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The Problem of Diagnosis and Treatment of Acute Inflammatory Diseases of Conjunctiva in Children

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https://doi.org/10.30702/Ophthalmology.2019/09.083441

Malachkova N.V.1, Kryvetska N.V.1, Bersanukaieva Y.V.2


1National Pirogov Memorial Medical University, Vinnytsia, Ukraine
2Ophthalmology Clinic “Optimalˮ, Vinnytsia, Ukraine

Summary

Introduction. The article shows the results of the study of early diagnosis and treatment of acute conjunctivitis in children.

Aim. To determine the parents’ attitude to the problem of conjunctivitis in children, their awareness about the disease as well as possible consequences and complications of the inflammatory process, to identify the most “popularˮ antibacterial eye drops among the parents whose children have had conjunctivitis within the last year.

Materials and methods. Questionnaire of 150 parents of children aged from 2 months to 13 years and have had acute bacterial conjunctivitis within the last year was used. Bacteriological assessment of 38 conjunctival samples was carried out.

Results. The purulent discharge but not conjunctival hyperemia makes the parents pay their attention to the child’s ocular problem in 92.85 % cases. Only 70 % of the parents sought medical attention. In order to choose a medication for the treatment of their child, 62 % of parents consulted a pharmacist in a pharmacy, 7 % considered advertising, 17.3 % were guided by their own experience and 13.8 % used experience and advice of relatives. Self-treatment with antibacterial eye drops lasted about 10 days. The conjunctival bacteriological pre-treatment assessment was not conducted in 72 % cases.

Conclusions. Awareness of the population about inflammatory conditions of conjunctiva, their consequences and possible complications remains low, as treatment was often carried out as a self-treatment. All of the above leads to the complications of the disease and increases duration and cost of the treatment.

Keywords: bacterial conjunctivitis, children, treatment efficacy.


REFERENCES
1. Antipova YuN, Antipova LN. [Experience of Oftaqix usage in pediatric ophthalmology]. Clinicheskaya ophthalmologiya. 2009;10(4):151–2. (in Russian).
2. Bessikalo VI, Reznichenko YuG, Solovieva SP, Odinokova ZhG, Samus TYu, Pavlova OP. [Ways of improvement of recurrent inflammation of the eye in children and adolescents]. Journal of Ophthalmology. 2006;5:25–7. (in Russian).
3. Bobrova NF, Molodaya AL. [Microflora in conjunctivitis and dacryocystitis in newborns and its sensitivity to antibacterial drugs]. Journal of Ophthalmology. 2011;6:4–7. (in Russian). http://doi.org/10.31288/oftalmolzh2011648
4. Vorontsova TN, Brzheskiy VV, Mikchailova MV. Microflora of conjunctiva in children and its sensitivity and resistance to antibacterial drugs. Ophthalmologiya in Russia. 2012;9(1):83-91. (in Russian). https://doi.org/10.18008/1816-5095-2012-1-83-91
5. Dolzhich GI, Eliseeva GV. [Phloxal in the treatment of bacterial conjunctivitis in children]. Pediatric Ophthalmology: results and perspectives: Proceedings of the Scientific and Practical Conference; 2006 Nov 21–23; Moscow, Russia. Moscow; 2006. p. 311. (in Russian).
6. Maichuk YuF. [Modern therapy of conjunctivitis in children]. Pediatriya. 2007;(2):80–7. (in Russian).
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8. Petrunya A, Selivanova O, Stepanenko G. [To the ground of application of thiol drugs at bacterial conjunctivitis treatment]. Archive of Ukrainian Ophthalmology. 2013;1(1):60–7. (in Russian).
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10. Savko VV, Naritsina NI, Konovalova NV, Novik AYa. [Efficacy of the drug Artelak in rehabilitation of patients with inflammatory diseases of the anterior section of the eye]. Journal of Ophthalmology. 2008;(4):5–7. (in Russian).
11. Hemavathi, Sarmah P, Shenoy P. Profile of Microbial Isolates in Ophthalmic Infections and Antibiotic Susceptibility of the Bacterial Isolates: A Study in an Eye Care Hospital, Bangalore. J Clin Diagn Res. 2014;8(1):23–5.
12. Teweldemedhin M, Gebreyesus H, Atsbaha AH, Asgedom SW, Saravanan M. Bacterial profile of ocular infections: a systematic review. BMC Ophthalmology. 2017;17:212 https://doi.org/10.1186/s12886-017-0612-2
13. Miller D. Update on the epidemiology and antibiotic resistance of ocular infections. Middle East Afri J Ophthalmol. 2017;24(1):30–42.
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Received: 13 Aug. 2018

Published: April 2019

A New Method of Episcleral Sealing with Operating Microscope and Optical System

Details

Ulrich Spandau, MD, PhD

Uppsala University Hospital, Uppsala, Sweden 

Summary. In this paper, a new method of sealing with an operating microscope and an optical system will be presented.

The optical fiber of the chandelier illuminator is inserted into the flat part of the ciliary body (the ciliary body) in the pars plana into the very cornea of the eye. The image of the retina will be shown on the screen of the standard optical system (BIOM). Thanks to the optical system, it is much easier to view the posterior segment of the eye and to find retroperitoneal locations much faster than indirect (reverse) ophthalmoscopy. In addition, the sewing of sealing material (silicone sponge) is easier to perform with a microscope than with indirect ophthalmoscopy. From this, it can be concluded that using the microscope and the optical system is easier and faster to track breaks in the retina than in the retrospect of ophthalmoscopy examination of the eye. Today, specialists in vitreoretinal surgery have extensive experience in working with a microscope and an optical system than the technique of indirect binocular ophthalmoscopy (using a microscope). This new method facilitates the operation of episcal seals and improves the outcome of the surgical intervention itself.


Received: 12 Nov. 2018

Published: April 2019

The Ways of Minimization the Side Effects of Antiglaucoma Drugs

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https://doi.org/10.30702/Ophthalmology.2019/09.105461

 Demin Yu. A.1, Shebanov R. V.2

1Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
2International Medical Center “Ophtalmicaˮ, Kharkiv, Ukraine

 Summary. Drug therapy is the method of first choice in glaucoma. Adverse events, that are associated with local usage of drugs, can have an effect on the patient’s adherence to prescribed treatment, the interaction between the doctor and the patient, and the quality of life. BAC (benzalkonium chloride) is the most commonly used preservative currently used in eye drops for the treatment of glaucoma. BAC is a highly effective antimicrobial preservative, but it also has a toxic effect on the cells of various structural eyes. In vitro studies, even low concentrations of BAH lead to toxic changes and apoptosis of the trabecular apparatus cells. Theoretically, long-term topical therapy with antiglaucoma drugs, in which BAC is used as a preservative, can cause of decreasing of trabecular function and worsening of glaucoma. In addition, prolonged use of drugs with BAC leads to decrease in the number of cells of the conjunctiva, disruption of the intercellular contacts of epithelial cells of the cornea with the development of their excessive desquamation, as well as epithelial metaplasia. At the cellular level, BAC induces oxidative stress, causes cell membrane lysis and protein denaturation, triggering the mechanism of apoptosis, activates and maintains the immune-inflammatory response, causing the so-called pro-inflammatory readiness of the conjunctiva and promoting the development of subconjunctival fibrosis. An alternative to antiglaucoma drops with BAC is using other, less toxic preservatives or non-preservative forms of drugs. At the beginning of 2019, the first non-preservative anti-glaucoma preparation from the group of prostaglandin analogues (prostamide), Bimikan ECO in a multi-dose vial, is available in Ukraine. The bottle of Bimikan® ECO is supplied with a special dropper, patented, as the system Novelia® produced by Nemera (France).

Keywords: glaucoma, BAC, non-preservative forms, Bimikan® ECO, Novelia® system.


REFERENCES

  1. European Glaucoma Society. Treatment principles and options. Chapter 3. In: EGS. Terminology and guidelines for glaucoma. 4th ed. Savona; 2014. p. 131–90.
  2. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global Prevalence of Glaucoma and Projections of Glaucoma Burden through 2040: A Systematic Review and Meta-Analysis. Ophthalmology. 2014;121(11):2081–90. https://doi.org/10.1016/j.ophtha.2014. 05.013
  3. Hopes M, Broadway D. Preservative-free Treatment in Glaucoma is a Sensible and Realistic Aim for the Future. Eur. Ophthalmic Rev. 2010;4:23–8. http://doi.org/10.17925/EOR.2010.04.01.23
  4. Astakhov SY, Grabovetskiy VR, Nefedova DM, Tkachenko NV. [Advantages and disadvantages of hypotensive eye drops without preservatives]. Oftalmologicheskie vedomosti. 2011;IV(2):95–7. (in Russian).
  5. Pisella PJ, Fillacier K, Elena PP, Debbasch C, Baudouin C. Comparison of the effects of preserved and unpreserved formulations of timolol on the ocular surface of albino rabbits. Ophthalmic Res. 2000;32:3–8. http://doi.org/10.1159/000055579
  6. Noecker RJ, Herrygers LA, Anwaruddin R. Corneal and conjunctival changes caused by commonly used glaucoma medication. Cornea. 2004;23:490–6.
  7. Collin HB, Grabsch BE. The effect of ophthalmic preservatives on the healing rate of the rabbit corneal epithelium after keratectomy. Am J Optom Physiol Opt. 1982 Mar;59(3): 215–22.
  8. Sherwood MB, Grierson I, Millar L, Hitchings RA. Long-term morphologic effects of antiglaucoma drugs on the conjunctiva and Tenon’s capsule in glaucomatous patients. Ophthalmology. 1989;96(3):327–35.
  9. Broadway DC, Grierson I, O’Brien C, Hitchings RA. Adverse effects of topical antiglaucoma medication. II. The outcome of filtration surgery. Arch Ophthalmol. 1994;112(11): 1446–54.

Received: 01 March 2019

Published: April 2019

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