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Paterson R, Drake B, Tabin G, Cushing T. Wilderness Medical Society Clinical Practice Guidelines for Treatment of Eye Injuries and Illnesses in the Wilderness: 2024 Update. Wilderness Environ Med 2024; 35:67S-77S. [PMID: 38425236 DOI: 10.1177/10806032231223008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
A panel convened to develop an evidence-based set of guidelines for the recognition and treatment of eye injuries and illnesses that may occur in the wilderness. These guidelines are meant to serve as a tool to help wilderness providers accurately identify and subsequently treat or evacuate for a variety of ophthalmologic complaints. Recommendations are graded based on the quality of their supporting evidence and the balance between risks and benefits according to criteria developed by the American College of Chest Physicians.
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Affiliation(s)
- Ryan Paterson
- Department of Emergency Medicine, Denver Health Medical Center/University of Colorado School of Medicine, Denver, CO, USA
- Department of Emergency Medicine, Kaiser Permanente Medical Group - Colorado, Glenwood Springs, CO, USA
| | | | - Geoffrey Tabin
- Department of Ophthalmology, Stanford University, Palo Alto, CA, USA
| | - Tracy Cushing
- Department of Emergency Medicine, Denver Health Medical Center/University of Colorado School of Medicine, Denver, CO, USA
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Tian X, Sun H, Huang Y, Sui W, Zhang D, Sun Y, Jin J, He Y, Lu X. Microbiological isolates and associated complications of dacryocystitis and canaliculitis in a prominent tertiary ophthalmic teaching hospital in northern China. BMC Ophthalmol 2024; 24:56. [PMID: 38317063 PMCID: PMC10840201 DOI: 10.1186/s12886-024-03323-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND To report the microbiological isolates, aetiology, complications, antibiotic susceptibilities, and clinical remission of dacryocystitis and canaliculitis in a prominent tertiary ophthalmic teaching and referral hospital located in northern China and to offer appropriate recommendations for preventing and formulating drug treatment strategies. METHODS This prospective study recruited a total of 477 participants who had been diagnosed with either dacryocystitis or canaliculitis. The cohort comprised 307 patients with chronic dacryocystitis, 111 patients with acute dacryocystitis, and 59 patients with canaliculitis. Purulent discharge from the lacrimal duct was collected using a sterile swab and immediately subjected to microbial culture. Antimicrobial susceptibility testing was conducted following established protocols. All participants were scheduled for follow-up visits within 14 days after receiving antibiotic therapy. RESULTS The present findings indicated that women exhibited a higher susceptibility to the condition, as evidenced by the occurrence of 367 cases in comparison to 110 cases among men. Among the 477 patients, definitive causes were established in 59 individuals, accounting for 12.4% of the patients. Additionally, ocular complications were reported by 132 patients, representing 27.7% of the total. Monocular involvement was observed in the majority of cases, with 402 out of 477 patients (84.3%) affected, while binocular involvement was present in 75 patients (15.7%). In total, 506 microbiological strains were recovered from 552 eyes, with Staphylococcus epidermidis (16.4%) being the most prevalent microorganism. Other predominant isolates included Corynebacterium macginleyi (9.1%), Staphylococcus aureus (5.1%), Streptococcus pneumoniae (4.9%), Haemophilus (4.4%), Propionibacterium acnes (3.5%), and Eikenella corrodens (3.1%). Among the 12 isolated fungi, Candida parapsilosis accounted for 66.7%. The susceptibility to antimicrobial agents tested in gram-negative bacilli (79.5%) was observed to be higher than that of anaerobic bacteria (76.7%) and gram-positive cocci (55.4%). With pharmacological therapy, the remission rate of acute dacryocystitis (72.7%) was found to be higher than that of canaliculitis (53.3%) and chronic dacryocystitis (42.3%). CONCLUSIONS This study highlights the microbial spectrum of dacryocystitis and canaliculitis, particularly C.macginleyi, E.corrodens and C.parapsilosis, which are also more frequently isolated. Vancomycin and imipenem may be more effective treatment options. Most cases have an unknown aetiology, and essential preventive measures involve postoperative cleansing of the lacrimal passage following eye and nasal surgeries, as well as the proactive management of rhinitis.
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Affiliation(s)
- Xiaobo Tian
- Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, China
| | - Hua Sun
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, China
| | - Yanfei Huang
- Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, China
| | - Wenjun Sui
- Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, China
| | - Dan Zhang
- Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, China
| | - Yufeng Sun
- Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, China
| | - Jing Jin
- Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, China
| | - Yueqing He
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, China
| | - Xinxin Lu
- Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, China.
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Chen R, Yu X, Xie L, Hu Y, Jiang A, Wumaier A, Meng Z, Li J, Shen Y, Chen M, Li S, Huang D, Liang X. Microbial distributions in the conjunctiva and lacrimal sacs of patients with chronic dacryocystitis in a tertiary hospital. Int Ophthalmol 2023:10.1007/s10792-023-02743-w. [PMID: 37338773 DOI: 10.1007/s10792-023-02743-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/06/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND The aim was to clarify the distributions of bacteria in the conjunctival sac and lacrimal sac in patients with chronic dacryocystitis. METHODS In total, 297 (322 eyes) chronic dacryocystitis patients who underwent nasal endoscopic dacryocystorhinostomy (EN-DCR) were included. Conjunctival sac secretions from the affected eye were collected preoperatively, and lacrimal sac retention fluid from the affected side in the same patient was collected intraoperatively. Bacterial culture and drug sensitivity testing were performed to determine bacterial distributions. RESULTS In total, 127 bacterial isolates (49 species) were detected in 123 eyes in the conjunctival group, with a positivity rate of 38.2% (123/322); 85 bacterial isolates (30 species) were detected in 85 eyes in the lacrimal sac group, with a positivity rate of 26.4% (85/322). The positivity rates were significantly different (P = 0.001) between two groups. The gram-negative bacilli proportion in the lacrimal sac group (36/85, 42.4%) was significantly higher than that in the conjunctival sac group (37/127, 29.2%) ( P = 0.047). Positive conjunctival sac secretion culture (123/322) was significantly associated with increased ocular secretion (281/322, 87.3%) (P = 0.002). Among the culture-positive bacteria in the conjunctival sac group and the lacrimal sac group, 30/127, 23.6% and 43/127, 26.7% and 21/85, 24.7% and 20/85, 23.5% were resistant to levofloxacin and tobramycin, respectively. CONCLUSIONS This study illustrated differences in bacterial distributions between conjunctival sac secretions and retained lacrimal sac fluid in chronic dacryocystitis patients, with a higher proportion of gram-negative bacilli in lacrimal sac secretions. The ocular surface flora in chronic dacryocystitis patients is partially resistant to levofloxacin and tobramycin, which need to be considered by ophthalmologists.
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Affiliation(s)
- Rongxin Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, 54 South Xianlie Road, Guangzhou, 510060, China.
| | - Xinyue Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Lingling Xie
- Ophthalmologic Center, The Affiliated Kashi Hospital of Sun Yat-Sen University, The First People's Hospital of Kashi Prefecture, Kashi, 844000, China
| | - Yu Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Aixin Jiang
- Ophthalmologic Center, The Affiliated Kashi Hospital of Sun Yat-Sen University, The First People's Hospital of Kashi Prefecture, Kashi, 844000, China
| | - Aizezi Wumaier
- Ophthalmologic Center, The Affiliated Kashi Hospital of Sun Yat-Sen University, The First People's Hospital of Kashi Prefecture, Kashi, 844000, China
| | - Ziwei Meng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Jing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Yongqing Shen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Meiqing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Shuiling Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Danping Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, 54 South Xianlie Road, Guangzhou, 510060, China
| | - Xuanwei Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Diseases, 54 South Xianlie Road, Guangzhou, 510060, China.
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Patil R, Dehari D, Chaudhuri A, Kumar DN, Kumar D, Singh S, Nath G, Agrawal AK. Recent advancements in nanotechnology-based bacteriophage delivery strategies against bacterial ocular infections. Microbiol Res 2023; 273:127413. [PMID: 37216845 DOI: 10.1016/j.micres.2023.127413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
Antibiotic resistance is growing as a critical challenge in a variety of disease conditions including ocular infections leading to disastrous effects on the human eyes. Staphylococcus aureus (S. aureus) mediated ocular infections are very common affecting different parts of the eye viz. vitreous chamber, conjunctiva, cornea, anterior and posterior chambers, tear duct, and eyelids. Blepharitis, dacryocystitis, conjunctivitis, keratitis, endophthalmitis, and orbital cellulitis are some of the commonly known ocular infections caused by S. aureus. Some of these infections are so fatal that they could cause bilateral blindness like panophthalmitis and orbital cellulitis, which is caused by methicillin-resistant S. aureus (MRSA) and vancomycin-resistance S. aureus (VRSA). The treatment of S. aureus infections with known antibiotics is becoming gradually difficult because of the development of resistance against multiple antibiotics. Apart from the different combinations and formulation strategies, bacteriophage therapy is growing as an effective alternative to treat such infections. Although the superiority of bacteriophage therapy is well established, yet physical factors (high temperatures, acidic pH, UV-rays, and ionic strength) and pharmaceutical barriers (poor stability, low in-vivo retention, controlled and targeted delivery, immune system neutralization, etc.) have the greatest influence on the viability of phage virions (also phage proteins). A variety of Nanotechnology based formulations such as polymeric nanoparticles, liposomes, dendrimers, nanoemulsions, and nanofibres have been recently reported to overcome the above-mentioned obstacles. In this review, we have compiled all these recent reports and discussed bacteriophage-based nanoformulations techniques for the successful treatment of ocular infections caused by multidrug-resistant S. aureus and other bacteria.
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Affiliation(s)
- Rohit Patil
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, U.P., India
| | - Deepa Dehari
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, U.P., India
| | - Aiswarya Chaudhuri
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, U.P., India
| | - Dulla Naveen Kumar
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, U.P., India
| | - Dinesh Kumar
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, U.P., India
| | - Sanjay Singh
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, U.P., India; Babasaheb Bhimrao Ambedkar University, Lucknow 226025, U.P., India
| | - Gopal Nath
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, U.P., India
| | - Ashish Kumar Agrawal
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, U.P., India.
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Arinelli A, Aleixo ALQC, Freitas DFS, do Valle ACF, Almeida-Paes R, Nobre Guimarães AL, Oliveira RVC, Gutierrez-Galhardo MC, Curi ALL. Ocular Manifestations of Sporotrichosis in a Hyperendemic Region in Brazil: Description of a Series of 120 Cases. Ocul Immunol Inflamm 2023; 31:329-337. [PMID: 35080998 DOI: 10.1080/09273948.2022.2027465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe 120 cases of ocular sporotrichosis. METHODS Review of medical records of patients with culture-proven (from eye specimen) ocular sporotrichosis, in Rio de Janeiro, from 2007 to 2017. RESULTS Women were more affected (61.7%) and median age was 24 years. The isolated ocular form was more frequent (75.8%). Fixed cutaneous sporotrichosis was the most commonly associated form (48.3%). Hypersensitivity reactions were observed in 10% of patients. Ocular involvement was unilateral in 98.3% of the cases, and the most frequent clinical presentation was granulomatous conjunctivitis (86.7%), followed by eyelid lesion (25%). Dacryocystitis represented 7.5% of the cases, predominantly in children (55.6%). Itraconazole was the first choice treatment (95.8%). Sequelae were observed in 23 patients (22.5%), and surgical treatment was required for most of them. CONCLUSION Ocular sporotrichosis can be considered a characteristic form of the zoonotic transmission, with high morbidity. Delay in initiating specific treatment is likely to increase the risk of progression to more severe forms of the disease, and development of ocular sequelae.
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Affiliation(s)
- Andrea Arinelli
- Laboratory of Clinical Research in Infectious Ophthalmology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Ana L Q C Aleixo
- Laboratory of Clinical Research in Infectious Ophthalmology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Dayvison F S Freitas
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Antonio C F do Valle
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Rodrigo Almeida-Paes
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Ana L Nobre Guimarães
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Raquel V C Oliveira
- Laboratory of Epidemiology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - André L L Curi
- Laboratory of Clinical Research in Infectious Ophthalmology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
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Minezaki T, Hattori T, Shibata M, Nakagawa H, Kumakura S, Goto H. Corneal Perforation Associated with Lacrimal Canaliculitis: A Case Series. Int Med Case Rep J 2023; 16:83-89. [PMID: 36748025 PMCID: PMC9899018 DOI: 10.2147/imcrj.s394715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
Purpose To report seven eyes of six patients diagnosed with corneal perforation and lacrimal canaliculitis in a single facility. Methods Clinical records of patients with corneal perforation accompanied by lacrimal canaliculitis seen by the authors were reviewed. Results Six patients (7 eyes) with corneal perforation accompanied by lacrimal canaliculitis were identified. All patients were female, and all were treated with topical antibiotics while five were receiving topical corticosteroids. Two patients had a history of dacryocystitis and three had systemic immune diseases. The corneal lesions did not respond to topical antibiotics but were effectively treated by removal of concretions in the lacrimal canaliculi and lacrimal duct drainage together with conjunctival autograft or corneal transplantation. Conclusion Lacrimal canaliculitis is a risk factor for corneal perforation. When corneal perforation does not respond to antibiotics, lacrimal canaliculitis should be considered.
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Affiliation(s)
- Teruumi Minezaki
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
| | - Takaaki Hattori
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan,Correspondence: Takaaki Hattori, Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan, Tel +81-3-3342-6111, Fax +81-3-3342-9170, Email
| | - Motoko Shibata
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
| | - Hayate Nakagawa
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
| | - Shigeto Kumakura
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
| | - Hiroshi Goto
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
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Abebe T, Teklemariam Z, Shume T, Mekuria S, Urgesa K, Weldegebreal F. Bacterial Profile of External Ocular Infections, Its Associated Factors, and Antimicrobial Susceptibility Pattern among Patients Attending Karamara Hospital, Jigjiga, Eastern Ethiopia. Int J Microbiol 2023; 2023:8961755. [PMID: 36937542 PMCID: PMC10023229 DOI: 10.1155/2023/8961755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 01/10/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Abstract
Background External ocular infection is a global public health problem. Frequently, bacteria cause an ocular infection that ranges from morbidity to loss of vision. The increasing bacterial resistance in ocular infections leads to the risk of treatment failure with possibly serious consequences. Objective The study aimed to assess the bacterial profile of external ocular infections, their associated factors, and antimicrobial susceptibility pattern among patients admitted to Karamara hospital, Jigjiga, Eastern Ethiopia. Method Institutional-basedcross-sectional study was conducted on 288 conveniently selected patients among patients admitted to Karamara hospital from May 1 to June 30, 2020. Data were collected using a structured questionnaire. The ocular sample was collected and cultured in the appropriate culture media and identified using a series of biochemical tests. Antimicrobial susceptibility testing of isolates was performed by using the disk diffusion method. Data were double entered onto EpiData version 3.1 then exported to SPSS version 20 and analyzed to calculate descriptive frequency and odds ratio, and p value ≤0.05 was taken as the significant value. Result The prevalence of bacterial infection in external ocular samples was 62.2% (95% CI: 56.6%, 68.4%). Out of the 179 isolates, the majority of the bacterial isolates (87.7%) were Gram-positive. Staphylococcus aureus (53.1%) was the predominant isolate. Using soap for washing the face (AOR = 0.43; 95% CI: 0.29, 0.95), having diabetes mellitus (AOR = 3.11; 95% CI: 1.45, 6.75), and history of hospitalization (AOR = 2.82; 95% CI: 1.44, 5.54) were significantly associated with external ocular infection. Most (95.5%) of the Gram-positive bacteria showed resistance to penicillin, but they were susceptible to vancomycin, clindamycin, and ciprofloxacin. Conclusion The study showed a high prevalence of bacterial infections with the predominant isolate was S. aureus. Penicillin-resistant bacteria were identified among Gram-positive bacterial isolates. Soap usage, hospitalization, and diabetes mellitus were associated with the infection. Antibiotics that were susceptible to the specific bacteria should be used as a drug of choice and using soap for washing the face is advisable to protect against external ocular infection.
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Affiliation(s)
- Tigist Abebe
- 1Jigjiga University, College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Jigjiga, Ethiopia
| | - Zelalem Teklemariam
- 2Haramaya University, College of Health and Medicine Sciences, Harar, Ethiopia
| | - Tadesse Shume
- 2Haramaya University, College of Health and Medicine Sciences, Harar, Ethiopia
| | - Surafel Mekuria
- 1Jigjiga University, College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Jigjiga, Ethiopia
| | - Kedir Urgesa
- 2Haramaya University, College of Health and Medicine Sciences, Harar, Ethiopia
| | - Fitsum Weldegebreal
- 2Haramaya University, College of Health and Medicine Sciences, Harar, Ethiopia
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Sternberg J, Lambiel S, Van HC, Massa H, Landis BN. Epstein–Barr virus-related dacryocystitis: a case report. J Med Case Rep 2022; 16:430. [PMID: 36401292 PMCID: PMC9675078 DOI: 10.1186/s13256-022-03646-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/13/2022] [Indexed: 11/21/2022] Open
Abstract
Background and objective Acute dacryocystitis is an atypical and rare manifestation of pediatric mononucleosis still widely underdiagnosed in clinical practice. We report this rare condition and describe challenges in its diagnosis and treatment on the basis of a presented case. Case presentation A 6-year-old Caucasian girl without any ophthalmic history was admitted for right preseptal cellulitis requiring intravenous antibiotic therapy. During hospitalization, she developed a fluctuating lump in the nasolacrimal region which resembled an abscess, both clinically and radiologically. There was no spontaneous purulent discharge. Serology was positive for acute mononucleosis and Epstein–Barr virus-related dacryocystitis was diagnosed. Following multidisciplinary discussion, she was treated conservatively with digital lacrimal sac massages and intravenous antibiotic therapy with an excellent outcome. Discussion This rare form of Epstein–Barr virus is poorly documented in the literature, and thus barely known. As initial symptoms are nonspecific (rhinitis, fever, eyelid edema and erythema lack of purulent discharge, and moderate bilateral cervical lymphadenopathy), diagnosis is often difficult. Nevertheless, differentiating between dacryocystitis and abscess is crucial to select the appropriate treatment and avoid unnecessary, potentially harmful surgery. Conservative management of dacryocystitis appears to be the gold standard of treatment. Conclusion Acute dacryocystitis in children free of ophthalmic history should raise suspicion of primary Epstein–Barr virus infection. With conservative treatment, prognosis appears to be excellent; therefore, surgery should be avoided as much as possible.
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Affiliation(s)
- J. Sternberg
- grid.150338.c0000 0001 0721 9812Department of Pediatrics, Geneva University Hospital, Geneva, Switzerland
| | - S. Lambiel
- grid.150338.c0000 0001 0721 9812Department of Clinical Neurosciences, Oto-Rhino-Laryngology and Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - H. Cao Van
- grid.150338.c0000 0001 0721 9812Department of Clinical Neurosciences, Oto-Rhino-Laryngology and Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - H. Massa
- grid.150338.c0000 0001 0721 9812Department of Clinical Neurosciences, Ophthalmology Unit, Geneva University Hospital, Geneva, Switzerland
| | - B. N. Landis
- grid.150338.c0000 0001 0721 9812Department of Clinical Neurosciences, Oto-Rhino-Laryngology and Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
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Dohlman JC, Rizzo JF. Diagnostics for Infectious Orbital and Ocular Adnexal Disease. Int Ophthalmol Clin 2022; 62:87-100. [PMID: 35325912 DOI: 10.1097/iio.0000000000000417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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The Bacterial Profile and Microbial Susceptibility of Acute and Chronic Dacryocystitis in Matini Hospital, Kashan, Iran. Jundishapur J Microbiol 2021. [DOI: 10.5812/jjm.115547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Recent studies have shown an increasing incidence of antibiotic resistance in dacryocystitis. Management of diseases may include determining microbial agents and choosing appropriate antibiotics for treatment. Objectives: This study aimed to present the best treatments for dacryocystitis. To this end, specimens' microbiology and antibiotic susceptibility were examined in patients with dacryocystitis in the microbiology laboratory of the Kashan University of Medical Sciences. Methods: This cross-sectional study was performed on 172 patients presenting with acute and chronic dacryocystitis at the Matini Hospital, Kashan, between 2017 - 2018. Patient characteristics, culture isolates, and antimicrobial susceptibility data were collected. The PCR assay of the mecA gene was performed in all methicillin-resistant Staphylococcus isolates. Results: The most common bacteria were coagulase-negative staphylococci (CoNS), Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii. The majority of the isolated microbes were sensitive to rifampicin, linezolid, amikacin, and gentamicin. In Gram-negative bacilli, nine of the isolates were extended-spectrum beta-lactamase positive. The PCR test showed the frequency of mecA gene of resistant S. aureus and resistant CoNS isolates to be 40 and 46.3%, respectively. Conclusions: Coagulase-negative staphylococci were the most frequently isolated bacteria. The highest antibiotic susceptibility was observed to rifampin, linezolid, amikacin, and gentamicin. A high percentage of CoNS carried the mecA gene.
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Atkova EL, Magomedov MM, Maydanova AA, Magomedova NM. [Modern methods in diagnostics of lacrimal system vertical part obliteration]. Vestn Otorinolaringol 2021; 86:97-103. [PMID: 34269032 DOI: 10.17116/otorino20218603197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A review of the literature is devoted to the description of modern diagnostic methods that are directed at detecting lacrimal pathway obstruction. The presented analysis is based on the study of data from Russian and foreign literary sources on both routine and high-tech lacrimal system examination methods, as well as on authors' experience in studying the diagnostic efficiency of imaging methods such as lacrimal scintigraphy, computed tomography with lacrimal pathway contrasting, and also single photon emission computed tomography. The article gives information about the advantages and disadvantages of the presented methods, highlights the questions of the prospects of their usage in practical dacryology.
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Affiliation(s)
- E L Atkova
- Research Institute of Eye Diseases, Moscow, Russia
| | - M M Magomedov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A A Maydanova
- Research Institute of Eye Diseases, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
| | - N M Magomedova
- Pirogov Russian National Research Medical University, Moscow, Russia
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Qing H, Yang Z, Shi M, Zhang J, Sun S, Han L. Microbial spectrum and antibiotic sensitivity in infantile dacryocystitis. Graefes Arch Clin Exp Ophthalmol 2021; 259:1263-1272. [PMID: 33417095 DOI: 10.1007/s00417-020-05026-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/03/2020] [Accepted: 11/23/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To identify the characteristics and the spectrum of microbial agents of infantile dacryocystitis and to assess the trends in both antibiotic sensitivities and pathogens over the past 10 years. METHODS The microbial and medical records of 546 culture-proven patients (546 eyes) of infantile dacryocystitis diagnosed at Henan Eye Hospital between January 2009 and December 2018 were retrospectively reviewed. Patient demographics, microbial analysis, and susceptibility rates to various antibiotics were done. A chi-squared test for trends was applied to evaluate changes in antibiotic susceptibility and microbial spectrum over time. RESULTS A total of 546 patients with infantile dacryocystitis were documented. The average age was 2.97 ± 4.15 months, and 42.7% were female. The proportion of gram-positive microbes, gram-negative microbes, and fungi was 80.2, 19.4, and 0.4%, respectively. Minocycline was sensitive to gram-positive bacteria (98.0%). Imipenem was sensitive to gram-negative bacteria (89.2%). Increasing susceptibility was observed in two bacterial isolates: Staphylococcus aureus (P = 0.005) and Streptococcus mitis (P = 0.001). Decreasing susceptibility was observed in one bacterial isolate: Staphylococcus epidermidis (P < 0.0001). Increasing microbial susceptibility over time was detected for 12 antibiotics. Decreasing microbial sensitivity was observed for one antibiotic. CONCLUSIONS The most common cause of infantile dacryocystitis is Staphylococcus epidermidis. Though a significant trend towards increasing microbial sensitivity to some antibiotics was observed, including glycopeptides, cephalosporins, fluoroquinolones, tetracyclines, and lincosamides, a significant trend towards decreasing microbial sensitivity to amikacin was also detected.
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Affiliation(s)
- Huiling Qing
- Department of Ophthalmology, Henan Eye Hospital, Henan Eye Institute, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, NO.7, Wei-wu Road, Zhengzhou, 450003, China.
| | - Zhengwei Yang
- Department of Ophthalmology, Henan Eye Hospital, Henan Eye Institute, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, NO.7, Wei-wu Road, Zhengzhou, 450003, China
| | - Menghai Shi
- Department of Ophthalmology, Henan Eye Hospital, Henan Eye Institute, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, NO.7, Wei-wu Road, Zhengzhou, 450003, China
| | - Junge Zhang
- Department of Ophthalmology, Henan Eye Hospital, Henan Eye Institute, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, NO.7, Wei-wu Road, Zhengzhou, 450003, China
| | - Shengtao Sun
- Department of Ophthalmology, Henan Eye Hospital, Henan Eye Institute, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, NO.7, Wei-wu Road, Zhengzhou, 450003, China
| | - Lei Han
- Department of Ophthalmology, Henan Eye Hospital, Henan Eye Institute, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, NO.7, Wei-wu Road, Zhengzhou, 450003, China
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Trevisan M, Tamaro G, Conversano E, Cozzi G, Dall'Amico R, Barbi E. Newborn With a Swelling Cherry Eye. Ann Emerg Med 2019; 74:453-456. [PMID: 31445546 DOI: 10.1016/j.annemergmed.2019.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Matteo Trevisan
- Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy
| | - Gianluca Tamaro
- Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy
| | - Ester Conversano
- Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy
| | - Giorgio Cozzi
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Roberto Dall'Amico
- Pediatric Department, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Egidio Barbi
- Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy; Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
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14
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Constante AR, Rebelo F, Bicho A, Fortunato F. Bilateral Lacrimal Sac Swelling in a Newborn. Neoreviews 2019; 20:e242-e244. [PMID: 31261067 DOI: 10.1542/neo.20-4-e242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Ana Rita Constante
- Department of Pediatrics, Centro Hospitalar Oeste, Caldas da Rainha, Portugal
| | - Filomena Rebelo
- Department of Pediatrics, Centro Hospitalar Oeste, Caldas da Rainha, Portugal
| | - Anabela Bicho
- Department of Pediatrics, Centro Hospitalar Oeste, Caldas da Rainha, Portugal
| | - Fabiana Fortunato
- Department of Pediatrics, Centro Hospitalar Oeste, Caldas da Rainha, Portugal
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Drapkin Z, Franchek-Roa K, Srinivas GL, Buchi KF, Miescier MJ. Is my baby normal? A review of seemingly worrisome but normal newborn signs, symptoms and behaviors. Am J Emerg Med 2019; 37:1153-1159. [PMID: 30952605 DOI: 10.1016/j.ajem.2019.03.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/18/2019] [Accepted: 03/20/2019] [Indexed: 12/20/2022] Open
Abstract
Infant patients are a unique challenge to emergency department (ED) physicians as the spectrum of normal infant signs, symptoms and behaviors are often difficult to differentiate from abnormal and potentially life-threatening conditions. In this article, we address some common chief complaints of neonates and young infants presenting to the ED, and contrast reassuring neonatal and young infant signs and symptoms against those that need further workup and intervention.
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Affiliation(s)
- Zachary Drapkin
- Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, UT, USA; Department of Surgery, Division of Emergency Medicine, University of Utah, Salt Lake City, UT, USA.
| | | | - Ganga L Srinivas
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Karen F Buchi
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Michael J Miescier
- Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, UT, USA
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Chen L, Fu T, Gu H, Jie Y, Sun Z, Jiang D, Yu J, Zhu X, Xu J, Hong J. Trends in dacryocystitis in China: A STROBE-compliant article. Medicine (Baltimore) 2018; 97:e11318. [PMID: 29953020 PMCID: PMC6039673 DOI: 10.1097/md.0000000000011318] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The aim of the study was to review the distribution, current trends, and microbiological characteristics of bacterial pathogens isolated from dacryocystitis patients in China during the last 15 years.This is a retrospective multiple-center noncomparative case series. The medical records of 15,452 consecutive patients from 7 cities diagnosed as having dacryocystitis between 2002 and 2016 were reviewed. The patients' demographics, microbiological data, and antibiotic sensitivity were reviewed and analyzed.A total of 3344 lacrimal sac content cultures were taken (21.6%) during the study period. A pathogen was identified in 1996 samples (59.7%), with bacterial isolates accounting for 1902 of the positive cultures (95.3%). Gram-positive isolates, gram-negative isolates, and anaerobic bacteria were found in 1218 (61.0%), 607 (30.4%), and 285 (14.3%) samples, respectively. An increase in gram-positive isolates over the study duration was found (P = .003). The predominant isolates were coagulase negative Staphylococci (485, 25.5%), Staphylococcus aureus (186, 9.8%), Pseudomonas aeruginosa (184, 9.7%), and Haemophilus influenzae (152, 9.0%). There was a trend toward increasing resistance to erythromycin from 10.5% during the first 5 years of the study to 20.7% during the last 5 years (P < .001). Antimicrobial susceptibility testing showed that gatifloxacin was the most effective drug against most of gram-positive, gram-negative, and anaerobic bacteria.The microbial culture rate of dacryocystitis in China is low. There was an increase in the percentage of gram-positive bacteria over time. The sensitivity of gram-positive isolates to tested antibiotics is relatively low compared with that of gram-negative isolates. Our data show that the empiric use of fourth-generation fluoroquinolones in refractory dacryocystitis may be justified.
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Affiliation(s)
- Lijuan Chen
- People's Hospital of Putuo District, Shanghai
| | - Tongsheng Fu
- Department of Ophthalmology, People Hospital, Yangzhong
| | - Hao Gu
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang
| | - Ying Jie
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory Beijing, China
| | - Zhongmou Sun
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Donghong Jiang
- Department of Ophthalmology, The Second People Hospital, Taixing
| | - Jibing Yu
- The Affiliated Hospital of Ningbo University, Ningbo
| | - Xinxing Zhu
- Rudong Hospital of Traditional Chinese Medicine, Rudong
| | - Jianjiang Xu
- Department of Ophthalmology and Visual Science, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiaxu Hong
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang
- Department of Ophthalmology and Visual Science, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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Abstract
PURPOSE Recent studies suggest an increasing incidence of gram-negative bacteria and methicillin-resistant Staphylococcus aureus in dacryocystitis. Since patients are often treated empirically without culture data, a changing microbiologic profile will markedly affect the success of oral treatment. To provide current guidelines for the treatment of this common condition, we investigated the microbiology and antibiogram of dacryocystitis seen at our institution. METHODS The charts of all patients presenting with acute and/or chronic dacryocystitis in University Hospital, Newark, from 2007 to 2015 were reviewed. Patient demographics, culture isolates, and in vitro antimicrobial susceptibility data were collected. Additional sensitivity data were obtained from the Sanford Guide to Antimicrobial Therapy. RESULTS A total of 137 patients were included in the study. Of 205 samples collected, S. aureus was the most commonly isolated organism (46 of 156, 30%) followed by Pseudomonas species (19 of 156, 12%) and Propionibacterium acnes (15 of 156, 10%). Based on sensitivity data, the two oral antibiotics that would have been most effective in this population were levofloxacin and amoxicillin/clavulanate; however, even these antibiotics would have encountered at least one resistant organism in 16% and 32% of patients, and potentially in another 15% and 8% of patients, respectively. CONCLUSIONS Given the broad range of causative organisms, routine treatment of dacryocystitis with any specific antibiotic may fail in up to one-third of patients. Obtaining a culture at the time empiric antibiotic treatment is initiated can prove extremely valuable when treating patients with dacryocystitis.
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Affiliation(s)
- Stella Y Chung
- a Institute of Ophthalmology and Visual Science , Rutgers New Jersey Medical School , Newark , NJ , USA
| | - Leon Rafailov
- a Institute of Ophthalmology and Visual Science , Rutgers New Jersey Medical School , Newark , NJ , USA
| | - Roger E Turbin
- a Institute of Ophthalmology and Visual Science , Rutgers New Jersey Medical School , Newark , NJ , USA
| | - Paul D Langer
- a Institute of Ophthalmology and Visual Science , Rutgers New Jersey Medical School , Newark , NJ , USA
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18
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Magomedov MM, Borisova OY, Bakharev AV, Lapchenko AA, Magomedova NM, Gadua NT. [The multidisciplinary approach to the diagnostics and surgical treatment of the lacrimal passages]. Vestn Otorinolaringol 2018; 83:88-93. [PMID: 29953065 DOI: 10.17116/otorino201883388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The primary objective of the present study was to highlight the current state of research on the pathology of the lacrimal organs based on the results of the analysis of the relevant publications in the domestic and foreign scientific literature. Special attention in this review is given to the problems of diagnostics, indications for the probing, the treatment and stenting strategies. The authors report their original observations contributing to the better understanding of the anatomical features of the nasolacrimal passages. In addition, the data on the principal pathogenic agents are presented together with certain peculiarities of the surgical treatment of the pathology under consideration.
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Affiliation(s)
- M M Magomedov
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow, Russia, 117513
| | - O Yu Borisova
- Federal budgetary institution of science 'G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology Clinical Otorhinolaryngology, Federal Service on Surveillance for Consumer Rights Protection and Human Well-Being', Moscow, Russia, 125212
| | - A V Bakharev
- N.I. Pirogov Municipal Clinical Hospital #1, Moscow, Russia, 190049
| | - A A Lapchenko
- N.I. Pirogov Municipal Clinical Hospital #1, Moscow, Russia, 190049
| | - N M Magomedova
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow, Russia, 117513
| | - N T Gadua
- Federal budgetary institution of science 'G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology Clinical Otorhinolaryngology, Federal Service on Surveillance for Consumer Rights Protection and Human Well-Being', Moscow, Russia, 125212
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Alsuhaibani A, AlRajeh M, Gikandi P, Mousa A. An evidence-based medicine audit of the ophthalmic emergency services unit of King Abdulaziz University Hospital (KAUH). Int Ophthalmol 2017; 38:1923-1931. [PMID: 29019025 DOI: 10.1007/s10792-017-0678-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 08/01/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To improve the interventions provided for patients presenting with acute ophthalmic conditions to the ophthalmic emergency unit through applying the best available evidences from quality literature for managing such conditions. METHODS A retrospective cohort study at a tertiary eye care university hospital in Riyadh, Saudi Arabia, involving a two-phase audit of diagnosis-intervention was conducted. The first phase was done retrospectively for the duration from April 1 to May 30, 2014, after disseminating the results of the first phase to King Abdulaziz University Hospital ophthalmology department staff, and the second phase was done retrospectively for the duration from November 1 to December 30, 2015. The validity of outcomes was assessed through a literature search using Medline and the Cochrane Database of Systematic Reviews. The participants were masked on the study objectives to avoid Hawthorne's phenomenon (prescribing bias). RESULTS In the first part of the audit, 73.2% out of 355 interventions were found to be evidence based. There was notable improvement of 80.9% in the number of evidence-based interventions in the second part of the audit. This improvement was statistically significant (p = 0.017). CONCLUSION Evidence-based medicine audit can be a helpful tool to assess the performance and can lead to quality improve of the provided care by reducing the number of medical errors and refining medical decisions and interventions.
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Affiliation(s)
- Adel Alsuhaibani
- Department of Ophthalmology, College of Medicine, King Saud University, P O BOX 245, Riyadh, 11411, Saudi Arabia
| | - Mohammed AlRajeh
- Department of Surgery, Ophthalmology Division, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Priscilla Gikandi
- Department of Ophthalmology, College of Medicine, King Saud University, P O BOX 245, Riyadh, 11411, Saudi Arabia
| | - Ahmed Mousa
- Department of Ophthalmology, College of Medicine, King Saud University, P O BOX 245, Riyadh, 11411, Saudi Arabia.
- Glaucoma Research Chair, Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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20
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Getahun E, Gelaw B, Assefa A, Assefa Y, Amsalu A. Bacterial pathogens associated with external ocular infections alongside eminent proportion of multidrug resistant isolates at the University of Gondar Hospital, northwest Ethiopia. BMC Ophthalmol 2017; 17:151. [PMID: 28830451 PMCID: PMC5567627 DOI: 10.1186/s12886-017-0548-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 08/14/2017] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND External ocular infection is a public health problem in Ethiopia. The aim of this study was to determine the prevalence and antimicrobial susceptibility pattern of external ocular bacterial infections. METHODS A cross sectional study was conducted at the University of Gondar Hospital among patients seeking health services at the Department of Ophthalmology from January to April, 2016. All patients with suspected external ocular infections were examined under slit lamp microscope. External ocular samples were collected using aseptic techniques. All samples were investigated by culture and bacteria were identified using standard methods. Drug susceptibility test was done using the Kirby-Bauer Disk diffusion method according to the guidelines of Clinical and Laboratory Standard Institute (CLSI). RESULT A total of 312 samples were collected and 58.3% were culture positive. The proportion of Gram positive bacterial pathogens was (88%), and Staphylococcus aureus (50.3%) was the predominantly isolated pathogen, followed by Coagulase negative staphylococci (CoNS) (33.5%) and Klebsiella species (4.7%). Conjunctivitis was the dominant clinical feature, but a high positive result for bacterial pathogens was observed among patients with dacryocystitis cases. The Gram positive bacterial isolates were susceptible to ciprofloxacin, chloramphinicol, amoxicillin-clavulanate and ceftriaxone. However, 65% of these Gram positive bacterial pathogens showed resistance to penicillin, ampicillin and amoxicillin. The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection was 24% and multidrug resistance (MDR) was observed in 87% of the isolated bacteria. CONCLUSION Conjunctivitis was the dominant ophthalmic disease followed by blepharitis. The dominant bacteria species was S. aureus and MRSA infection is increasingly prevalent. The overall MDR bacterial pathogen proportion was very high. The high prevalence of MRSA and MDR bacterial pathogens dictate the need for effective prevention as important as for therapies.
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Affiliation(s)
- Ergibnesh Getahun
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences (CMHS), University of Gondar (UOG), P.O. box 196, Gondar, Ethiopia
| | - Baye Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences (CMHS), University of Gondar (UOG), P.O. box 196, Gondar, Ethiopia.
| | - Abate Assefa
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences (CMHS), University of Gondar (UOG), P.O. box 196, Gondar, Ethiopia
| | - Yared Assefa
- Department of Ophthalmology, School of Medicine, CMHS, UOG, P.O. box 196, Gondar, Ethiopia
| | - Anteneh Amsalu
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences (CMHS), University of Gondar (UOG), P.O. box 196, Gondar, Ethiopia
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Modeling Chronic Dacryocystitis in Rabbits by Nasolacrimal Duct Obstruction with Self-Curing Resin. J Ophthalmol 2017; 2017:3438041. [PMID: 28717520 PMCID: PMC5498895 DOI: 10.1155/2017/3438041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/28/2017] [Accepted: 06/07/2017] [Indexed: 11/17/2022] Open
Abstract
We established a chronic dacryocystitis model by injecting of 0.05, 0.1, and 0.15 ml self-curing resin via the lacrimal punctum in rabbits. Animals were randomized into four groups (n = 11 animals/group). The control group received 0.15 ml normal saline. Within three months postinjection, epiphora and eye discharge were observed. At the 90th day postlacrimal passage irrigation, CT dacryocystography was performed to find changes in the lacrimal image, and hematoxylin and eosin staining was made to identify pathological changes of the lacrimal sac. Three months postinjection, the rabbits in control group and those who received 0.05 and 0.1 ml self-curing resin failed to develop chronic dacryocystitis. However, 8/11 (72.7%) rabbits those received 0.15 ml self-curing resin were symptomatic and showed complete reflux in lacrimal passage irrigation, indicating the obstruction of the nasolacrimal duct. CT dacryocystography showed that the obstruction was present only in the animals with chronic dacryocystitis. Pathological examinations of chronic dacryocystitis also revealed significantly inflammatory changes, such as mucus epithelium thickening, irregular papillary proliferation, and submucosal fibrous deposition. Local injection of 0.15 ml self-curing resin can induce permanent obstruction of the nasolacrimal duct in rabbits and establish a model of chronic dacryocystitis.
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Freitas DFS, Lima IAR, Curi CL, Jordão L, Zancopé-Oliveira RM, Valle ACFD, Galhardo MCG, Curi ALL. Acute dacryocystitis: another clinical manifestation of sporotrichosis. Mem Inst Oswaldo Cruz 2016; 109:262-4. [PMID: 24810176 PMCID: PMC4015260 DOI: 10.1590/0074-0276130304] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 07/22/2013] [Indexed: 11/22/2022] Open
Abstract
Sporotrichosis associated with exposure to domestic cats is hyperendemic in Rio de Janeiro, Brazil. A review of the clinical records at our institute revealed four patients with clinical signs of dacryocystitis and a positive conjunctival culture for Sporothrix who were diagnosed with Sporothrix dacryocystitis. Three patients were children (< 13 years of age) and one patient was an adult. Two patients reported contact with a cat that had sporotrichosis. Dacryocystitis was associated with nodular, ulcerated lesions on the face of one patient and with granulomatous conjunctivitis in two patients; however, this condition manifested as an isolated disease in another patient. All of the patients were cured of the fungal infections, but three patients had chronic dacryocystitis and one patient developed a cutaneous fistula. Sporotrichosis is usually a benign disease, but may cause severe complications when the eye and the adnexa are affected. Physicians, especially ophthalmologists in endemic areas, should be aware of the ophthalmological manifestations and complications of sporotrichosis.
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Affiliation(s)
| | | | - Carolina Lemos Curi
- Departamento de Oftalmologia, Hospital da Polícia Militar de Niterói, Niterói, RJ, Brasil
| | - Livia Jordão
- Departamento de Oftalmologia, Hospital da Polícia Militar de Niterói, Niterói, RJ, Brasil
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Ramírez Soto MC. Sporotrichosis in the Ocular Adnexa: 21 Cases in an Endemic Area in Peru and Review of the Literature. Am J Ophthalmol 2016; 162:173-179.e3. [PMID: 26585212 DOI: 10.1016/j.ajo.2015.11.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 11/08/2015] [Accepted: 11/09/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe the clinical and epidemiologic characteristics of sporotrichosis in ocular adnexa and give an insight into factors associated with this condition. DESIGN Retrospective case series and literature review. METHODS We retrospectively reviewed all cases of sporotrichosis in ocular adnexa between 2004 and 2014 in the Santa Teresa Clinic of Abancay, Peru and reviewed all case reports of sporotrichosis in ocular adnexa in the literature. RESULTS We reviewed records of 21 patients with sporotrichosis in ocular adnexa; 12 (57.1%) of them were male and their median age surrounded 9 years. In our series, 19 patients had lesions in the eyelids and 2 in the eyebrows. The lymphocutaneous form occurred in 62% of them. Ten patients (47.6%) were cured with potassium iodide. Among 65 patients with sporotrichosis in ocular adnexa (our 21 patients and 44 from the literature), the average age was 9 years, and 78% were ≤15 years of age; 54% were male. The lesions were more frequent on the eyelids (n = 53 [82%]), followed by the lacrimal gland (n = 5), conjunctiva (n = 4), and eyebrows (n = 3). The lymphocutaneous clinical form (54%) was the most frequent. Fifty patients were cured: 31 of them with potassium iodide, 16 with itraconazole, and 3 with a combination including potassium iodide, itraconazole, and fluconazole. Twenty-nine patients (44.6%) resided in a hyperendemic region, and 5 patients reported contact with cats that had sporotrichosis. CONCLUSIONS Sporotrichosis in ocular adnexa is associated with children ≤15 years of age, and in 82% of these cases the disease is limited to the eyelids.
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Affiliation(s)
- Max Carlos Ramírez Soto
- Unidad de Postgrado, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru.
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Ku CA, Forcina B, LaSala PR, Nguyen J. Granulicatella adiacens, an unusual causative agent in chronic dacryocystitis. J Ophthalmic Inflamm Infect 2015; 5:12. [PMID: 25897344 PMCID: PMC4395622 DOI: 10.1186/s12348-015-0043-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/23/2015] [Indexed: 11/10/2022] Open
Abstract
Background Granulicatella adiacens, a recent taxonomic addition, is a commensal organism of the oral, gastrointestinal, and urogenital tracts and is rarely encountered in the orbit and eye. Findings We present a 46-year-old Caucasian woman with chronic dacryocystitis who underwent an external dacryocystorhinostomy and was found to have G. adiacens. Conclusions This is an unusual causative organism isolated in the nasolacrimal system and, to our knowledge, the first reported case of chronic dacryocystitis associated with G. adiacens.
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Affiliation(s)
- Cristy A Ku
- Robert C. Byrd Health Sciences Center, West Virginia University School of Medicine, Morgantown, WV 26505 USA
| | - Blake Forcina
- Department of Ophthalmology, West Virginia University Eye Institute, One Stadium Drive, Morgantown, WV 26505 USA
| | - Paul Rocco LaSala
- Department of Pathology, West Virginia University, Morgantown, WV 26505 USA
| | - John Nguyen
- Department of Ophthalmology, West Virginia University Eye Institute, One Stadium Drive, Morgantown, WV 26505 USA
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Abstract
PURPOSE Dacryocystitis is a common inflammation of the lacrimal sac, usually from an underlying bacterial infection. Most cases can be attributed to common ocular flora such as Staphylococcus aureus or Streptococcus pneumoniae; however, uncommon bacterial causes such as Proteus mirabilis can still occur. P. mirabilis is a gram-negative bacillus that is found abundantly in people who have undergone long-term catheterization and is uncommonly found in or around the eyes except in people who have undergone long-term catheterization. Proteus species can cause conjunctivitis, canaliculitis, and dacryocystitis and have the ability to manifest into preseptal cellulitis; therefore, timely recognition and treatment are important to prevent potential further complications. CASE REPORT An 84-year-old white man had several recurrences of acute dacryocystitis that had marginal improvement with empiric antibiotic treatment. Resultant culture of the ocular discharge revealed an uncommon bacterium, P. mirabilis. Successful dosing of oral antibiotics resolved the infection but ultimately the patient required an external dacryocystorhinostomy (DCR) procedure to maintain patency of the nasolacrimal lacrimal system and prevent recurrence. At 3 months after external DCR, the patient was symptom free with no recurrences. CONCLUSIONS Dacryocystitis has a distinctive clinical presentation and is usually easily treated when appropriate oral antibiotics are directed at the underlying pathogen. In nonresponsive cases, culturing of the ocular discharge should be performed to identify the underlying pathogen. Cases of dacryocystitis caused by Proteus species are usually responsive to several standard antibiotics used orally in eye care; however, culturing and susceptibility testing can streamline the diagnostic and management sequence considerably in unclear or unresponsive cases. Typically, patients with dacryocystitis return to normal after appropriate treatment, but chronic recurrences and epiphora are potential sequelae. Patients should be educated that a DCR surgical procedure may be needed to prevent future recurrences in some cases.
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Paterson R, Drake B, Tabin G, Butler FK, Cushing T. Wilderness Medical Society Practice Guidelines for Treatment of Eye Injuries and Illnesses in the Wilderness: 2014 Update. Wilderness Environ Med 2014; 25:S19-29. [DOI: 10.1016/j.wem.2014.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 08/14/2014] [Accepted: 08/20/2014] [Indexed: 11/29/2022]
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Domont F, Le Flèche‐Matéos A, Brémond‐Gignac D, Hamdad F. Kocuria dacryocystitis infection, caused by kocuria ocularis sp. Nov. JMM Case Rep 2014. [DOI: 10.1099/jmmcr.0.002022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Fanny Domont
- Laboratoire de Bactériologie, Centre de Biologie Humaine, CHU sud, Amiens, France
| | | | - Dominique Brémond‐Gignac
- Unité CNRS UMR8194, Université Paris V, Paris, France
- Service d’Ophtalmologie, CHU d’Amiens, Amiens, France
| | - Farida Hamdad
- Laboratoire de Bactériologie, Centre de Biologie Humaine, CHU sud, Amiens, France
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A.V. P, Patil SS, Koti S, J.S. A, Garag SS, Hegde JS. Clinico-bacteriological study of chronic dacryocystitis cases in northern karnataka, India. J Clin Diagn Res 2013; 7:2502-4. [PMID: 24392383 PMCID: PMC3879854 DOI: 10.7860/jcdr/2013/6636.3590] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 09/12/2013] [Indexed: 11/24/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to identify the organisms responsible and to determine the antibiotic susceptibility pattern of the bacterial isolates from conjunctiva and nasal mucosa in cases of chronic dacryocystitis and comparing with lacrimal sac specimen. DESIGN Prospective longitudinal study. METHODS A prospective analysis of 44 lacrimal sac contents of patients with chronic dacryocystitis conducted during the period from April 2012 to March 2013. Material was obtained directly from the lacrimal sac while making sac flap during external dacryocystorhinostomy for chronic dacryocystitis. Samples were also collected from ipsilateral conjunctiva and inferior meatus of nose. The specimens were cultured and results analyzed. STATISTICAL ANALYSIS The results were analyzed by using Chi-square (χ(2)) test. RESULTS All the patients were in age group of 30 and above. Gram positive bacteria i.e., Coagulase negative staphylococci and Staphylococcus aureus were the most common isolates (71% and 14% respectively). Vancomycin, amikacin, 3(rd) generation cephalosporins and amoxyclav were most sensitive antibiotics (100%, 89%, 83%, and 78% respectively). Comparison between lacrimal and nasal/conjunctival isolates showed high degree of identicalness between the isolates of two sites (p< 0.05). CONCLUSION Majority of the chronic dacryocystitis cases are caused by Coagulase negative Staphylococci and Staphylococcus aureus. Amoxyclav and 3(rd) generation cephalosporins can be used to treat chronic dacryocystitis. Commensal flora of nose and conjunctiva have a direct role in pathogenesis of chronic dacryocystitis.
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Affiliation(s)
- Pradeep A.V.
- Assistant Professor, Department of Ophthalmology, Sri Dharmasthala Manjunatheshwara College of Medical Sciences & Hospital, Sattur, Dharwad, Karnataka, India
| | - Satish S. Patil
- Assistant Professor, Department of Medical Microbiology, Sri Dharmasthala Manjunatheshwara College of Medical Sciences & Hospital, Sattur, Dharwad, Karnataka, India
| | - S.V. Koti
- Lecturer, Department of Ophthalmology, Sri Dharmasthala Manjunatheshwara College of Medical Sciences & Hospital, Sattur, Dharwad, Karnataka, India
| | - Arunkumar J.S.
- Professor, Department of ENT, Sri Dharmasthala Manjunatheshwara College of Medical Sciences & Hospital, Sattur, Dharwad, Karnataka, India
| | - Santosh S. Garag
- Assistant Professor, Department of ENT, Sri Dharmasthala Manjunatheshwara College of Medical Sciences & Hospital, Sattur, Dharwad, Karnataka, India
| | - Jyotirmay S. Hegde
- Assistant Professor, Department of ENT, Sri Dharmasthala Manjunatheshwara College of Medical Sciences & Hospital, Sattur, Dharwad, Karnataka, India
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Wilderness Medical Society practice guidelines for treatment of eye injuries and illnesses in the wilderness. Wilderness Environ Med 2012; 23:325-36. [PMID: 23158204 DOI: 10.1016/j.wem.2012.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 08/26/2012] [Accepted: 08/30/2012] [Indexed: 11/22/2022]
Abstract
A panel convened to develop an evidence-based set of guidelines for the recognition and treatment of eye injuries and illnesses that may occur in the wilderness. These guidelines are meant to serve as a tool to help wilderness providers accurately identify and subsequently treat or evacuate for a variety of ophthalmologic complaints. Recommendations are graded based on the quality of their supporting evidence and the balance between risks and benefits according to criteria developed by the American College of Chest Physicians.
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