Pseudomonas aeruginosa Keratitis in an Atopic Silicone Hydrogel Lens Wearer With Rosacea

Rosacea: The eyes have it

Rosacea is a chronic inflammatory dermatosis typically affecting the facial skin but also the eyes. With its chronic course with fluctuating episodes of flashing, redness, papulopustules, and nodules it poses a severe psychologic burden to the affected individuals. In addition to the facial changes, more than half of the patients have ocular involvement ranging from blepharitis and conjunctival hyperemia to more severe ophthalmic damage, and even blindness. Clinically, the ocular involvement in rosacea includes meibomian gland dysfunction with relapsing hordeola and chalazia, diffuse hyperemic conjunctivitis, photophobia, episcleritis, or kerato-conjunctivitis, and in rare cases, corneal ulcers. These are mainly observed in adult patients but can also occur in children. Depending on the degree of cutaneous or ocular findings, patients with rosacea may present first to the dermatologist or to the ophthalmologist. Both specialists should be aware of the potential oculocutaneous involvement. Any ocular complaints expressed by the patient in the setting of a dermatologist's office should be referred promptly for an ophthalmologic examination. Conversely, signs suggestive of rosacea in the eye should lead the ophthalmologist to consider underlying skin disease. A timely interdisciplinary collaboration is paramount for the earlier diagnosis and treatment, thus preventing permanent eye impairment in this chronic dermatosis.

Research progress on albumin-based hydrogels: Properties, preparation methods, types and its application for antitumor-drug delivery and tissue engineering

Albumin is derived from blood plasma and is the most abundant protein in blood plasma, which has good mechanical properties, biocompatibility and degradability, so albumin is an ideal biomaterial for biomedical applications, and drug-carriers based on albumin can better reduce the cytotoxicity of drug. Currently, there are numerous reviews summarizing the research progress on drug-loaded albumin molecules or nanoparticles. In comparison, the study of albumin-based hydrogels is a relatively small area of research, and few articles have systematically summarized the research progress of albumin-based hydrogels, especially for drug delivery and tissue engineering. Thus, this review summarizes the functional features and preparation methods of albumin-based hydrogels, different types of albumin-based hydrogels and their applications in antitumor drugs, tissue regeneration engineering, etc. Also, potential directions for future research on albumin-based hydrogels are discussed.

Ocular rosacea: common and commonly missed

Rosacea is a prevalent disorder that may be disfiguring and cause significant ocular morbidity, if not diagnosed and managed appropriately. Ocular rosacea, in particular, is often left undiagnosed as no specific test is available to confirm the diagnosis. Accurate diagnosis is further complicated because symptoms of ocular rosacea are not always specific to the disorder alone. Other ophthalmic disorders may present with similar findings. Further challenges exist because the severity of ocular symptoms is often not related to the severity of cutaneous findings in rosacea. Isolating a disease marker may facilitate earlier diagnosis and treatment, and could also contribute to better understanding of disease pathogenesis. The glycomics of tear fluid and saliva in patients with rosacea shows promise as an initial step in the search for a biomarker specific to the disease. We have previously found potentially important disease biomarkers in roseatic tear and saliva samples. Further investigation should prove important in the early stages of developing a set of markers for accurate disease identification.

Prescription and management of contact lenses in patients with monocular visual impairment

PURPOSE

Contact lens correction for refractive error in patients with monocular visual impairment may be desirable. However, the potential for damage to the sound eye must always be considered in such patients. This report outlines the prescription and management of contact lens wear in a monocular patient. The case report is followed by a discussion of the risks of vision loss associated with contact lens wear.

CASE REPORT

The author conducted a clinical interview, refraction, ocular examination, and contact lens evaluation of a 38-year-old female patient who had undergone a lensectomy in her right eye and the enucleation of her left eye. The patient presented wearing a conventional aphakic hydrogel contact lens in her right eye. She routinely wore her contact lens for up to 16 hours daily and occasionally slept while wearing it. Best-corrected spectacle acuity was 20/40-2 with +13.75 diopter sphere in her right eye. Clinical examination showed 3 to 4 mm of well-perfused neovascularization with associated pannus in the superior quadrant of her cornea and 1 to 2 mm of peripheral neovascularization in the remainder of the cornea. She was refit with a 2-week replacement hydrogel contact lens that partially corrected her refractive error, and she was encouraged to wear polycarbonate spectacles full time for the remainder of her refractive correction and for protection of the right eye.

CONCLUSIONS

Monocularly impaired patients who choose to wear contact lenses for the correction of refractive error should be aware of the risk of potentially sight-threatening contact lens complications. The importance of meticulous hygiene and appropriate contact lens wearing schedules should be emphasized with monocular patients. They should also be encouraged to wear the appropriate spectacle correction to reduce the risk of injury to their sound eyes.