PURPOSE: To evaluate and compare the efficacy and sensation of instillation between 0.05% cyclosporine nanoemulsion group and microemulsion group. METHODS: This is a double-blind, prospective randomized clinical trial. Patients had 2 weeks of wash-out period before the study. They were randomly assigned to either nanoemulsion group or microemulsion group and treated with each group's cyclosporine eye drop. Artificial eye drop and topical steroid were used together according to severity of dryness of cornea. We checked every patient's Break-up time (BUT), Schirmer test, Staining Score and Ocular surface disease index (OSDI) on baseline, 1 month and 3 months after. Patients also self-checked frequency of use of artificial eye drop and topical steroid. Sensation of instillation was also checked. RESULTS: Both nanoemulsion eye-drop and microemulsion eye-drop improved BUT, Schirmer test, Staining Score and OSDI throughout 12 weeks. The nanoemulsion type reduced OSDI significantly compared to the microemulsion type. The mean frequency of use of artificial tear and topical steroid was similar in both groups. Foreign body sense score was higher in microemulsion group. CONCLUSIONS: 0.05% cyclosporine nanoemulsion type has simillar efficacy and subjectively less foreign body sensation.
Cornea ; Cyclosporine ; Dry Eye Syndromes ; Eye, Artificial ; Foreign Bodies ; Humans ; Prospective Studies ; Sensation ; Tears

PURPOSE: To report the surgical technique to remove a chestnut thorn through a corneal incision. CASE SUMMARY: A 54-year-old female visited our clinic complaining of a sudden foreign body sensation and conjunctival injection in her left eye after picking chestnuts 4 days prior to her visit. Visual acuity of both eyes was 1.0 and the intraocular pressures were within normal limits. Slit lamp examination revealed that a chestnut thorn had deeply penetrated the left corneal stroma and a small number of inflammatory cells were observed in the anterior chamber. There was no corneal defect stained with fluorescein and the Seidel test was negative. A corneal foreign body comprised of a chestnut thorn and its remnants was diagnosed and emergency surgery was performed. A partial corneal incision was made along the foreign body and the exposed foreign body was easily and completely removed. The patient was treated with topical antibiotics after surgery and no complication was observed during a follow-up period of 3 months. CONCLUSIONS: In the case of a corneal foreign body comprised of a chestnut thorn, the foreign body with its remnants were easily removed by performing a partial corneal incision.
Anterior Chamber ; Anti-Bacterial Agents ; Corneal Injuries ; Corneal Stroma ; Emergencies ; Eye Foreign Bodies ; Female ; Fluorescein ; Follow-Up Studies ; Foreign Bodies ; Humans ; Intraocular Pressure ; Middle Aged ; Sensation ; Slit Lamp ; Visual Acuity

This paper aims to make recommendations for the management of eye health related to fine dust exposure. Fine dust is one of the biggest problems related to air pollution in Korea and is becoming a social issue. Fine dust can be classified into fine dust, ultrafine dust, and nanoparticles according to the size of the constituent particles. Although studies evaluating the harmful effects of particulate matter (PM) have been conducted mainly on cardiovascular and respiratory diseases, the ocular surface is a tissue that is continuously exposed to the atmosphere. Eye symptoms caused by PM exposure include eye redness, irritation, and sensation of a foreign body. Typical eye diseases caused by PM exposure include conjunctivitis, dry eye disease, and blepharitis. PM is thought to induce and exacerbate ocular surface diseases and lead to damage through oxidative stress, toxicity, and immune and inflammatory reactions on the ocular surface. For eye health management related to PM exposure, it is necessary to reduce the chance of exposure to PM in advance according to the PM forecast, avoid additional repeated exposure after PM exposure, and remove PM through eye washing and eyelid cleaning. In addition, eye drops, such as artificial tears, diquafosol, and cyclosporin A, can be used to prevent and treat ocular surface disease and deterioration of the damage. In patients who already have ocular surface disease, the harmful effects of PM exposure may be greater and more attention should be paid to eye health management.
Air Pollution ; Atmosphere ; Blepharitis ; Conjunctivitis ; Cyclosporine ; Dust ; Eye Diseases ; Eyelids ; Foreign Bodies ; Humans ; Korea ; Lubricant Eye Drops ; Nanoparticles ; Ophthalmic Solutions ; Oxidative Stress ; Particulate Matter ; Sensation

Intraorbital wooden foreign bodies may present difficulties in diagnosis due to their radiolucent nature. Delayed recognition and management can cause significant complications. We present a case report that demonstrates these problems and the sequela that can follow. A 56-year-old man presented with a 3-cm laceration in the right upper eyelid, sustained by a slipping accident. After computed tomography (CT) scanning and ophthalmology consultation, which revealed no fractures and suggested only pneumophthalmos, the wound was repaired by a plastic surgery resident. Ten days later, the patient’s eyelid displayed signs of infection including pus discharge. Antibiotics and revisional repair failed to solve the infection. Nearly 2 months after the initial repair, a CT scan revealed a large wooden fragment in the superomedial orbit. Surgical exploration successfully removed the foreign body and inflamed pocket, and the patient healed uneventfully. However, the prolonged intraorbital infection had caused irreversible damage to the superior rectus muscle, with upgaze diplopia persisting 1 year after surgery and only minimal muscle function remaining. We report this case to warn clinicians of the difficulties in early diagnosis of intraorbital wooden foreign bodies and the grave prognosis of delayed management.
Anti-Bacterial Agents ; Delayed Diagnosis ; Diagnosis ; Diplopia ; Early Diagnosis ; Eye Foreign Bodies ; Eye Injuries, Penetrating ; Eyelids ; Foreign Bodies* ; Humans ; Lacerations ; Middle Aged ; Ophthalmology ; Orbit ; Prognosis ; Suppuration ; Surgery, Plastic ; Tomography, X-Ray Computed ; Wounds and Injuries

PURPOSE: To report a case of a SmartPlug that partially extruded through the canalicular mucosa. CASE SUMMARY: A 62-year-old female patient visited our Department of Ophthalmology for redness and discharge in her right eye that began worsening a week prior. The patient was diagnosed with severe dry eye syndrome via Sjogren's syndrome. The SmartPlug was inserted into her left lower punctum 12 years prior, and another plug was inserted in the right 9 years prior. Nothing notable was found in her history. The best corrected visual acuity and intraocular pressure at the initial visit was 1.0 and 14 mmHg, respectively, in both eyes. Swelling, erythema, and tenderness at the right lower punctum were identified. As we irrigated the lower lacrimal system, partial obstruction was suspected and a large amount of mucopurulent discharge in the conjunctival fornix with conjunctival injection was seen. Under the right lower punctum, a 1 × 1 mm yellowish foreign body was partially extruding from the canalicular mucosa. The foreign body was removed, and a round defect was left. The patient's symptom completely resolved after 4 weeks of topical antibiotics and ointment treatment. CONCLUSIONS: In patients who have a SmartPlug inserted prior to visits for redness and discharge, a SmartPlug plug extrusion should be considered.
Anti-Bacterial Agents ; Dry Eye Syndromes ; Erythema ; Female ; Foreign Bodies ; Humans ; Intraocular Pressure ; Middle Aged ; Mucous Membrane* ; Ophthalmology ; Sjogren's Syndrome ; Visual Acuity

PURPOSE: To report a case of conjunctival lithiasis with clinical manifestations of superior limbic keratoconjunctivitis. CASE SUMMARY: A 40-year-old male complained of pain, foreign body sensation and injection in the left eye lasting 1 month. The slit-lamp examination revealed injection of the superior bulbar conjunctiva, linear corneal band opacity, fine punctate staining and epithelial defect in the superior cornea area. After eversion of the left upper eyelid, there were many various-sized conjunctional concretions and inflammation in the superior tarsal conjunctiva. Therefore, we considered conjunctival lithiasis-induced clinical manifestations of superior limbic keratoconjunctivitis and then removed the conjunctival concretions using a 30-gauge needle. After the procedures, artificial tears, antibiotic eye drops, steroid eye drops and a therapeutic contact lens were applied. After 1 week, all symptoms and signs improved and there was no recurrence for 4 months. CONCLUSIONS: Mechanical stimulation by severe conjunctival lithiasis can induce clinical manifestations of superior limbic keratoconjunctivitis. Therefore, in patients with clinical manifestations of superior limbic keratoconjunctivitis, conjunctival lithiasis should be considered by observing the superior tarsal conjunctiva more closely.
Adult ; Conjunctiva ; Cornea ; Eyelids ; Foreign Bodies ; Humans ; Inflammation ; Keratoconjunctivitis* ; Lithiasis* ; Lubricant Eye Drops ; Male ; Needles ; Ophthalmic Solutions ; Recurrence ; Sensation

PURPOSEThe intraorbital wooden foreign body is often misdiagnosed or missed on computed tomog- raphy (CT) scan, due to the invisible or unclear images. The residual foreign bodies often occur during surgical removal. The clinical manifestations, imaging features and treatment of intraorbital wooden foreign bodies were discussed in this study.

METHODWe retrospectively analyzed 14 cases of intraorbital wooden foreign bodies managed at our hospital between January 2007 and May 2015. All patients underwent orbital CT examination before surgery, and surgery was performed under general anesthesia with orbital wound debridement and suture, as well as exploration and removal of wooden foreign bodies.

RESULTSAt first, 11 cases underwent removal of foreign bodies, including 1 case with incomplete removal and then receiving a secondary surgery. Foreign bodies were not found in three cases with preoperative misdiagnosis and orbital MRI found residual foreign bodies in the orbit. Operations were performed via primary wound approach in eight cases, conjunctival approach in two cases, and anterior orbitotomy in four cases. Postoperatively, one case was complicated with eye injuries, three cases with ocular muscle injuries, eight cases with visual loss, and eight cases with orbital abscess. The length of foreign bodies ranged from 1.8 cm to 11.0 cm. The maximum of four foreign bodies were removed at the same time.

CONCLUSIONBecause the imaging of orbital wooden foreign bodies is complex and varied, MRI should be combined when they are invisible on CT scan. At the same time injuries trajectory and clinical mani- festations of patients should be taken into account. Surgical exploration should be extensive and thor- ough, and foreign bodies and orbital abscess must be cleared.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Eye Foreign Bodies ; diagnostic imaging ; surgery ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Wood

Foreign bodies (FBs) in the eye are usually classified as intraocular (IOFB) or extraocular (EOFB). In IOFB the FB is within the eye ball and in EOFB it is outside. This classification seems oversimplified. Hence a new classification is proposed on the basis of FB locations, in which adnexal FBs (in orbit, lids, con- junctiva and lacrimal apparatus) are also included. These are further classified according to their exact location. FBs can also be classified in many other ways. Besides IOFB and EOFB, another condition IMFB (intramural foreign body) is also described. The FBs are situated within cornea or sclera and are neither IOFB nor EOFB. Ocular trauma also includes trauma to ocular adnexa and hence the terms IOFB and EOFB have been replaced by IGFB (intraglobal foreign body) and EGFB (extraglobal foreign body).
Eye Foreign Bodies ; classification ; Humans

OBJECTIVE: Daily clinical activities in dental operatory expose dental surgeons to varied forms of ocular events. The purpose of the study was to determine the prevalence and pattern of ocular splashes and foreign bodies among dental surgeons in Nigeria. METHODS: This questionnaire-based cross-sectional of dental surgeons in Southern Nigeria was conducted between September 2010 and August 2011. The information elicited were demography, experience and type of ocular event, implicated dental procedure and action taken. RESULTS: Of the 185 studied, 148 of them responded. Of these 148 respondents, 56 (37.8%) reported foreign body, 18 (12.2%) splash, 33 (22.3%) both foreign body and splash while 41 (27.7%) reported no ocular event. It therefore means that the overall prevalence of ocular events among the respondents was 107 (72.3%). The prevalence of ocular events was significantly associated with age (p = 0.014), years of practice (p = 0.033) and safety eye goggle use (p = 0.023). The main dental procedures implicated in the ocular events among the respondents were scaling 77 (72.0%), tooth/cavity preparation 17 (15.9%), polishing 11 (10.3%) and forcep tooth extraction 10 (9.3%). The major implicated aetiological agents in the ocular events were calculus 74 (69.2%), saliva 29 (27.1%), mixed blood & saliva 19 (17.8%), tooth particles 15 (14.0%) and blood 9 (8.4%). The predominant action taken by the respondents was to rinse the eye under running water 89 (83.2%). CONCLUSION: Ocular splash and foreign body events are high among dental surgeons in Nigeria. Age, years of practice and safety eye goggles wear were also found to be associated with ocular events. Eye safety awareness is therefore deemed a necessity for dental surgeon in Southern Nigeria.
Calculi ; Data Collection ; Demography ; Eye Protective Devices ; Foreign Bodies ; Nigeria ; Prevalence ; Running ; Saliva ; Surgical Instruments ; Tooth ; Tooth Extraction ; Water

PURPOSE: To investigate the clinical features and compliance of cosmetic contact lens (CL)-related complications compared with soft CL-related complications. METHODS: We performed a retrospective chart review of 97 patients (194 eyes) regarded as having CL-related complications at the outpatient clinic. The portion of complications, gender, age, and chief complaints at the initial visit were analyzed, as was compliance to cosmetic and soft CL-related guidelines for use. RESULTS: A total of 97 patients (49 patients with cosmetic CL-related complications and 43 patients with soft CL-related complications) were evaluated. The mean age of the subjects using cosmetic CL was 19.8 years (14-31 years), and all the patients were female. The chief complaints at the initial visit included ocular pain, injection, blurred vision, dryness, itching and foreign body sensation. The main complications included corneal erosion, sterile corneal infiltrate, allergic disease, neovascularization, corneal ulcer and dry eye syndrome. No statistical difference was found regarding chief complaints or complications. The proportion of patients lost to follow-up was 47% in cosmetic CL-related and 20% in soft CL-related complications, a significant difference (p = 0.015). CONCLUSIONS: Because young females are the most common CL patients and do not always fully comply with the guidelines for use, ophthalmologists need to warn these patients about the risk of serious complications.
Ambulatory Care Facilities ; Compliance* ; Contact Lenses, Hydrophilic ; Corneal Neovascularization ; Dry Eye Syndromes ; Female ; Foreign Bodies ; Humans ; Lost to Follow-Up ; Pruritus ; Retrospective Studies ; Sensation ; Ulcer