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Lagophthalmos express the imperfect palpebra closure. It can be result as feelings like there's commodity in the eyes, Ophthalmalgia, Epiphora or dry eyes, vague vision, red eyes, scleritis, light perceptivity, Insomnolence. Complete eyes close with a nictitation is important for maintaining a stable lacrimal layer and Healthy Eyes. Twenty years of girl visit to hospital with complaints of redness of left eye, Water secretion continuously specially with pain in left eye at night which was intolerable, severe light sensitivity, blurry vision, constant headache, not able to concentrate due to pain and blurry vision. Initially patient feels dry eyes during the day before a couple of day of starting continuously water secretion. On examination they conclude that patient eyes are not properly closed during sleeping which interpret in formation of stable tear film. After all examination they conclude that she has lagophthalmos. For management of her condition, she was prescribed with Optimoist Ultra 400 E/D, Moxiqua 0.5%. Lagophthalmos cannot be treated completely as the point so, Doctor suggests the lifelong therapy of this eye drops and eye gel for better outcomes and to prevent further symptoms flare. There should not be any surgical therapy in this case because lagophthalmos was detected in early stage within 2-3 weeks. According to guidelines if lagophthalmos is detected within 1-6 weeks then medical care therapy is sufficient to give better result. Lagophthalmos can be chronic if not treated early it can be causing complete and permeant vision loss. [ABSTRACT FROM AUTHOR]

To identify periodic trends in internet searches for ocular symptoms and to determine the seasonal peaks and troughs. This cross-sectional study examined publicly available Google Trends data from the United States (01/01/2015 to 12/31/2019). A list of common ocular symptoms was compiled from the American Academy of Ophthalmology Eye Health website and Wills Eye Manual. Ocular symptoms were stratified into categories involving vision change, eye pain, or eye redness. The search volume over time for each term was modeled using periodic regression functions and the goodness-of-fit was reported. Fisher's exact tests were used to compare the characteristics of periodic vs. non-periodic query terms. Seasonal trends were demonstrated by 45% (48/106) of the ocular symptoms included in this investigation. Search terms with best fit to the periodic model included stye (r2 = 0.89), pink eye (r2 = 0.82), dry eye (r2 = 0.76), blurry vision (r2 = 0.72), and swollen eye (r2 = 0.71). Periodic search terms were more likely to involve eye redness (21% vs. 11%, p =.014) and less likely to involve vision change (11% vs. 36%; p <.001). Periodic queries involving eye redness most often peaked in the spring and those involving eye pain peaked in the summer. Ocular symptom queries directly reflect seasonal trends for allergic eye disease and ocular trauma. Search query analyses can serve as accurate epidemiological tools with research and real-world clinical applications. [ABSTRACT FROM AUTHOR]

The present study applied a nano-synergistic approach to enhance besifloxacin's potency via nano-formulating besifloxacin on gold nanoparticles (Besi-AuNPs) and adding quercetin as a natural synergistic compound. In fact, a one-pot AuNP synthesis approach was applied for the generation of Besi-AuNPs, where besifloxacin itself acted as a reducing and capping agent. Characterization of Besi-AuNPs was performed by spectrophotometry, DLS, FTIR, and electron microscopy techniques. Moreover, antibacterial assessment of pure besifloxacin, Besi-AuNPs, and their combinations with quercetin were performed on Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. UV-spectra showed a peak of AuNPs at 526 nm, and the electron microscopy-based size was estimated to be 15 ± 3 nm. The effective MIC50 concentrations of besifloxacin after loading on AuNPs were reduced by approximately 50% against the tested bacterial strains. Interestingly, adding quercetin to Besi-AuNPs further enhanced their antibacterial potency, and isobologram analysis showed synergistic potential (combination index below 1) for different quercetin and Besi-AuNP combinations. However, Besi-AuNPs and quercetin combinations were most effective against Gram-positive S. aureus in comparison to Gram-negative P. aeruginosa and E. coli. Their potent activity against S. aureus has its own clinical significance, as it is one the main causative agents of ocular infection, and besifloxacin is primarily used for treating infectious eye diseases. Thus, the outcomes of the present study could be explored further to provide better medication for eye infections caused by resistant pathogens. [ABSTRACT FROM AUTHOR]

Zika virus (ZIKV) infection causes ocular and neurological pathologies with ZIKV-induction of developmental abnormalities following in utero infection a major concern. The study here has compared ZIKV and the related dengue virus (DENV) infection in the eye and brain. In vitro, both ZIKV and DENV could infect cell lines representing the retinal pigmented epithelium, endothelial cells, and Mueller cells, with distinct innate responses in each cell type. In a 1-day old mouse challenge model, both ZIKV and DENV infected the brain and eye by day 6 post-infection (pi). ZIKV was present at comparable levels in both tissues, with RNA increasing with time post-infection. DENV infected the brain, but RNA was detected in the eye of less than half of the mice challenged. NanoString analysis demonstrated comparable host responses in the brain for both viruses, including induction of mRNA for myosin light chain-2 (Mly2), and numerous antiviral and inflammatory genes. Notably, mRNA for multiple complement proteins were induced, but C2 and C4a were uniquely induced by ZIKV but not DENV. Consistent with the viral infection in the eye, DENV induced few responses while ZIKV induced substantial inflammatory and antiviral responses. Compared to the brain, ZIKV in the eye did not induce mRNAs such as C3, downregulated Retnla, and upregulated CSF-1. Morphologically, the ZIKV-infected retina demonstrated reduced formation of specific retinal layers. Thus, although ZIKV and DENV can both infect the eye and brain, there are distinct differences in host cell and tissue inflammatory responses that may be relevant to ZIKV replication and disease. [ABSTRACT FROM AUTHOR]

We studied the antimicrobial effect of gold quantum dots (AuQDs), femtosecond laser irradiation, and the combined effect of laser irradiation and AuQD treatment against common infectious eye pathogens. The INSPIRE HF100 laser system (Spectra Physics) provided a femtosecond laser, which was pumped by a mode-locked femtosecond Ti: sapphire laser MAI TAI HP (Spectra Physics), while a Quanta-Ray nanosecond Nd: YAG laser (Spectra-Physics) was used to precisely synthesize 7.8, 8.7, and 11.6 nm spherical AuQDs. Then, the in vitro growth kinetics and growth rate analysis of E. coli, methicillin-resistant Staphylococcus aureus, Enterococcus faecalis, Listeria monocytogenes, and Candida albicans (treated with the AuQDs, femtosecond laser irradiation, or combined laser and AuQDs treatment) was measured. The biocompatibility of the AuQDs with the retinal epithelial cell lines (ARPE-19) and their toxicity to the cells was assayed. The results showed that (1) in vitro irradiation using a 159 J/cm2 energy density obtained from the 400 nm femtosecond laser suppressed the growth of each of the five pathogens. (2) Similarly, treatment with the AuQDs was antimicrobial against the four bacteria. The AuQDs with an average size of 7.8 nm were more highly antimicrobial and biocompatible and were less cytotoxic than the larger AuQD sizes. (3) The combined femtosecond laser irradiation and AuQD treatment was more highly antimicrobial than each treatment alone. (4) The AuQD treatment did not impair the rate of wound closure in vitro. These findings suggest that combined femtosecond laser irradiation and AuQD treatment is significantly antimicrobial against Candida albicans, Gram-positive L. monocytogenes, S. aureus, and E. faecalis, as well as Gram-negative E. coli. The nontoxicity and biocompatibility of the AuQD particles tested suggest that this form of treatment may be clinically viable. [ABSTRACT FROM AUTHOR]

The development of potent antibiotic alternatives with rapid bactericidal properties is of great importance in addressing the current antibiotic crisis. One representative example is the topical delivery of predatory bacteria to treat ocular bacterial infections. However, there is a lack of suitable methods for the delivery of predatory bacteria into ocular tissue. This work introduces cryomicroneedles (cryoMN) for the ocular delivery of predatory Bdellovibrio bacteriovorus (B. bacteriovorus) bacteria. The cryoMN patches are prepared by freezing B. bacteriovorus containing a cryoprotectant medium in a microneedle template. The viability of B. bacteriovorus in cryoMNs remains above 80% as found in long‐term storage studies, and they successfully impede the growth of gram‐negative bacteria in vitro or in a rodent eye infection model. The infection is significantly relieved by nearly six times through 2.5 days of treatment without substantial effects on the cornea thickness and morphology. This approach represents the safe and efficient delivery of new class of antimicrobial armamentarium to otherwise impermeable ocular surface and opens up new avenues for the treatment of ocular surface disorders. [ABSTRACT FROM AUTHOR]

Fungal eye infections can lead to loss of vision and blindness. The disease is most prevalent in the tropics, although case numbers in moderate climates are increasing as well. This study aimed to determine the dominating filamentous fungi causing eye infections in Germany and their antifungal susceptibility profiles in order to improve treatment, including cases with unidentified pathogenic fungi. As such, we studied all filamentous fungi isolated from the eye or associated materials that were sent to the NRZMyk between 2014 and 2020. All strains were molecularly identified and antifungal susceptibility testing according to the EUCAST protocol was performed for common species. In total, 242 strains of 66 species were received. Fusarium was the dominating genus, followed by Aspergillus, Purpureocillium, Alternaria, and Scedosporium. The most prevalent species in eye samples were Fusarium petroliphilum, F. keratoplasticum, and F. solani of the Fusarium solani species complex. The spectrum of species comprises less susceptible taxa for amphotericin B, natamycin, and azoles, including voriconazole. Natamycin is effective for most species but not for Aspergillus flavus or Purpureocillium spp. Some strains of F. solani show MICs higher than 16 mg/L. Our data underline the importance of species identification for correct treatment. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus is a most important reason of bacterial keratitis. The emergence of S. aureus resistance to methicillin necessitates searching for new antimicrobial components for keratitis. CM11 is a cationic peptide with strong antibacterial activity against a range of bacteria. In this study, in vitro bactericidal activity of CM11 was investigated using the time-killing assay. For this purpose, corneal methicillin-resistant S. aureus (MRSA)-infected rabbit models were experimentally developed through intrastromal injection of bacteria. The infected rabbits were treated in three groups by artificial tear, gentamicin, and CM11, and their conjunctiva, iris, and cornea were clinically examined using a slit lamp and histopathological examination. The variance analyses of microbial (colony counts) and pathological examinations on the harvested cornea samples showed a significant improvement in the treated groups (CM11 and gentamicin) compared to the control eyes (P ≤ 0.05). According to findings, CM11 and gentamicin could significantly reduce the CFU in comparison with the group received artificial tear. The mean bacterial counts (log CFU/ml) from corneal culture were 2.1, 5.02, and 8.89 for gentamicin, CM11, and control group, respectively (P ≤ 0.05). The above-mentioned findings displayed the efficacy of CM11 cationic peptide for curing the MRSA-mediated keratitis. [ABSTRACT FROM AUTHOR]

The most common ocular disease affecting cattle worldwide is infectious bovine keratoconjunctivitis (IBK), which has been associated with Moraxella bovis bacterium. Objective: To report the molecular characterization of the ocular bacterial microbiota and its relation to IBK in cattle in two dairy regions in Michoacán, Mexico. Methods: A total population of 761 bovines were evaluated, of which 17 (2.23%) showed symptoms of IBK. Thirty-eight bacterial isolates from ocular samples of bovines with IBK were characterized by Gram-staining and antimicrobial sensitivity. In addition, isolates were identified by sequence comparisons of the 16S ribosomal gene. Results: The genus Moraxella was one of the most abundant bacteria and M. bovoculi was the most predominant species. Conclusion: The bacterial isolates identified in eye lesions of cattle and associated to IBK are diverse. To the author's knowledge, this is the first study on the subject in Mexico; therefore, more research is needed to estimate the incidence of IBK and determine its associated microbiota. [ABSTRACT FROM AUTHOR]

Eye infection due to microbial infection is hard to treat and painful. Two types of eye drops that are commonly used to relieve eye pain offered by pharmacists have been tested in this study namely solution A (containing tetrahydrozoline hydrochloride) and solution B (containing gentamicin and dexamethasone). The efficacy and the activities of these eye drops were tested on Acanthamoeba sp. (a clinical isolate from an Acanthamoeba keratitis patient) to study the cytotoxicity effects of the solutions on the Acanthamoeba. The Acanthamoeba were exposed to solution A and B for 24 hr and cell viability was assessed using MTT assays, morphological changes using the light microscope and through acridine orange and propidium iodide (AO/PI) staining for cytoplasmic biochemical activities. The IC50 value for Acanthamoeba cell viability was 45.1% and 20.3% for solutions A and B respectively. Morphological observation shows the inhibition of acanthapodia formation on the surface of the cells. Solution A and B-treated Acanthamoeba appeared in the red color of the cytoplasm upon staining with AO/PI indicating a necrotic mode of cell death. This is due to loss of membrane integrity of Acanthamoeba cell membrane after exposed to solution A and B at their IC50 value. It is shown that solutions A and B can cause cell death in trophozoite of Acanthamoeba cells at moderate IC50 value. Unfortunately, the necrosis mode of cell death is not a preferable type of cell death for treating Acanthamoeba infection. Therefore, it can be concluded that solutions A and B are not suitable to treat eye infected with Acanthamoeba sp. as it does not promise absolute healing as the solution concentration needed is quite high and the cell death mechanism is necrosis. [ABSTRACT FROM AUTHOR]

Introduction: Eye diseases originated due to virus occupy an important place in daily routine of the specialty. Objective: To characterize patients with eye infections due to herpesvirus according to clinical and epidemiological variables of interest. Methods: A descriptive and cross-sectional study of 29 adult patients with infections due to herpesvirus was carried out, they were assisted in the ophthalmologic service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from September, 2012 to the same month in 2013. Results: In the case material white skin patients (55.1 %), female sex (69.0 %) and 57 years and over age group (48.3 %) prevailed. Red eye and ciliumconjuntival injection constituted the most common symptoms and signs (75.9 %). The most frequent lesions were located in the eyelids, the skin and cornea (31.0 %). The affectation of the visual acuteness below 0.3 was related to the occurrence of stromal affectation and the localization of lesions in the pupilar area. No patient presented inflammation of the later segment. Conclusions: Arguments about the existent relationship between the localization of lesions and the affectation of the visual acuteness were not found, which prevented to carry out comparisons. [ABSTRACT FROM AUTHOR]

Intraorbital infection shows a low incidence, but it might cause blindness or even death. This case is unusual in that its origin from a craniofacial bone fracture prior to infection of the maxillary sinus. A 33-year-old female patient was referred for right cheek swelling. When she visited the emergency room, we removed right cheek hematoma and bacterial examination was done. In the past, she had craniofacial bone surgical history due to a traffic accident 6 years ago. Next day, the swelling had remained with proptosis and pus was recognized in the conjunctiva. We planned an emergency operation and removed the pus which was already spread inside the orbit. And the evaluation for sinusitis was consulted to the otorhinolaryngology department simultaneously. There were Prevotella oralis and methicillin-resistant Staphylococcus epidermidis bacterial infection in the intraorbital and sinus respectively. Afterwards, the vigorous dressing was done for over a month with intravenous antibiotics. Though the intraorbital infection was resolved, blindness and extraocular movement limitation were inevitable. In conclusion, close follow up of the maxillary sinus in facial bone fracture patients is important and aggressive treatment is needed when an infection is diagnosed. [ABSTRACT FROM AUTHOR]

Background and Objectives: Staphylococcus aureus is the main Gram-positive bacteria isolated from patients with ocular infections. Herein, we describe the pattern of antibiotic resistance, presence of resistance genes including ermA, ermB, ermC, msrA, mecA and the pvl cytotoxin gene in S. aureus isolates collected from patients with external ocular infection. Materials and Methods: In this study, 8 S. aureus isolates were collected from 81 patients that suffered from eye damage. Antibacterial susceptibility of isolates was determined using the Kirby-Bauer disk diffusion method. Resistance genes including ermA, ermB, ermC, msrA, mecA and the pvl virulence gene were detected by PCR method. Staphylococcal cassette chromosome mec (SCCmec) in MRSA isolates were detected by the multiplex-PCR method. Results: Three isolates were resistant to cefoxitin which is considered MRSA. The mecA gene was identified in MRSA isolates. SCCmec type IV and the pvl gene were detected in one of the MRSA isolates that was recovered from a diabetic patient. Conclusion: The emergence of S. aureus isolates belonging to SCCmec type IV and pvl gene among patients with ocular infection is very serious; therefore, identify genetic characterization of MRSA isolates for empirical therapy and infection control is very important. [ABSTRACT FROM AUTHOR]

Not all red eyes are due to infections. Not all eye infections respond to antibiotic eye drops. Conjunctivitis is the most common eye infection. Most cases are viral and do not require antibiotic eye drops. Infectious keratitis is a cause of blindness. It is an emergency that requires specialist treatment. Infectious endophthalmitis is an emergency that has become more frequent with the use of intravitreal injections. Intravitreal antibiotics are needed to try and prevent visual loss. [ABSTRACT FROM AUTHOR]

The profit and production of an average Finnish blue fox farm was simulated using a deterministic bio-economic farm model. Risk was included using Arrow-Prat absolute risk aversion coefficient and profit variance. Risk-rated economic values were calculated for pregnancy rate, litter loss, litter size, pelt size, pelt quality, pelt colour clarity, feed efficiency and eye infection. With high absolute risk aversion, economic values were lower than with low absolute risk aversion. Economic values were highest for litter loss (18.16 and 26.42 EUR), litter size (13.27 and 19.40 EUR), pregnancy (11.99 and 18.39 EUR) and eye infection (12.39 and 13.81 EUR). Sensitivity analysis showed that selection pressure for improved eye health depended strongly on proportion of culled animals among infected animals and much less on the proportion of infected animals. The economic value of feed efficiency was lower than expected (6.06 and 8.03 EUR). However, it was almost the same magnitude as pelt quality (7.30 and 7.30 EUR) and higher than the economic value of pelt size (3.37 and 5.26 EUR). Risk factors should be considered in blue fox breeding scheme because they change the relative importance of traits. [ABSTRACT FROM AUTHOR]

Background: Nosocomial infections (NIs) in Neonatal Intensive Care Unit (NICU) are one of the leading causes of mortality and long term morbidity in developing countries. We retrospectively analyzed data of NICU patients from June 2013-June 2014. Total 120 patients met inclusion criteria. 73 episodes of nosocomial infections were documented in 67 patients. Eye infection and umbilical sepsis was most common infection followed by systemic blood infection. Klebsiella Pneumoniae and E. coli were the most common organisms causing sepsis. Chlamydia trachomatis and Staphylococcus aureus were the most common organisms responsible for eye infection and umbilical sepsis respectively. Imipenem, Amikacin and Vancomycin showed good sensitivity against most of gram negative and gram positive organisms respectively. [ABSTRACT FROM AUTHOR]

Bacterial keratitis can lead to severe visual impairment from corneal ulceration, subsequent scarring, and possible perforation. The mainstay of treatment is topical antibiotics, whereas the use of adjunctive topical corticosteroid drops remains a matter of debate. Herein, we review the rationale for and against the use of topical corticosteroids and we assess their effectiveness and safety in the published randomized controlled trials that have evaluated their role as adjunctive therapy for bacterial corneal ulcers. In the largest study to date, the Steroids for Corneal Ulcers Trial, topical corticosteroid drops were neither helpful nor harmful for the 500 participants as a whole. However, subgroup analyses suggested that topical corticosteroids may be beneficial upon early administration (within 2-3 days after starting antibiotics) for more central corneal ulcers with poorer vision at presentation, for invasive Pseudomonas strains, and for non-Nocardia ulcers. These results are discussed within the limitations of the study. [ABSTRACT FROM AUTHOR]

Mucormycosis is a potentially fatal fungal infection caused by a group of molds called mucormycetes. Rhino-Orbital-Cerebral Mucormycosis (ROCM) represents nearly half of all cases. This is the case of a 46-year-old female recently diagnosed with leukaemia and was started on chemotherapy. After initiating chemotherapy, she complained of headache, blurring of vision in the right eye and nasal discharge. Examinations revealed orbital apex syndrome. MRI disclosed an inflammation affecting the right orbit, ethmoid sinus and the frontal lobe. Ethmoidectomy was performed and biopsies confirmed mucormycosis. After that, symptoms persisted and complete loss of vision in her right eye occurred. Right orbital exenteration was required. The response was noticed over the subsequent weeks until she became asymptomatic. Five weeks after initially being diagnosed with leukaemia, she entered remission and was discharged on oral itraconazole and oral retinoic acid. Later, she remained in complete remission. In conclusion, early suspicion and diagnosis especially in immunocompromised patients with early aggressive treatment can be life saving. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to present the clinical course of a laboratory-acquired case of acute hemorrhagic conjunctivitis (AHC) caused by coxsackievirus A24 variant (CA24v). Also, the anti-CA24v neutralizing activity and anti-CA24v immunoglobulin (Ig) G and secretory IgA (sIgA) in acute and convalescent tears and/or sera are presented. Case: A 60-year-old male presented with acute-onset left eyelid edema, tearing, conjunctival erythema, pain, foreign body sensation, and subconjunctival hemorrhage 24 hours after suspected laboratory exposure. Bilateral conjunctivitis presented 24 hours later and resolved in 10 days. Methods: Tear and blood samples were collected for virus isolation and neutralizing assays. CA24v-reactive IgG and sIgA in tear and/or serum samples were detected by immunofluorescent antibody analysis of ethanol-fixed virus-infected cells. Results: Peak tear neutralization titers (1,000-1,500 U/mL) against the isolated virus occurred 1 day post-onset (po) of AHC. Tear neutralization titers became undetectable by the sixth day as serum neutralization titers became detectable on the ninth day po (60 U/mL), peaked by 21 days (3,000 U/mL), declined by 1 year to 200 U/mL, and remained at 30 U/mL 5 years po. Antibody to human IgG, IgA, and secretory component (sIgA) reacted with CA24v-infected cells treated with pooled acute tears collected 1-4 days po. Predominantly, sIgA was detected in CA24v-infected cells treated with tears collected 4 years and 5 years post-AHC, while convalescent serum contained predominantly anti-CA24v IgG. Conclusion: AHC was confirmed by CA24v isolation, tear anti-CA24v neutralizing activity, and seroconversion. The detection of CA24v-reactive IgG, sIgA, and neutralizing activity in tears collected 1-4 days po of AHC supports plasma extravasation of IgG and suggests a defensive role for tear anti-CA24v sIgA. The results suggest that immunofluorescent antibody analysis of tears for persistent anti-CA24v sIgA may be useful in epidemiological monitoring of AHC. [ABSTRACT FROM AUTHOR]

Purpose: To determine the role of the amino terminus of herpes simplex virus-1 (HSV-1) glycoprotein K (gK) in corneal infection, neuroinvasion, and establishment of virus latency in trigeminal ganglia of mice. Methods: The recombinant virus HSV-1 (McKΔgK31-68) was constructed by engineering gK genes encoding gK lacking 38 amino acids immediately after the gK signal sequence. A rescued virus was also produced. Mouse eyes were scarified and infected with 105 plaque forming units (PFU) in each eye. Clinical signs of ocular disease were monitored daily. Thirty days postinfection trigeminal ganglia were collected and processed for quantitative PCR (qPCR) analysis of viral DNA and recovery of infectious virions by cell culture of ganglionic tissues. Results: Deletion of the amino terminus of gK encoded by the McKΔgK31-68 mutant virus did not substantially affect its replication kinetics on African green monkey kidney cells (Vero), while it reduced cell-to-cell spread. McK viral infection of scarified mouse corneas with 105 PFU produced severe ocular disease. In contrast, McKΔgK31-68 viral infection with 105 PFU produced no significant ocular disease symptoms. All ganglia from mice infected with the McK virus produced high numbers of infectious virions upon explant culture in Vero cells, in agreement with qPCR results detecting high number of HSV-1 viral DNA in ganglionic tissues. In contrast, qPCR failed to detect any viral genomes in McKΔgK31-68 ganglia, while two of the ten ganglia revealed the presence of low numbers of infectious virions upon explant culture in Vero cells. Conclusions: The results show that the amino terminus of gK is essential for neuroinvasiveness and acute herpes keratitis in the mouse eye model. It is likely that gK is involved in efficient infection of axonal termini, since mouse eye scarification provided a direct access to the high density of neuronal axons innervating mouse corneas. [ABSTRACT FROM AUTHOR]

Infection with herpes simplex virus type 1 (HSV-1) and HSV-2 is initiated by viral glycoprotein D (gD) binding to a receptor on the host cell. Two receptors, herpesvirus entry mediator (HVEM) and nectin-1, mediate entry in murine models of HSV-1 and HSV-2. HVEM is dispensable for HSV-2 infection of the vagina and brain, but is required for WT pathogenesis of HSV-1 infection of the cornea. By challenging WT and HVEM KO mice with multiple strains of HSV-1 and HSV-2, we demonstrate that without HVEM, all HSV-1 strains tested do not replicate well in the cornea and infection does not result in severe symptoms, as observed in WT mice. In contrast, all HSV-2 strains tested had no requirement for HVEM to replicate to WT levels in the cornea and still cause severe disease. These findings imply that HSV-2 does not require HVEM to cause disease regardless of route of entry, but HVEM must be present for HSV-1 to cause full pathogenesis in the eye. These findings uncover a unique role for HVEM in mediating HSV-1 infection in an area innervated by the trigeminal ganglion and may explain why the presence of HVEM can lead to severe inflammation in the cornea. Thus, the dependence on HVEM is a dividing point between HSV-1 and HSV-2 that evolved to infect areas innervated by different sensory ganglia. [ABSTRACT FROM AUTHOR]

. Purpose: N-chlorotaurine (NCT) and its analogues N-monochloro-2,2-dimethyltaurine (NVC-612) and N-dichloro-2,2-dimethyltaurine (NVC-422) are new anti-infectives for topical treatment for conjunctivitis. The aim of this study was to show that these compounds are safe in an EpiOcular model and effective in corneas infected ex vivo. Methods: Corneal buttons were excised from porcine eyes. In 183 of the 229 corneas, erosion and artificial superficial stromal incision were induced. They were bathed in suspensions of Pseudomonas aeruginosa or Staphylococcus aureus for 24 hr at 37°C and incubated in solutions of the test substances at 37°C and pH 7.1. Subsequently, they were subjected to histology ( n = 20) or homogenized followed by quantitative bacterial cultures ( n = 209). Ocular irritation was tested using the EpiOcular™ tissue system (MatTek Corporation). Results: Bacterial accumulations were detected histologically both on the corneal surface and also in the anterior third of the stroma of incised corneal buttons. All three test compounds at a concentration of 55 m m (equals 1% NCT) reduced the bacterial counts of P. aeruginosa and S. aureus by approximately 5 log10 after 60- and 120-min incubation, respectively. Significant killing was observed as early as after 5-min incubation. Also intrastromal bacteria were inactivated. In the EpiOcular™ tissue model, NCT, NVC-422 and NVC-612 had no or very low potential to irritate corneal tissue. Conclusion: N-chlorotaurine, NVC-422 and NVC-612 are non-irritating in cornea and kill P. aeruginosa and S. aureus, even following penetration into the deeper corneal stromal layers. [ABSTRACT FROM AUTHOR]

Since their discovery by Bangham and coworkers almost four decades ago, liposomes have become models for biomembranes and vehicles for pharmaceutical, diagnostic, and cosmetic agents. One of the advantages of using liposomes as a drug vehicle is their ability for slow release, thus reducing dosage, localizing a drug, and minimizing its side-effects. Antibiotic resistance is a growing global problem, including for ocular bacterial infection by Staphylococcus aureus, where time is an important parameter that determines the severity of infection. This situation has prompted the pursuit of ways to prepare drug-encapsulating liposomes that enable bulk release of the drug chloramphenicol (CAP) once the liposomal structure is perturbed. Our approach is a two-step process: first, to characterize the interaction of CAP with model biomembranes of dimyristoylphosphatidylcholine (DMPC) used to prepare CAP-liposomes by different formulations; second, to test the efficiency of these formulation against S. aureus. Solid-state NMR, differential scanning calorimetry, and infrared spectroscopy were used to study the interaction of CAP with DMPC bilayers. The minimum inhibitory concentrations and time-kill curves for S. aureus using different liposomal preparations were compared. Evidence of conformational changes in the DMPC molecules and the effectiveness of the CAP encapsulated in liposomes are reported. © 2007 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 97:2691–2701, 2008 [ABSTRACT FROM AUTHOR]

Purpose: To determine the role of herpes simplex virus-1 (HSV-1) glycoprotein K(gK) in corneal infection, neuroinvasion, and virus latency in trigeminal ganglia of mice. Methods: The recombinant virus HSV-1 (McKrae) Δ gK (MKΔ gK) carrying a deletion of the gK gene was constructed by insertional/deletion mutagenesis and replaced by a gene cassette constitutively expressing the enhanced green fluorescence protein. The gK deletion of the MKΔ gK virus was rescued to produce the wild-type-like virus MKgK. Balb/c mice were infected ocularly with either virus, and the infection pattern in the eye, clinical disease progression, and establishment of viral latency was monitored. Results: Mice infected with the MKΔ gK strain produced in a gK complementing cell line did not exhibit clinical signs when compared with mice infected with the MKgK virus. Direct visualization of infected eyes revealed that the MKΔ gK virus was unable to spread in mouse corneas, while the MKgK rescued virus spread efficiently. Nineteen of 20 scarified and 5/12 unscarified mice infected with the MKgK virus produced infectious virus after coculture with permissive cells, while 0/20 scarified and 0/12 unscarified mice infected with the MKΔ gK virus produced infectious virus. HSV DNA was detected in trigeminal ganglia by PCR in 19/20 scarified and 9/12 unscarified mice inoculated with MKgK, while HSV DNA was detected in the trigeminal ganglia of 3/20 scarified and 0/12 unscarified mice inoculated with MKΔ gK. Conclusions: The results show that HSV-1 gK is essential for efficient replication and spread in the corneal epithelium and trigeminal ganglia neuroinvasion in MKΔ gK inoculated mice. [ABSTRACT FROM AUTHOR]

Abstract: Fever and periorbital swelling are the manifestation of a broad array of diseases. Among them are emergency situations, which need prompt physician input. Swiftly formulating a differential diagnosis approach is crucial. Diseases causing fever and periorbital edema are either local or systemic. Nevertheless, their impact can be systemic if they evade diagnosis. Infectious diseases and non-infectious diseases (inflammatory and allergic diseases, autoimmune diseases, neoplastic diseases, and trauma) can all lead to fever and periorbital edema. A meticulous history and physical examination in association with targeted tests against the presented spectrum of diseases (specific serological tests, radiological tests, cultures taken from the surface of the periorbital area and other relevant areas, and skin biopsy for histological and microbiological examination) will clarify the diagnosis. [Copyright &y& Elsevier]

Ocular infections are common and vary from self-limiting to sight-threatening. All the structures of the eye can be infected by various microbes.The present study was undertaken to determine the prevalence of bacterial and fungal infections of the eye and also to assess the antibiotic susceptibility pattern of bacterial isolates at an eye care hospital in Bangalore, India. Material and Methods: Two hundred thirty five samples were received from infections of the eye-conjunctivitis including dacrocystis, corneal ulcers, endophthalmitis and post-traumatic infections. Culture, Gram's stain and potassium hydroxide (KOH) mount was done for allclinical specimens. Giemsa staining was done occasionally as required. Antibiotic susceptibility testing was performed for bacterial growth. Results: Out of 235 samples processed, 81(34.5%) yielded bacterial growth and 32 (13.6%) yielded fungal growth. One corneal scraping showed the presence of Acanthamoeba by microscopy. Predominant bacterial isolates were- Staphylococcus species 36 (39.9%), Pseudomonas species 20 (22.2%) and Escherichia coli 12 (13.3%). Among 25 fungal isolates, Aspergillus flavus 11(44%) and Fusarium 8 (32%) predominated. Bacterial strains were susceptible to gatifloxacin (86.4%), tetracycline (65.4%), chlorampenicol (69.1%) and least sensitive to the beta- lactam group like amoxicillin (23.5%). Conclusion: Conjunctival specimens yielded mainly bacterial growth with Staphylococcus species being the predominant isolate followed by Pseudomonas species. Maximum fungal isolates were from corneal scrapings with Aspergillus flavus and Fusarium being predominant. Majority of the bacteria were susceptible to gatifloxacin. [ABSTRACT FROM AUTHOR]

Non-tuberculous or ‘atypical’ mycobacteria are unusual causes of ocular or periocular infection. We report a case of postoperative Mycobacterium abscessus infection of the conjunctiva. A 71-year-old gentleman developed nodular conjunctival injection and irritation 6 weeks after cataract surgery. After failure of topical therapy with antibiotics, steroids and lubricants, a biopsy was taken. Histological examination revealed non-caseating granulomas within which were clusters of acid-fast bacilli, subsequently identified as M. abscessus. The patient received a total of 16 weeks of oral antimycobacterial treatment and the conjunctivitis completely resolved. A suspected recurrence was successfully treated with topical ciprofloxacin and at final follow up 15 months later there was no evidence of infection. To the best of our knowledge this is the first report of non-tuberculous mycobacterial infection of the conjunctiva occuring after cataract surgery. [ABSTRACT FROM AUTHOR]

A surprisingly high incidence of chloramphenicol sensitization is reported in 8 patients with periocular or periauricular dermatitis. In 6 of them, relevance was established to the use of topical chloramphenicol. Concurrent sensitization to polymyxin B sulphate was found in 2. The findings stress the fact that chloramphenicol allergy remains a persistent problem. [ABSTRACT FROM AUTHOR]

Background: Helcococcus ovis, belonging to the genus of Helcococcu in Peptostreptococcaceae, is one kind of facultative anaerobic and gram-positive cocci, which was first isolated from a mixed infection in sheep in 1999. To our knowledge, it's known as an invasive pathogen in animals, and never been reported as a human pathogen in published literature. The aims of this work are to describe the first report of H. ovis which was recovered from the artificial eye of human case and perform a literature review.Case Presentation: A 26 year-old man reporting pyogenic infection with an artificial eye attended ophthalmic ward in Tongji hospital. After physical examination, clinical and laboratory investigations, the diagnosis of eye infection caused by Helcococcus ovis and Staphylococcus aureus was established. Receiving a medico-surgical approach, the patient was successfully treated. The treatment consisted in intravenous cefotaxime and ornidazole, levofloxacin eye drops during two weeks and removing of right artificial eye with debridement.Conclusions: We describe here the first known case of H. ovis which was recovered from human artificial eye. This report different from previous data found in the literature emphasizes the invasive potential of this bacterial species as a pathogen in human. Prospectively, the application of next generation sequencing tools would contribute to a more accurate classification of clinical strains. [ABSTRACT FROM AUTHOR]

Background: Colonisation with Panton-Valentine Leukocidin expressing strains of Staphylococcus aureus (PVL + SA) is characterised by recurrent skin and soft tissue infections. While periorbital and orbital infections are common in children and frequently caused by S. aureus the role of PVL + SA in recurrent eye infections has not been studied. This study aimed to detect and report frequency and recurrence of periorbital or orbital infections as additional symptoms of PVL + SA colonisation in children.Methods: We conducted a retrospective cohort study of pediatric patients who were treated for PVL + SA skin and soft tissue infection in our in- and outpatient clinics in Berlin, Germany from January 2012 to January 2017. We identified cases with periorbital or orbital infections in the year prior to the first PVL + SA evidence. In these cases, we conducted follow-up interviews by phone to determine recurrence of symptoms after the completion of decolonisation procedures.Results: Fifty pediatric patients (age range: one week to 17 years) were evaluated and treated for PVL + SA infections in the reported time period. 19 patients (38%) reported periorbital infection or conjunctivitis, with recurrent hordeola as the most frequent finding (n = 9; 18%). Reappearance of hordeola (n = 5) was associated with recurrence of skin and soft tissue infections and/or de novo detection of PVL + SA. No further hordeola or other eye infections occurred after successful decolonisation.Conclusion: Our findings suggest a frequent involvement of periorbital skin in children with PVL + SA infections. Pediatric patients with recurrent periorbital infections might benefit from PVL + SA screening and consecutive decolonisation procedures. [ABSTRACT FROM AUTHOR]

The article presents a study that deals with the use of voriconazole and caspofungin in a patient with fungal endophthalmitis. The patient underwent 52 days of combination therapy using systemic voriconazole with therapeutic intraocular concentrations. A switch to posaconazole orally was made due to clinical unresponsiveness of an infection to therapy. The administration of posaconazole treatment prevented the recurrence of the infection and led to the improvement of the patient's vision to hand motions.