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Demodex is a saprophytic mite of the ocular adnexa, which can in certain circumstances proliferate on the skin of the face and on the eyelid margins. It is involved in facial rosacea (especially in the papulopustular form) and in the development or aggravation of anterior and/or posterior blepharitis or even keratoconjunctivitis, often in association with cutaneous lesions ; the pathophysiology is often multifactorial. Symptoms are non-specific, but the presence of cylindrical sleeves on the eyelashes is very suggestive of infestation, and certain techniques of biomicroscopic examination or imaging, such as confocal microscopy in vivo, allow direct visualization of the parasite. Parasitological examination of the eyelashes can confirm the diagnosis and can be improved by good sampling technique. Eyelid hygiene and oil-based ointments are the cornerstone of treatment. New specific treatments, in particular topical treatments based on tea tree oil, ivermectin, as well as pulsed light therapy and micro-exfoliation of the eyelid margin, can help to reduce the parasitic load and improve symptoms., (Copyright © 2020. Published by Elsevier Masson SAS.)

Introduction: Atopic keratoconjunctivitis is associated with eyelid eczema. It may require the use of local corticosteroids which if prolonged can be a source of ocular complications. Tacrolimus is an immunosuppressant used in cutaneous application in atopic dermatitis. The aim of this study was to measure the efficacy and tolerance of tacrolimus 0.1% ointment in palpebral application in atopic keratoconjunctivitis., Patients and Methods: This retrospective, single-center study was conducted between June 2014 and February 2017. Patients with atopic keratoconjunctivitis not controlled by first-line medical treatments were included. The primary endpoint was the evolution of functional signs as assessed by the NEI-VFQ25 and OSDI quality of life scores. Secondary endpoints were visual acuity and local corticosteroid use., Results: Among the 18 patients included, the mean age was 37.9±16.8 years. The first follow-up visit was on average 68.3±55.3 days after initiation of treatment. The NEI-VFQ25 score was significantly improved for seven of its sub-scores (P<0.05) and the mean OSDI decreased significantly from 52.3±26.2 to 22.0±27.0 (P<0.001) showing a decrease in eye discomfort. A significant reduction was observed in the number of patients using local corticosteroids. There was no significant change in visual acuity., Conclusion: Tacrolimus ointment 0.1% in palpebral application appears to be an effective treatment for the management of atopic keratoconjunctivitis., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Allergies are frequently implicated in ophthalmologic practice. These typically benign allergies can be potentially severe for the ocular surface and have an impact in everyday life. We relate, through a case of keratoconjunctivitis involving 2 types of hypersensitivity, the various triggers and therapeutic choices to allow a more effective treatment., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Introduction: adult gonococcal keratoconjunctivitis is a rare disease possibly leading to blindness, whose severity is related to the risk of corneal perforation and whose progression is conditioned by the rapidity of diagnosis and therapeutic management., Purpose: discuss the value of general corticotherapy in the treatment of scleritis associated with this disease., Patients and Methods: retrospective analysis of patients with adult gonococcal keratoconjunctivitis managed in an emergency setting in 2007., Observation: three patients aged 22-55 years contracted the disease during unprotected sexual activity. Involvement was bilateral in two cases out of three; the intensity of the signs was always asymmetrical. Each patient underwent stromal melting of the superior limbic structures, with severity proportional to the delay in treatment. For each case, systemic and local antibiotics did not control corneal thinning, which seemed correlated with the intensity of the systematically associated signs of scleral inflammation. Treatment of scleritis with general corticotherapy under antibiotic cover stabilized the corneal thickness., Discussion: whether the physiopathology of perilimbic corneal thinning can lead to ocular perforation in this condition is unknown. In our experience, the stabilization of corneal thickness seems correlated with regression of the scleritis observed after introducing general corticotherapy, potentially indicating aseptic inflammatory involvement., Conclusion: stromal melting of the limbus observed in adult gonococcal keratoconjunctivitis seems to be related to the associated scleritis. Systemic corticotherapy controls progression and reduces the risk of corneal perforation., (2010 Elsevier Masson SAS. All rights reserved.)

73 patients were diagnosed as having epidemic keratoconjunctivitis using 2 inclusions criteria: 1) Negative conjunctival smear culture and 2) Eosinophilic inclusions and chromatic nucleus in conjunctival cells. A new therapeutical approach is proposed.

Immunofluorescence (IF) techniques were used to evaluate the therapeutical efficiency of moroxidine hydrochloride against herpes virus (HSV) induced keratoconjunctivitis. In 56 out of the 77 followed-up and treated patients, the IF reactions revealed the presence of both types 1 and 2 of herpes virus, while in 21 only type 1 was found. The treatment with moroxidine hydrochloride led to a reduction of 63% and 92%, respectively, of the incidence of herpes virus type 1 and 2 antigens in the conjunctival cells, coincident with the improvement of clinical symptoms or persistent recovery.