tetracycline and Conjunctival-Diseases

To report the presence of an asymptomatic cilium in the subconjunctival area and an adjacent sterile scleral ulcer, together as a complication of subtenon injection of steroids, and the resolution of the ulcer despite the in situ cilium.. Medical management of a 51-year-old man, who was a known case of ankylosing spondylitis, with a 3-mm scleral ulcer located in the inferior palpebral area with one adjacent fully embedded cilium at the probable site of subtenon injection given for suspected acute iridocyclitis.. On altering the medication, the ulcer resolved completely. This occurred despite the in situ cilium, which did not act as a nidus for infection or inflammation.. The presence of cilia did not adversely affect the outcome of treatment of the adjacent ulcer. Therefore, if there is no exposure of the entrapped cilium through the conjunctiva, as was in this case, conservative management of the ulcer and not trying to remove the cilium seems to be a good alternative as opposed to reports in literature, which warrant its removal in most cases.

Topics: Anti-Bacterial Agents; Ascorbic Acid; Carboxymethylcellulose Sodium; Chloramphenicol; Cilia; Conjunctival Diseases; Drug Therapy, Combination; Eye Foreign Bodies; Humans; Iatrogenic Disease; Injections, Intraocular; Iridocyclitis; Male; Middle Aged; Scleral Diseases; Spondylitis, Ankylosing; Steroids; Tetracycline; Ulcer; Vitamins

Topics: Anti-Bacterial Agents; Conjunctival Diseases; Humans; Hyperpigmentation; Male; Middle Aged; Tetracycline

Cicatricial pemphigoid (CP) is one of the subepidermal autoimmune bullous dermatoses in which pathologic separation occurs between the epidermis and dermis. Ocular findings characteristic of CP include conjunctival cicatrization, subepithelial fibrosis, and symblepharon formation, which may progress to blindness. Ocular CP (OCP) is usually treated with steroids or immunosuppressive agents, which are problematic in and of themselves within the elderly population, which is most often afflicted with OCP. We describe the utility and effectiveness of therapy with tetracycline and niacinamide in elderly patients with OCP.

Topics: Administration, Oral; Aged; Aged, 80 and over; Anti-Bacterial Agents; Conjunctival Diseases; Diagnosis, Differential; Female; Humans; Niacinamide; Pemphigoid, Benign Mucous Membrane; Tetracycline

Unpigmented and pigmented cystic epithelial inclusions were found bilaterally within the lower palpebral conjunctiva temporally of a 31-year-old man. He had a history of tetracycline/minocycline therapy for 14 years because of acne vulgaris. The cysts were studied by light and electron microscopy, histochemistry, and ultraviolet light. By light microscopy the unpigmented cysts contained faintly eosinophilic globular material that disclosed yellowish-green autofluorescence indicating the presence of tetracycline/minocycline. The pigmented cysts revealed laminated eosinophilic to brownish concretions that also showed yellowish-green autofluorescence. Autofluorescence, however, decreased with increasing brown pigmentation of the concretions. Histochemically, the pigment, which failed to show the staining characteristics of lipofuscin, melanin or iron, probably represented an oxidation product of tetracycline. By electron microscopy the cysts contained moderately electron dense amorphous material as well as degenerating epithelial cells. The epithelial cells lining the conjunctival cysts, did not contain membrane-bound, large, pigment granules within their cytoplasm as has been demonstrated in the colloid and follicular epithelium of the thyroid following minocycline therapy.

Topics: Acne Vulgaris; Adult; Conjunctiva; Conjunctival Diseases; Cysts; Cytoplasmic Granules; Drug Therapy, Combination; Epithelium; Humans; Male; Microscopy, Electron; Minocycline; Tetracycline; Tetracyclines

Ocular rosacea was diagnosed in 6.3% of a cornea/external disease referral practice where more than half of the patients referred are for corneal surgery. The most common signs and symptoms are also common to many patients in the general practice of ophthalmology, i.e., foreign body sensation, burning, superficial punctate erosions, chalazia and blepharitis. Less common but dangerous to the vision was corneal thinning, vascularization and infiltrates. Three new associated symptoms were described. These were map dot subepithelial opacities, recurrent erosions and moderately severe foreign body sensation, pain or burning with minimal associated signs. Oral tetracycline 250 mg q.i.d. resulted in improvement in almost all patients from 4 to 17 days after initiation of therapy. Although most of the patients have been able to taper and stop therapy, those with foreign body sensation, burning and pain have had recurrences of their symptoms with all attempts at stopping therapy.

Topics: Adult; Aged; Conjunctival Diseases; Corneal Diseases; Eyelid Diseases; Female; Humans; Male; Middle Aged; Rosacea; Tetracycline; Time Factors

A 26-year-old man had been treated for acne vulgaris with tetracycline and minocycline orally for 12 years. He developed dark brown to black pigmentary deposits in the palpebral conjunctiva bilaterally. These deposits resembled those seen in epinephrine pigmentation of the conjunctiva. Histologically the pigmented deposits were concretions in conjunctival cysts. Although they contained calcium, the concretions displayed the characteristic yellow autofluorescence of tetracycline under ultraviolet light. Presumably, tetracycline had formed extracellular chelation complexes with calcium, thus accounting for the pigmentation of the conjunctiva.

Topics: Adult; Conjunctival Diseases; Humans; Male; Minocycline; Pigmentation Disorders; Tetracycline; Tetracyclines