanco A, Gordon I, Safi S, Lingham G, Evans J, Keel S. A Systematic Review of Clinical Practice Guidelines for Infectious and Non-infectious Conjunctivitis. Ophthalmic Epidemiol 2021; 29:473-482. [PMID: 34459321 DOI: 10.1080/09286586.2021.1971262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To systematically review and critically appraise clinical practice guidelines (CPGs) and summarise the recommendations for non-infectious and infectious conjunctivitis. METHODS CPGs published on non-infectious and infectious conjunctivitis between 2010 and March 2020 were reviewed, evaluated, and selected using nine items from the Appraisal of Guidelines for Research and Evaluation II tool (4, 7, 8, 10, 12, 13, 15, 22 and 23). CPGs with an average score for items 4, 7, 8, 12, or 22 below 3 and/or a sum of the two researchers' average score for all nine items less than 45 were excluded. Two authors independently extracted and validated the data using standardised forms. RESULTS Fifteen CPGs from five sources remained for data extraction. CPGs consistently recommended non-pharmacological interventions (artificial tears, cold compress, avoidance or removal of allergens) for non-infectious conjunctivitis and pharmacological interventions (topical anti-histamine, mast-cell stabiliser and dual-acting agent) for allergy types. Observation without treatment was strongly recommended for non-herpetic viral and bacterial infections. Systemic and topical anti-viral was consistently recommended for herpetic viral conjunctivitis, while systemic and topical antibiotics were recommended for chlamydial and gonorrhoeal conjunctivitis. The methods used to assess the level of evidence and the strength of recommendation varied among CPGs. CONCLUSIONS There are a number of high-quality CPGs for non-infectious and infectious conjunctivitis. While there were a number of consistencies in the recommendations provided within these CPGs, several inconsistencies were also identified. Many of which related to the scope of practise of the targeted end-user of the particular guideline.
Collapse
Affiliation(s)
- Ving Fai Chan
- Centre for Public Health, Queen's University Belfast, Northern Ireland, UK.,College of Health Sciences, University KwaZulu Natal, Durban, South Africa
| | - Ai Chee Yong
- Centre for Public Health, Queen's University Belfast, Northern Ireland, UK
| | | | - Iris Gordon
- Cochrane Eyes and Vision, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Sare Safi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Who Collaborating Centre for the Eye Care and Prevention of Blindness, Iran
| | - Gareth Lingham
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Australia
| | - Jennifer Evans
- Cochrane Eyes and Vision, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Stuart Keel
- Department of Noncommunicable Diseases, Vision and Blindness Prevention Programme, World Health Organization, Geneva, Switzerland
| |
Collapse
|
2
|
Herpes Simplex Virus-Related Conjunctivitis Resistant to Aciclovir: A Case Report and Review of the Literature. Cornea 2020; 40:1055-1058. [PMID: 33264148 DOI: 10.1097/ico.0000000000002613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/05/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To report a rare case of herpes virus type 2-related conjunctivitis, resistant to aciclovir (ACV). METHODS Case report and review of literature. RESULTS A 28-year-old human immunodeficiency virus-positive man presented with chronic, recurrent follicular conjunctivitis. Multiplex reverse transcription polymerase chain reaction assay testing was positive for herpes simplex virus (HSV); subsequent typing with HSV assay revealed the presence of HSV type 2. Oral ACV failed to control the disease, and the patient continued to worsen clinically until resistance testing was performed. This revealed an M183stop within thymidine kinase, thus confirming the suspected resistance. The patient improved after 14 days of high-dose continuous intravenous infusion of ACV. CONCLUSIONS This is a rare case of isolated conjunctivitis due to herpes virus type 2, in an human immunodeficiency virus-positive patient, which was found to be resistant to ACV. Drug-resistant HSV is likely to emerge as an important clinical entity in the future, increasing the need for new drugs with novel mechanisms of action.
Collapse
|
3
|
Santiago LA, Silva JMRD, Azevedo OGRD, Vasconcelos PRLD. Comparative study on the efficacy of non-steroidal, steroid and non-use of anti-inflammatory in the treatment of acute epidemic conjunctivitis. Acta Cir Bras 2020; 34:e201901206. [PMID: 32049186 PMCID: PMC7006370 DOI: 10.1590/s0102-865020190120000006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/03/2019] [Indexed: 01/14/2023] Open
Abstract
PURPOSE To evaluate the effects of prednisolone against sodium diclofenac both with ciprofloxacin compared to artificial tears on the symptoms and signs of acute viral conjunctivitis. METHODS Study included 37 patients diagnosed with acute conjunctivitis and distributed by three groups: A (1% prednisolone acetate + ciprofloxacin (0.3%); B (Sodium diclofenac (0.1%) + ciprofloxacin (0.3%) and C (artificial tears + ciprofloxacin (0.3%). Patients received medication 6/6 hours daily. Signs and symptoms (e.g. lacrimation, burning, photophobia, etc.) were scored at baseline and on the first, third, fifth and seventh days and in the end of treatment using a standardized questionnaire and slit lamp anterior segment examination. RESULTS All three groups demonstrated an improvement in the signs and symptoms of conjunctivitis in their follow-up visits. There was no significant difference in symptom and sign scores between Group A and B and B and C in the study visits ( p >0.05). However, the comparison between groups A and C showed a clinical trend (p=0.05) on third evaluation suggesting better clinical action using the corticosteroids. CONCLUSION The prednisolone acetate was not superior to the use of sodium diclofenac or artificial tears in relieving the signs and symptoms of viral conjunctivitis.
Collapse
|
4
|
Pinto RDP, Lira RPC, Arieta CEL, de Castro RS, Bonon SHA. The prevalence of adenoviral conjunctivitis at the Clinical Hospital of the State University of Campinas, Brazil. Clinics (Sao Paulo) 2015; 70:748-50. [PMID: 26602522 PMCID: PMC4642493 DOI: 10.6061/clinics/2015(11)06] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 09/09/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Viral conjunctivitis is a common, highly contagious disease that is often caused by an adenovirus. The aim of this study was to evaluate the prevalence of adenoviral conjunctivitis by analyzing data from a prospective clinical study of 122 consecutively enrolled patients who were treated at the Clinical Hospital of the State University of Campinas (UNICAMP) after a clinical diagnosis of infectious conjunctivitis between November 2011 and June 2012. METHODS Polymerase chain reaction was used to evaluate all cases of clinically diagnosed infectious conjunctivitis and based on the laboratory findings, the prevalence of adenoviral infections was determined. The incidence of subepithelial corneal infiltrates was also investigated. RESULTS Of the 122 patients with acute infectious conjunctivitis included, 72 had positive polymerase chain reaction results for adenoviruses and 17 patients developed subepithelial corneal infiltrates (13.93%). CONCLUSIONS The polymerase chain reaction revealed that the prevalence of adenoviral conjunctivitis was 59% in all patients who presented with a clinical diagnosis of infectious conjunctivitis from November 2011 to June 2012. The prevalence of adenoviral conjunctivitis in the study population was similar to its prevalence in other regions of the world.
Collapse
|
5
|
Abstract
IMPORTANCE Conjunctivitis is a common problem. OBJECTIVE To examine the diagnosis, management, and treatment of conjunctivitis, including various antibiotics and alternatives to antibiotic use in infectious conjunctivitis and use of antihistamines and mast cell stabilizers in allergic conjunctivitis. EVIDENCE REVIEW A search of the literature published through March 2013, using PubMed, the ISI Web of Knowledge database, and the Cochrane Library was performed. Eligible articles were selected after review of titles, abstracts, and references. FINDINGS Viral conjunctivitis is the most common overall cause of infectious conjunctivitis and usually does not require treatment; the signs and symptoms at presentation are variable. Bacterial conjunctivitis is the second most common cause of infectious conjunctivitis, with most uncomplicated cases resolving in 1 to 2 weeks. Mattering and adherence of the eyelids on waking, lack of itching, and absence of a history of conjunctivitis are the strongest factors associated with bacterial conjunctivitis. Topical antibiotics decrease the duration of bacterial conjunctivitis and allow earlier return to school or work. Conjunctivitis secondary to sexually transmitted diseases such as chlamydia and gonorrhea requires systemic treatment in addition to topical antibiotic therapy. Allergic conjunctivitis is encountered in up to 40% of the population, but only a small proportion of these individuals seek medical help; itching is the most consistent sign in allergic conjunctivitis, and treatment consists of topical antihistamines and mast cell inhibitors. CONCLUSIONS AND RELEVANCE The majority of cases in bacterial conjunctivitis are self-limiting and no treatment is necessary in uncomplicated cases. However, conjunctivitis caused by gonorrhea or chlamydia and conjunctivitis in contact lens wearers should be treated with antibiotics. Treatment for viral conjunctivitis is supportive. Treatment with antihistamines and mast cell stabilizers alleviates the symptoms of allergic conjunctivitis.
Collapse
Affiliation(s)
- Amir A Azari
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison
| | | |
Collapse
|
6
|
The prevalence of adenoviral conjunctivitis at the Wills Eye Hospital Emergency Room. ACTA ACUST UNITED AC 2007; 78:236-9. [PMID: 17478342 DOI: 10.1016/j.optm.2006.11.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2006] [Revised: 11/22/2006] [Accepted: 11/23/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the prevalence of adenoviral conjunctivitis by analyzing data from a prospective clinical study of 50 consecutive patients presenting to the Wills Eye Hospital Emergency Room (WEH ER) with a clinical diagnosis of infectious conjunctivitis from July 2003 to October 2003. METHODS The polymerase chain reaction (PCR) was used to evaluate all cases of clinically diagnosed infectious conjunctivitis. Based on the laboratory findings, the prevalence of adenovirus was determined. RESULTS Of the 50 consecutive patients with acute infectious conjunctivitis, 31 patients were PCR positive for adenovirus. CONCLUSIONS The prevalence of adenoviral conjunctivitis was found by PCR to represent 62% of all patients presenting with a clinical diagnosis of infectious conjunctivitis from July 2003 to October 2003.
Collapse
|
7
|
Sambursky R, Tauber S, Schirra F, Kozich K, Davidson R, Cohen EJ. The RPS adeno detector for diagnosing adenoviral conjunctivitis. Ophthalmology 2006; 113:1758-64. [PMID: 17011956 DOI: 10.1016/j.ophtha.2006.06.029] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2006] [Revised: 06/14/2006] [Accepted: 06/21/2006] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To compare the sensitivity, specificity, and accuracy of the RPS Adeno Detector (Rapid Pathogen Screening Inc., South Williamsport, PA) against both viral cell culture with confirmatory immunofluorescence staining (CC-IFA) and the polymerase chain reaction (PCR) for diagnosing adenoviral conjunctivitis. DESIGN Prospective, nonrandomized, masked, multicenter clinical trial. PARTICIPANTS One hundred eighty-six consecutive patients from 5 clinical centers seeking treatment within 1 week of developing a red eye and thought to have acute conjunctivitis. METHODS The RPS Adeno Detector is a 10-minute in-office lateral flow immunoassay. Patients were tested with the RPS Adeno Detector, CC-IFA, and PCR to detect the presence of adenovirus. MAIN OUTCOME MEASURES The sensitivity, specificity, and accuracy of the RPS Adeno Detector were assessed for identifying cases of adenoviral conjunctivitis. RESULTS Compared with CC-IFA, the RPS Adeno Detector was 88% sensitive and 91% specific at detecting adenoviral conjunctivitis. Using PCR as a reference method, the sensitivity of the RPS Adeno Detector increased to 89% and the specificity increased to 94%. Compared with PCR, CC-IFA was found to be 91% as sensitive and 100% as specific. CONCLUSIONS The RPS Adeno Detector demonstrated sufficient sensitivity and specificity to be used in the physician's office for the detection of adenoviral conjunctivitis.
Collapse
MESH Headings
- Acute Disease
- Adenovirus Infections, Human/diagnosis
- Adenovirus Infections, Human/virology
- Adenoviruses, Human/genetics
- Adenoviruses, Human/immunology
- Adenoviruses, Human/isolation & purification
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antigens, Viral/analysis
- Child
- Child, Preschool
- Conjunctivitis, Viral/diagnosis
- Conjunctivitis, Viral/virology
- DNA, Viral/analysis
- Female
- Humans
- Immunologic Techniques
- Infant
- Male
- Middle Aged
- Polymerase Chain Reaction
- Prospective Studies
- Reagent Kits, Diagnostic
- Reproducibility of Results
- Sensitivity and Specificity
- Tears/virology
- Virus Cultivation
Collapse
Affiliation(s)
- Robert Sambursky
- Manatee Sarasota Eye Clinic & Laser Center, Bradenton, Florida, USA.
| | | | | | | | | | | |
Collapse
|
8
|
Di Bartolomeo S, Mirta DH, Janer M, Rodríguez Fermepin MR, Sauka D, Magariños F, de Torres RA. Incidence of Chlamydia trachomatis and other potential pathogens in neonatal conjunctivitis. Int J Infect Dis 2002; 5:139-43. [PMID: 11724670 DOI: 10.1016/s1201-9712(01)90088-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Ocular infection in neonatology is a permanent and important health problem. To improve primary attention, prevention, and control, the study of the potential bacterial etiology of all consecutive cases of conjunctivitis was incorporated as a regular procedure in primary care from July 1995 to December 1998. MATERIALS AND METHODS Prof. A. Posadas Hospital (Great Buenos Aires) has an average of 4294 births per year. This report analyzes the results obtained in 332 infants (age range, 0-30 d) with conjunctivitis. Clinical conjunctivitis was diagnosed in inpatients and outpatients by the same specialized staff. Isolation and characterization of bacteria were done by conventional microbiologic methods, including specific search for Neisseria gonorrhoeae and Chlamydia trachomatis. Chlamydia trachomatis was studied by antigen immunodetection and polymerase chain reaction, and genotyped by restriction fragment length polymorphism. RESULTS Conjunctivitis had an incidence (cases per 1000 live births) of 39.6 in 1995, 25.3 in 1996, 15.4 in 1997, and 15.2 in 1998. Microbial growth was detected in 167 (50.3%) of 332 cases. Ocular C. trachomatis infection was detected in 26 cases (7.83%). Five of seven isolates in tissue cultures belonged to type E and two to type G. Bacteria from respiratory ecology were the main isolates: Haemophilus influenzae (16.9%), Streptococcus pneumoniae (12.3%), and Staphylococcus aureus (8.7%). Haemophilus influenzae isolates were not serotyped and 17.2% of them were b-lactamase producers. In 15 cases both H. influenzae and S. pneumoniae were isolated together. Of S. pneumoniae, 4.9% were oxacillin resistant. CONCLUSIONS There has been a decline in the total number of cases of neonatal conjunctivitis, but the disease is still an important health problem. Chlamydia trachomatis also shows a decreasing profile with an incidence of (cases per 1000 live births) 4.39 in 1995, 1.85 in 1996, 1.01 in 1997, and 0.78 in 1998, and a tendency to show more incidence in spring-summer and significant accumulation of cases in babies between 7 and 9 days of age. Haemophilus influenzae alone (12.3%) or associated with S. pneumoniae (4.5%) appears as a prevalent potential bacterial pathogen. A significant accumulation of H. influenzae and S. pneumoniae cases occurs in winter. In 47.6% of cases, there was no bacterial growth. No significant seasonal differences in percentage of negative cultures or among the three-day age groups were detected. Neisseria gonorrhoeae was not found associated with ophthalmia neonatorum in this series.
Collapse
Affiliation(s)
- S Di Bartolomeo
- Microbiology Laboratory, National Hospital Professor A. Posadas, Ministery of Public Health, Buenos Aires, Argentina
| | | | | | | | | | | | | |
Collapse
|
9
|
Uchio E, Takeuchi S, Itoh N, Matsuura N, Ohno S, Aoki K. Clinical and epidemiological features of acute follicular conjunctivitis with special reference to that caused by herpes simplex virus type 1. Br J Ophthalmol 2000; 84:968-72. [PMID: 10966946 PMCID: PMC1723617 DOI: 10.1136/bjo.84.9.968] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS It is reported by the national surveillance of ocular infectious diseases in Japan that 4.3% of cases of epidemic keratoconjunctivitis (EKC) diagnosed clinically were caused by herpes simplex virus (HSV). Clinical and virological studies of patients with HSV conjunctivitis were carried out. METHODS The study population consisted of 478 patients with acute follicular conjunctivitis. Virological analysis was carried out for adenovirus (Ad) and HSV by the cell culture method and fluorescein antibody (FA) method. Polymerase chain reaction for Chlamydia trachomatis was also carried out. RESULTS From 23 patients, HSV type 1 was isolated but Ad or C trachomatis was not isolated. 87% of cases were unilateral. Most cases showed clinical resolution within 9 days. Early corneal lesions and preauricular lymphadenopathy were less frequent in HSV conjunctivitis than in adenoviral conjunctivitis, especially that due to subgenus D. No case showed a positive result for HSV by the FA method using conjunctival swabs; however, the FA test was positive in all strains isolated by cell culture. CONCLUSIONS These results indicate that it is difficult clinically to differentiate HSV conjunctivitis from adenoviral conjunctivitis in the acute stage, since the clinical features of adenoviral conjunctivitis are similar to those of HSV conjunctivitis. A biological difference may exist between HSV strains causing keratitis and conjunctivitis.
Collapse
Affiliation(s)
- E Uchio
- Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Japan.
| | | | | | | | | | | |
Collapse
|
10
|
Mellman-Rubin TL, Kowalski RP, Uhrin M, Gordon YJ. Incidence of adenoviral and chlamydial coinfection in acute follicular conjunctivitis. Am J Ophthalmol 1995; 119:652-4. [PMID: 7733193 DOI: 10.1016/s0002-9394(14)70229-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE/METHODS After we studied a case of chlamydial and adenoviral coinfection in a 20-year-old woman, we determined the incidence of chlamydial infection in patients with acute adenoviral conjunctivitis. In a randomized retrospective study, we evaluated 100 specimens of patients with culture-proven adenoviral conjunctivitis. RESULTS/CONCLUSIONS Three of 100 (3%) specimens tested positive for chlamydial DNA using polymerase chain reaction. Adenoviral and chlamydial coinfection is rare, yet should be considered in patients with prolonged follicular keratoconjunctivitis.
Collapse
MESH Headings
- Acute Disease
- Adenovirus Infections, Human/complications
- Adenoviruses, Human/immunology
- Adenoviruses, Human/isolation & purification
- Adult
- Antigens, Viral/analysis
- Chlamydia Infections/complications
- Chlamydia Infections/diagnosis
- Chlamydia trachomatis/genetics
- Chlamydia trachomatis/isolation & purification
- Conjunctiva/microbiology
- Conjunctiva/virology
- Conjunctivitis, Inclusion/complications
- Conjunctivitis, Inclusion/microbiology
- Conjunctivitis, Viral/complications
- Conjunctivitis, Viral/diagnosis
- Conjunctivitis, Viral/virology
- DNA, Bacterial/analysis
- Female
- Humans
- Incidence
- Polymerase Chain Reaction
- Retrospective Studies
Collapse
Affiliation(s)
- T L Mellman-Rubin
- Department of Ophthalmology, College of Medicine, King Saud University
| | | | | | | |
Collapse
|
11
|
|
12
|
Dannevig L, Straume B, Melby K. Ophthalmia neonatorum in northern Norway. II. Microbiology with emphasis on Chlamydia trachomatis. Acta Ophthalmol 1992; 70:19-25. [PMID: 1557970 DOI: 10.1111/j.1755-3768.1992.tb02087.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In a population of 1928 neonates in Northern Norway, ophthalmia neonatorum was diagnosed in 18.9%, including mild and self-limiting cases. Sixteen out of 269 (6.0%) cultured cases were positive for Chlamydia trachomatis. No gonococcal ophthalmia was seen. In neonates whose symptoms began in the maternity wards, the distribution of the isolated microorganisms (mainly Staphylococcus aureus) was different from those in whom symptoms began after discharge (mainly S. aureus, Staphylococcus species (coagulase-negative), Streptococcus viridans and C. trachomatis). Growth of C. trachomatis was significantly associated with the intensity of conjunctivitis (P less than 0.001). However, no sequelae could be demonstrated in the eyes at the age of 6 months. 60% of the neonates with chlamydial ophthalmia also suffered from rhinitis. 31.4% of the neonates received silver nitrate instillation, which had no significant influence on the frequency of chlamydial ophthalmia. General practitioners are often faced with chlamydial ophthalmia. In cases of ophthalmia neonatorum, a microbiological examination is recommended, as a guide to appropriate antibiotic treatment. The result of microbiological examination may also indicate other infections in mother and child. In areas with a readily available health service, including an adequate microbiological laboratory service, prophylaxis in the eyes does not seem to be necessary.
Collapse
Affiliation(s)
- L Dannevig
- Department of Ophthalmology, University Hospital, Tromsø
| | | | | |
Collapse
|
13
|
Dannevig L, Straume B, Melby K. Ophthalmia neonatorum in northern Norway. I: Epidemiology and risk factors. Acta Ophthalmol 1992; 70:14-8. [PMID: 1557969 DOI: 10.1111/j.1755-3768.1992.tb02086.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
During one year, 1928 of all 1958 neonates born in the county of Troms in Northern Norway were followed until 6 weeks of age, regarding the development of ophthalmia neonatorum. Conjunctivitis was found in 364 cases (189 per 1000 neonates), including mild and self-limiting cases. In 14.5 cases per 1000 neonates the ophthalmia neonatorum was recorded as severe. Boys were more often affected than girls (P = 0.001). The age of the mother and obstetric events did not significantly influence the occurrence of conjunctivitis. 31.4% of the neonates received silver nitrate instillation. The frequency of conjunctivitis in the group with and without prophylaxis was 15.9 and 20.3%, respectively (P = 0.023). The incidence of chlamydial ophthalmia was 8 per 1000 neonates. At present, chlamydial ophthalmia is a common disease in neonates. Efforts should be made to screen fertile women for chlamydial genital infection and to encourage prompt microbiological examination in cases of ophthalmia neonatorum.
Collapse
Affiliation(s)
- L Dannevig
- Department of Ophthalmology, University Hospital, Tromsø, Norway
| | | | | |
Collapse
|
14
|
Bishop PN, Tullo AB, Killough R, Richmond SJ. An immune dot-blot test for the diagnosis of ocular infection with Chlamydia trachomatis. Eye (Lond) 1991; 5 ( Pt 3):305-8. [PMID: 1955052 DOI: 10.1038/eye.1991.48] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We report a new simple non culture technique for the diagnosis of chlamydial eye disease. The immune dot-blot test (IDBT) detects chlamydial lipopolysaccharide (LPS) antigen which, after being trapped on nitrocellulose membrane, is detected by autoradiography with 125I-labelled genus specific monoclonal antibody. This test was evaluated over a two year period in adults and neonates, by comparing it to culture, serological detection of chlamydial antibodies and clinical features. We demonstrate that the IDBT is more than twice as sensitive as culture, and suggest that in order to achieve a reliable diagnosis of chlamydial eye infection an immunological test for chlamydial antigen should be used in preference to tests which detect the organisms themselves.
Collapse
Affiliation(s)
- P N Bishop
- Department of Ophthalmology, University of Manchester, England
| | | | | | | |
Collapse
|
15
|
Morton CE, Mallinson H, Clearkin LG, Ansons AM, Kaye LC, Mutton KJ. Per-nasal swabbing as an aid to the diagnosis of chlamydial and adenovirus conjunctivitis. Eye (Lond) 1990; 4 ( Pt 3):510-3. [PMID: 2209918 DOI: 10.1038/eye.1990.67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Two hundred and thirty four patients (adults and babies) with conjunctivitis were investigated by taking eye swabs and in addition by taking per-nasal swabs. Chlamydia trachomatis was isolated from 20 patients and adenovirus from 14 patients. Per-nasal swabbing led to a 53% increase in chlamydia diagnosis and a 27% increase in the diagnosis of adenovirus infection. It is suggested that per-nasal swabbing has an important role to play in detecting chlamydial conjunctivitis which itself may be an indicator for high morbidity in patients and their contacts.
Collapse
|
16
|
Darougar S, Monnickendam MA, Woodland RM. Management and prevention of ocular viral and chlamydial infections. Crit Rev Microbiol 1989; 16:369-418. [PMID: 2539947 DOI: 10.3109/10408418909104473] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A majority of cases of preventable and/or curable ocular morbidity and blindness are caused by ocular infections. They may account for 70 to 90% of all ocular morbidity seen by family doctors, general practitioners, health centers, and local ophthalmologists in both developed and developing countries. Unfortunately, most health authorities and doctors, including ophthalmologists, consider these diseases to be of little or no importance because they are not fully aware of the high prevalence of these infections and the blinding sequelae which may occur following incorrect diagnosis and treatment. Also, they are not aware of the social and economic impact of these infections in the absence of proper management and implementation of preventive measures. In this review, we examine present knowledge of chlamydial and common viral ocular infections. We discuss the problems of diagnosis, management, and prevention and propose solutions relevant to developed and developing countries.
Collapse
Affiliation(s)
- S Darougar
- Section of Virology, Institute of Ophthalmology, London, England
| | | | | |
Collapse
|
17
|
Harding SP, Mutton KJ, van der Avoort H, Wermenbol AG. An epidemic of keratoconjunctivitis due to adenovirus type 37. Eye (Lond) 1988; 2 ( Pt 3):314-7. [PMID: 2841171 DOI: 10.1038/eye.1988.59] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
An epidemic of keratoconjunctivitis due to adenovirus type 37 in Liverpool in 1984 is reported. Initially serum neutralisation suggested that isolates were type 10 but further neutralisation studies supported by DNA restriction enzyme analysis showed that they were type 37. Clinical and epidemiological features of this cause of epidemic keratoconjunctivitis, recently recognised in the United Kingdom, are presented and the implications for the laboratory investigation discussed.
Collapse
|