muramidase and Conjunctival-Diseases

This paper considers the dubious role of asymptomatic marginal reduction of tear production in the aetiology of contact lens intolerance and how in the light of our present knowledge and the tests available it is difficult to identify such marginal underproduction of tears. Contact lenses have a possible therapeutic role in the management of established dry eyes with and without conjunctival scarring and destructive corneal changes. All soft contact lenses have been shown to lose a considerable percentage of their fully hydrated water content when put in any eye and the presence of a contact lens in an eye has been shown to increase tear evaporation, irrespective of evaporation from the contact lens. Soft contact lenses would appear to be able to withstand considerable dehydration and yet maintain their optical quality and in the eye with inadequate tears a lens of lower water content will remain hydrated to a reasonable extent for a longer period than one of a higher water content. Contact lenses may be necessary in the dry eye to provide an optical surface to the cornea when it is the site of destructive changes. In the case of the severely dry eye it may be necessary to use a silicone soft lens with no water content in order to obviate the problems of dehydration. There are considerable dangers in such eyes with and without conjunctival and corneal destructive changes and a decision to fit a lens should not be taken lightly and without adequate provision for close follow up.

Topics: Conjunctival Diseases; Contact Lenses; Contact Lenses, Hydrophilic; Corneal Diseases; Desiccation; Humans; Muramidase; Pemphigoid, Benign Mucous Membrane; Silicones; Tears; Time Factors; Visual Acuity; Xerophthalmia

Topics: Actins; Adult; Antigens, CD20; Biomarkers; Conjunctival Diseases; Dry Eye Syndromes; Humans; Lacrimal Apparatus Diseases; Lactoferrin; Muramidase; Prospective Studies; S100 Proteins; Stevens-Johnson Syndrome

To investigate the effects of chronic smoking on the ocular surface and tear characteristics.. The Schirmer I-test, tear film break-up time, rose Bengal staining scores, impression cytology, tear lysozyme concentration, eye irritation symptoms, and eye irritation indices were determined for 44 eyes in 44 healthy, chronic smokers who had smoked six or more cigarettes per day for the previous year. Thirty-seven eyes in 37 healthy, non-smokers were assessed in the same masked manner for comparison. Cytological specimens were obtained from the temporal interpalpebral bulbar conjunctiva by 'impression' technique. Goblet cells were counted in the specimens obtained and squamous metaplasia was graded following epithelial cell morphology assessment.. In chronic smokers, we found decreased tear film break-up time (p=0.022) and tear lysozyme concentration (p=0.013), and increased Schirmer I-test values (p=0.047), squamous metaplasia scores (p=0.016), eye irritation scores (p<0.001) and eye irritation indices (p=0.013), as compared with the control group. There were no statistically significant differences in goblet cell counts (p=0.710) or rose Bengal staining scores (p=0.827).. These findings suggest that chronic smoking has a negative effect on the ocular surface and affects some tear characteristics. The chronic ocular irritative effects of cigarette smoking may lead to defects in ocular surface defence.

Topics: Adult; Cell Count; Chronic Disease; Conjunctival Diseases; Corneal Diseases; Epithelial Cells; Fluorescent Dyes; Goblet Cells; Humans; Metaplasia; Muramidase; Rose Bengal; Smoking; Staining and Labeling; Tears

The tear lysozyme content in 111 normal subjects and in 159 patients with various conjunctival diseases was determined by a single radial immunodiffusion technique. Tear lysozyme level in normal people was 1.33/mg/ml. (SI conversion: mg/ml = g/l.) The mean tear lysozyme levels in patients with chronic irritative conjunctivitis (0.97 mg/ml) and nutritional deficiency with epithelial xerosis (0.76 mg/ml) were significantly lower than in the normal controls. The mean tear lysozyme levels in tears from patients with vernal conjuctivitis (1.20 mg/ml), phlyctenular conjunctivitis (1.10 mg/ml), and acute bacterial conjunctivitis (1.48 mg/ml) were not significantly different from those in the normal controls. Superimposition of acute bacterial conjunctivitis on trachoma did not alter the low tear lysozyme level that existed before in these patients.

Topics: Adolescent; Adult; Age Factors; Child; Conjunctival Diseases; Conjunctivitis; Female; Humans; Immunodiffusion; Male; Middle Aged; Muramidase; Sex Factors; Tears