Objective:The prevalence of seasonal allergic rhinitis （AR） and its combined diseases have been increasing recently. The purpose was to investigate the clinical characteristics and treatment of seasonal AR in northern China. Methods:A cross-sectional study was conducted in AR patients. The Visual analogue scale （VAS）, combined diseases, clinical features, allergic pollen and treatments were analyzed. Results:Of the 789 AR subjects included, 54.1% had a family history of atopic disease. The mian course wa s（7.4±5.9） years. 95.4% of the subjects had moderate to severe AR. The prevalence rates of allergic conjunctivitis （AC）, allergic asthma （AA）, and pollen food allergy syndrome （PFAS） were 71.1%, 19.0%, and 39.5% respectively. Among the patients, 13.8% presented with only AR, while 39.3% had an AR combined with other disease, and 1.9% exhibited comorbidity involving five different diseases. VAS was positively correlated with the number of comorbidities（r=0.186, P<0.001）. The mugwort exhibited the highest rate of pollen sensitization （48.9%）, closely followed by cypress （48.3%）. The prevalence of mono-sensitization to pollen was 20.2%, while the positive rates for double-sensitized pollens and more than three sensitized pollens were 17.4% and 62.4%, respectively. Among the study participants, 19.9% did not receive any form of treatment, while 66.2% were administered oral medication and 27.5% underwent nasal steroid spray therapy. The proportion of individuals receiving anti-IgE monoclonal antibodies was 4.3%, and allergen immunotherapy （AIT） treatment was undergone by 11.8%. Meanwhile, 41.2% of patients undergoing anti-IgE monoclonal antibody treatment also received AIT. The distribution of therapy types among patients was as follows: 44.7% received a single type, 22.2% received two types, and 9.8% received three types of therapy. Additionally, there was a subset of patients（1%） who were undergoing five distinct forms of treatment. The VAS score exhibited a significant negative correlation with no treatment（r=-0.199, P<0.001）, while it showed a positive association with the number of treatment modalities（r=0.245, P<0.001）. Conclusion:Mugwort and cypress are the predominant allergenic pollens responsible for seasonal AR in northern China. The majority of cases present with moderate to severe AR, often accompanied by various comorbidities, necessitating consideration of diverse treatment modalities. However, the current rate of adoption for AIT remains relatively insufficient.
Humans ; China/epidemiology* ; Cross-Sectional Studies ; Rhinitis, Allergic, Seasonal/therapy* ; Pollen/immunology* ; Adult ; Male ; Female ; Young Adult ; Adolescent ; Middle Aged ; Child ; Prevalence ; Allergens/immunology* ; Asthma/epidemiology* ; Conjunctivitis, Allergic

INTRODUCTION: This study aimed to determine the in vitro susceptibility of standard isolates of common pathogens causing bacterial conjunctivitis to non-fluoroquinolone antimicrobial ophthalmic medications. METHODS: This is a single-blind experimental study which compared the in vitro susceptibility of Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa and Staphylococcus epidermidis to locally available non-fluoroquinolone ophthalmic medications, specifically chloramphenicol, tobramycin, fusidic acid, gentamicin sulfate, sulfacetamide and polymyxin-neomycin. Utilizing the disk diffusion method, zones of inhibition in millimeters for each bacterial isolate was recorded and tabulated. Kruskal-Wallis test was used to determine statistical differences. RESULTS: Both Staphylococci were sensitive to all antibiotics except sulfacetamide. Only chloramphenicol showed activity against all four isolates. Tobramycin showed the largest zone of inhibition against Pseudomonas aeruginosa. There was statistically significant difference in the median zone of inhibition in each antimicrobial medication against Staphylococcus aureus (p = 0.002) and Staphylococcus epidermidis (p < 0.001) with the largest mean zone of inhibition by fusidic acid of 34 and 38 millimeters, respectively. Streptococcus pneumoniae was least susceptible to antibiotics tested; only chloramphenicol and fusidic acid showed activity. There were also significant differences in the median zones of inhibition across the isolates. CONCLUSION The standard isolates are susceptible to at least one non-fluoroquinolone ophthalmic medication. The antibiotics tested showed differences in activity against the four isolates. The findings of this study may be used as a basis to review local practice patterns or/and initiate revisions in the guidelines for prescribing initial treatment of bacterial conjunctivitis.
Conjunctivitis, Bacterial ; Anti-Bacterial Agents

BACKGROUNDS: Azithromycin mass drug administration (MDA) is a key part of the strategy for controlling trachoma. This systematic review aimed to comprehensively summarize the present studies of azithromycin MDA on trachoma; provide an overview of the impact of azithromycin MDA on trachoma in different districts; and explore the possible methods to enhance the effectiveness of azithromycin MDA in hyperendemic districts. METHODS: PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials.gov were searched up to February 2021 with no language restriction. Studies reporting the effect of azithromycin MDA on trachoma were included. Mathematical modeling studies, animal studies, case reports, and reviews were excluded. The trachomatous inflammation-follicular (TF) <5.0% was used to judge the effect of azithromycin MDA on eliminating trachoma as a public health problem. Two researchers independently conducted the selection process and risk of bias assessment. RESULTS: A total of 1543 studies were screened, of which 67 studies including 13 cluster-randomized controlled trials and 54 non-randomized studies were included. The effect of azithromycin MDA on trachoma was closely related to the baseline prevalence in districts. For the districts with baseline prevalence between 5.0% and 9.9%, a single round of MDA achieved a TF <5.0%. For the districts with baseline between 10.0% and 29.9%, annual MDA for 3 to 5 years reduced TF <5.0%. However, for the districts with high level of baseline prevalence (TF >30.0%), especially with baseline TF >50.0%, annual MDA was unable to achieve the TF <5.0% even after 5 to 7 years of treatment. Quarterly MDA is more effective in controlling trachoma in these hyperendemic districts. CONCLUSIONS Azithromycin MDA for controlling trachoma depends on the baseline prevalence. The recommendation by the World Health Organization that annual MDA for 3 to 5 years in the districts with TF baseline >10.0% is not appropriate for all eligible districts.
Anti-Bacterial Agents/therapeutic use* ; Azithromycin/therapeutic use* ; Humans ; Infant ; Mass Drug Administration ; Prevalence ; Trachoma/epidemiology*

Objective: This study aims to determine recurrence and complication rates among patients who underwent three current pterygium treatment techniques: preoperative subpterygeal injection of mitomycin C, intraoperative application of mitomycin with pterygium excision and pterygium excision with conjunctival autograft. Methods: This is a randomized controlled clinical trial in a tertiary hospital. We included patients with diagnosed primary pterygium and who underwent either: A = pre-operative injection of 0.02% mitomycin C one month prior to pterygium excision; B = pterygium excision with intraoperative mitomycin C application; or C = pterygium excision with conjunctival autograft. Results: We included 111 patients: a total of 120 eyes randomized to 3 groups (A, B, C) at 40 eyes per group. After 24 months of follow-up, there was no significant difference in the recurrence rates among the groups (6/40 [15%] in groups A and B and 2/40 cases [5%] in group C; P=0.29). No complications were noted in groups B and C, while 1 case of scleral thinning was noted in group A. There was no significant difference in the complication rates among the three procedures (P=1.00). Conclusion There were no significant differences in the recurrence and complication rates among the three techniques. Careful patient selection and follow-up are recommended to prevent complications such as scleral thinning.
Pterygium Of Conjunctiva And Cornea ; Pterygium ; Mitomycin ; Autografts ; Conjunctiva ; Conjunctivitis ; Transplantation, Autologous

PURPOSE: To evaluate clinical findings in phlyctenular keratoconjunctivitis patients and assess the function and morphology of Meibomian glands using an interferometer (LipiView®, TearScience, Morrisville, NC, USA) in such patients.METHODS: This retrospective study included 19 eyes of 13 patients diagnosed with phlyctenular keratoconjunctivitis. The lipid layer thickness (LLT) and meibograph of each eye was quantified by tear interferometry. Tear film break-up time (TBUT) and corneal staining score were measured. Meibomian gland morphology (lid margin vascularity, plugging of gland orifices, lid margin irregularity, lid margin thickening, and partial glands) was evaluated based on anterior photographs and meibographs.RESULTS: The mean age was 21.3 years (8–44 years). Mean BUT and Oxford corneal staining scores were 2.6 ± 1.2 seconds and 1.9 ± 0.8, respectively. Abnormal findings of the Meibomian glands were observed in all patients. The mean LLT was 79.6 ± 27.4 µm and the incomplete eye blinking frequency was 3.8 ± 5.9 during 20 seconds. The graphs of the tear lipid layer showed various patterns such as flat, up-hill, down-hill, and mixed.CONCLUSIONS: Meibomian gland dysfunctions and changes in the tear film lipid layer were noted in patients with phlyctenular keratoconjunctivitis. These factors are to be considered for the treatment of phlyctenular keratoconjunctivitis in young patients under 10 years of age.
Blinking ; Humans ; Interferometry ; Keratoconjunctivitis ; Meibomian Glands ; Retrospective Studies ; Tears

PURPOSE: To report a case of a Corynebacterium macginleyi-infected corneal ulcer of a patient who had been treated for conjunctivitis for more than 3 months. CASE SUMMARY: A 72-year-old female was transferred from a private ophthalmic clinic for evaluation of herpetic keratitis with progressive corneal edema and infiltration in the left eye. She had a history of conjunctival hyperemia and eyeball pain in her left eye 3 months prior to her visit. She was treated with levofloxacin eye drops and acyclovir ointment (Herpesid®, Samil, Co., Ltd. Seoul, Korea). On slit lamp examination, 5.4 × 4.0 mm corneal epithelial defects and stromal infiltrations were observed in the upper to central cornea, and endothelial keratic precipitates were found. Gram positive bacteria were detected on Gram staining and Corynebacterium macginleyi was identified on bacterial cultures from the conjunctiva and cornea. She was treated with topical vancomycin eye drops. After 3 months of treatment, the corneal ulcer was completely resolved, leaving mild superficial opacity on the cornea. CONCLUSIONS: While Corynebacterium macginleyi, normal flora of the conjunctiva, is considered a major causative agent for conjunctivitis and blepharitis, Corynebacterium macginleyi should also be considered a possible cause of slowly progressive keratitis in patients with chronic conjunctivitis.
Acyclovir ; Aged ; Blepharitis ; Conjunctiva ; Conjunctivitis ; Cornea ; Corneal Edema ; Corneal Ulcer ; Corynebacterium ; Female ; Gram-Positive Bacteria ; Humans ; Hyperemia ; Keratitis ; Keratitis, Herpetic ; Levofloxacin ; Ophthalmic Solutions ; Seoul ; Slit Lamp ; Vancomycin

Measles is a highly contagious infectious disease characterized by fever, rash, cough, coryza, and conjunctivitis. The causative organism is the measles virus transmitted via the respiratory route. Before the introduction of an effective vaccine, measles was one of most prevalent diseases worldwide. Mortality may occur in patients with complications, including pneumonia, which is the most common cause of measles-associated death. The diagnosis of measles is based on clinical symptoms and laboratory tests, including the detection of measles virus-specific antibodies or measles virus ribonucleic acid and cultured viruses. The treatment for measles is primarily supportive care. In Korea, availability of the measles vaccine has substantially reduced the incidence and mortality of the disease. The World Health Organization verified the elimination of measles in March 2014; however, small outbreaks continue to be reported. Although a large proportion of measles cases occur in infants less than 1 year old, the disease has been reported in young adults with a history of measles vaccination. Here, we review the current literature on measles and discuss the importance of measles prevention in Korean adults.
Adult ; Antibodies ; Communicable Diseases ; Conjunctivitis ; Cough ; Diagnosis ; Disease Outbreaks ; Exanthema ; Fever ; Humans ; Incidence ; Infant ; Korea ; Measles Vaccine ; Measles virus ; Measles ; Mortality ; Pneumonia ; RNA ; Vaccination ; World Health Organization ; Young Adult

PURPOSE: To determine the frequency of ocular diseases in infants visiting the ophthalmology department of a tertiary care hospital. METHODS: This was a cross-sectional descriptive study conducted in the department of ophthalmology, Abbasi Shaheed Hospital, from January 2015 to May 2016. The study included 377 infants ranging in age from 1 day to less than 1 year who were, selected by a nonprobability consecutive sampling technique. A detailed history was taken, and a complete ocular examination was performed. Descriptive statistics were used to calculate the mean and standard deviation for age. Frequencies were calculated for ocular diseases along with the percentages. Outcome variables included various congenital and acquired diseases such as conjunctivitis, congenital cataract, glaucoma, nasolacrimal duct blockage, squint, trauma, and fundus abnormalities. RESULTS: The mean age of infants was 5.0 ± 3.7 months. There were 196 (52%) males and 181 (48%) females. The sample included 330 (87.5%) full term infants. Acquired ocular diseases occurred in 230 (61%) infants; and congenital diseases, in 147 (39%). The most common ocular disease was conjunctivitis, which occurred in 173 (46%) infants, followed by congenital blocked nasolacrimal duct, which occurred in 57 (15 %) infants. Conjunctivitis was more common among neonates than infants. CONCLUSIONS: Acquired ocular diseases were more common than congenital ocular diseases. The most common ocular pathology was conjunctivitis, followed by congenital nasolacrimal duct obstruction, in infants. Conjunctivitis was more common in neonates than infants.
Cataract ; Conjunctivitis ; Female ; Glaucoma ; Humans ; Infant ; Infant, Newborn ; Male ; Nasolacrimal Duct ; Ophthalmology ; Pathology ; Strabismus ; Tertiary Healthcare

Thyroid ophthalmopathy is an autoimmune disease that affect the orbital and periorbital soft tissue, characterized by bulging eye (exophthalmos) and compressed orbital structures, such as the optic nerves. The indications for surgical treatment for thyroid ophthalmopathy include decreased visual acuity caused by optic neuropathy, conjunctivitis and progressive facial deformity caused by exophthalmos. Orbital wall decompression by nasal endoscopy resulte in good cosmetic effects and visual recovery. Balanced orbital decompression is considered to be a safe and effective surgery that can help avoid postoperative diplopia. We introduce three successful cases of orbital wall decompression for the treatment of thyroid ophthalmopathy.
Autoimmune Diseases ; Congenital Abnormalities ; Conjunctivitis ; Decompression ; Diplopia ; Endoscopy ; Exophthalmos ; Optic Nerve ; Optic Nerve Diseases ; Orbit ; Thyroid Gland ; Visual Acuity

PURPOSE: We report a case of toxic keratoconjunctivitis resulting from the self-application of human breast milk as a traditional folk remedy for allergic conjunctivitis. CASE SUMMARY: An 82-year-old woman presented with pain and conjunctival hyperemia in the right eye that had been worsening for three days. Two months previously, she was treated with antiallergic eye drops for allergic conjunctivitis at another eye clinic. However, the symptoms did not improve. She applied her daughter-in-law's breast milk into her right eye as a folk remedy for three days. The pain and conjunctival hyperemia worsened. At the initial visit, her corrected visual acuity was 0.3 in the right eye. Slit lamp examination demonstrated conjunctival hyperemia, punctate epithelial erosion at the central cornea, corneal keratic precipitates and white-colored deposits in the peripheral cornea combined with irregularly shaped small nodules. There was no anterior chamber inflammation. There was no medical history of rheumatoid arthritis or tuberculosis. Blood tests for serum and other infectious and inflammatory levels for infection and inflammatory markers were performed followed by application of topical steroids and antibiotics with artificial tears. After 3 weeks of treatment, conjunctival hyperemia and corneal deposits had almost resolved and best-corrected visual acuity improved to 1.0. CONCLUSIONS: The self-application of human breast milk may cause toxic keratoconjunctivitis. Therefore, efforts should be made, actively, to inform and educate the elderly in rural areas not to use human breast milk as a folk remedy.
Aged ; Aged, 80 and over ; Anterior Chamber ; Anti-Bacterial Agents ; Arthritis, Rheumatoid ; Breast ; Conjunctivitis, Allergic ; Cornea ; Female ; Hematologic Tests ; Humans ; Hyperemia ; Inflammation ; Keratoconjunctivitis ; Lubricant Eye Drops ; Medicine, Traditional ; Milk, Human ; Ophthalmic Solutions ; Slit Lamp ; Steroids ; Tuberculosis ; Visual Acuity