dorzolamide and Acute-Disease

To characterize and compare the ocular comfort and symptoms of dorzolamide and tear-replacement drops (placebo) in healthy volunteers.. Subjects were randomized in a double-masked fashion to receive each medicine for 6 days twice daily. Patients used a visual analog scale to assess the quality and intensity of pain temporally after initial (acute) dosing and after 6 days of chronic dosing. The visual analog scale, an objective measure of pain, allows a subject to grade their perceived intensity of pain on a line between 0 and 100 mm.. Of 28 subjects enrolled in the study, 27 completed the protocol (1 subject was lost to follow-up). Dorzolamide demonstrated statistically greater peak ocular pain (21.4 +/- 22.3 mm) compared with placebo (1.9 +/- 4.4 mm) (P<0.0001) after chronic dosing. Time of mean peak pain for dorzolamide products was 15 seconds after dosing. The pain was statistically greater with dorzolamide compared with placebo for 50 seconds after dosing. On average the discomfort associated with dorzolamide lasted 38.9 +/- 17.9 seconds after dosing. The average pain per second for the first minute was 7.1 +/- 10.1 mm for dorzolamide. No differences in pain intensity were observed after acute and chronic dosing. The discomfort with dorzolamide was characterized after chronic dosing as "burning" (14.8 +/- 25.0 mm) and was associated with tearing (1.9 +/- 5.2 mm).. Dorzolamide caused more ocular pain after instillation than placebo. However, the pain was characterized as mild and quickly resolved.

Topics: Acute Disease; Adult; Carbonic Anhydrase Inhibitors; Chronic Disease; Double-Blind Method; Eye Diseases; Female; Humans; Male; Ophthalmic Solutions; Pain; Pain Measurement; Sulfonamides; Thiophenes; Time Factors

The case concerns an 81-year-old woman on treatment with a topical fixed combination of timolol and brimonidine who was diagnosed in the Emergency Department with acute anterior granulomatous hypertensive uveitis. The patient responded favourably to the withdrawal of the eye drops without showing any subsequent relapse.. Uveitis due to brimonidine is a rare adverse effect, but it must be known. Once the diagnosis is suspected, the effective treatment is the withdrawal of brimonidine, with or without the addition of topical corticosteroids to control inflammation depending on the severity of the condition. It is a process with an excellent prognosis.

Topics: Acute Disease; Adrenergic alpha-2 Receptor Agonists; Aged, 80 and over; Brimonidine Tartrate; Conjunctivitis, Allergic; Cyclopentolate; Drug Therapy, Combination; Epithelium, Corneal; Female; Glaucoma, Open-Angle; Granuloma; Humans; Latanoprost; Lubricant Eye Drops; Ocular Hypertension; Ophthalmic Solutions; Prednisolone; Sulfonamides; Thiophenes; Timolol; Uveitis, Anterior

A wild young adult western screech owl (Megascops kennicottii) of unknown sex was presented for evaluation of an abnormal left eye (OS). Ophthalmic examination OS revealed raised intraocular pressure (37 mm Hg; reference interval 7-16 mm Hg), mydriasis, conjunctival and episcleral hyperemia, shallow anterior chamber due to anterior displacement of the lens and iris, rubeosis iridis, and engorgement of the pecten. The intraocular pressure in the right eye (OD) was 11 mm Hg. Multifocal pale, variably translucent, curvilinear to vermiform opacities were observed in the medial and ventral peripheral regions of the retina OD, consistent with focal retinitis. Mannitol (0.46 g/kg IV) was administered over 10 minutes. Forty minutes later, the intraocular pressure was 27 mm Hg OS and 13 mm Hg OD. Dorzolamide (one drop OS q12h), diclofenac (one drop OU q8-12h), and meloxicam (0.5 mg/kg PO q24h) were administered for 3 days. The intraocular pressure OS was within normal limits 1 day (11 mm Hg), 7 days (13 mm Hg), and 4 weeks (14 mm Hg) after this treatment. Complications arising during hospitalization and rehabilitation included superficial corneal ulceration of both eyes presumed secondary to trauma on being caught and superficial damage to a talon. The owl was released after a period of rehabilitation. Characteristic presenting signs as well as response to therapy suggest aqueous misdirection was the cause of ocular hypertension in this owl. To our knowledge, this is the first report of suspected aqueous misdirection and its medical management in a raptor.

Topics: Acute Disease; Animals; Bird Diseases; Carbonic Anhydrase Inhibitors; Diclofenac; Mannitol; Meloxicam; Ocular Hypertension; Strigiformes; Sulfonamides; Thiazines; Thiazoles; Thiophenes

Topics: Acute Disease; Antihypertensive Agents; Diclofenac; Drug Therapy, Combination; Female; Fluorescein Angiography; Glaucoma, Open-Angle; Humans; Middle Aged; Optic Disk; Optic Nerve Diseases; Retinal Detachment; Serum; Sulfonamides; Thiophenes; Timolol; Tomography, Optical Coherence; Vision Disorders; Visual Acuity

Topics: Acetazolamide; Acute Disease; Anesthesia, General; Atropine; Combined Modality Therapy; Corneal Edema; Dexamethasone; Drug Therapy, Combination; Female; Glaucoma, Angle-Closure; Humans; Laser Therapy; Mannitol; Middle Aged; Mydriasis; Pilocarpine; Postoperative Complications; Sulfonamides; Thiophenes; Timolol; Vomiting

Topics: Acute Disease; Aged; Angina Pectoris; Glaucoma, Open-Angle; Humans; Latanoprost; Male; Prostaglandins F, Synthetic; Prostaglandins, Synthetic; Sulfonamides; Thiophenes; Vasoconstrictor Agents