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Acute bacterial conjunctival infections are common, and this study identified the conjunctival bacterial community in infectious conjunctivitis cases seen at the outpatient clinic of Khanh Hoa General Hospital in Nha Trang, Vietnam from October 2016 through December 2017. Conjunctival swabs were collected and tested using conventional culture, PCR, and 16S ribosomal RNA sequencing. The study included 47 randomly selected patients. More than 98% of all DNA reads represented five bacterial phyla. Three of these phyla constituted 92% of all sequences (Firmicutes (35%), Actinobacteria (31%), and Proteobacteria (26%)). At the genus level, there were 12 common genera that constituted about 61% of all sequence reads. Seven of those genera were common (Streptococcus (10%), Cutibacterium (10%), Staphylococcus (7%), Nocardioides (7%), Corynebacterium 1 (5%), Anoxybacillus (5%), and Acinetobacter (5%)), which encompassed 49% of all reads. As for diversity analysis, there was no difference on PERMANOVA analysis (unweighted UniFrac) for sex (p = 0.087), chemosis (p = 0.064), and unclassified eyedrops (p = 0.431). There was a significant difference in cases with bilateral conjunctivitis (p = 0.017) and for using antibiotics (p = 0.020). Of the predominant phyla, Firmicutes had the highest abundance in bacterial conjunctivitis in this study. Pseudomonas as a resident commensal microbiota may have an important role in the prevention of infection., Microorganisms, 9(10), art. no. 2095; 2021

BACKGROUND Eye disorders in children with different presentations come to Ophthalmology OPD. Early detection and treatment of ocular morbidity is important. This study aimed to detect the prevalence and pattern of common ophthalmic problems in paediatric age group, in a rural based tertiary care hospital. MATERIALS AND METHODS Study design was observational, retrospective review of all children less than 12 yrs. old, who came to the rural based Chengalpattu Government medical college Ophthalmology OPD, between September 2015 and May 2016. Data collection and analysis was based on the age of presentation of both sexes (newborn (0-28 days), infants (1 year), preschool (1-5 years), school going (above 5 years)) from rural and semi-rural areas and diagnosis were analysed using graph pad prism 5.0. 'P value' less than 0.05 was considered statistically significant. RESULTS During the study period, out of total 2520 OP cases (100%), 230 children (10.95%) were evaluated. The male: Female ratio was 1.1:1. The children from school going age constituted the largest group, male (48 .4%) & Female (51.5%) (p

Bacterial conjunctivitis is a conjunctiva inflammation that caused by bacterial. This disease including to the most ten diseases of ophthalmology polyclinic at RSUD Ulin Banjarmasin ; however there is no data given on the sensitivity pattern to the antibiotic. The aim this research was to assess aerob bacterial sensitivity patterns causes conjunctivitis to a topical antibiotic. This research used the descriptive method with a cross-sectional study. The result with 21 samples isolate bacteria demonstrated that aerob bacterial sensitivity patterns to tobramicin (100%), to gentamicin (80,95%), to polymixin (80,95%), to ofloxacin (61,90%), to levofloxacin (61,90%), to chloramphenicol (42,86%); resistance to chloramphenicol (23,80%), to ofloxacin (9,52%), and to levofloxacin (9,52%). Based on the result, it can be concluded that tobramicin has the highest sensitivity pattern, followed by gentamicin, polymixin, ofloxacin, and levofloxacin. However, chloramphenicol has the smallest sensitivity pattern. Keywords : bacterial conjunctivitis, sensitivity patterns, antibiotic, ophthalmology polyclinic Abstrak: Konjungtivitis bakteri merupakan suatu peradangan pada konjungtiva yang disebabkan oleh bakteri. Penyakit ini masih termasuk di dalam sepuluh besar penyakit yang ada di poliklinik mata RSUD Ulin Banjarmasin dan belum ada data pada kepekaan isolate terhadap terhadap antibiotik. Penelitian ini bertujuan untuk mengetahui pola kepekaan isolat bakteri aerob penyebab konjungtivitis terhadap antibiotik topikal. Penelitian ini menggunakan metode deskriptif dengan pendekatan crossectional. Hasil penelitian dengan jumlah 21 sampel isolat bakteri didapatkan gambaran pola kepekaan bakteri aerob sensitive terhadap tobramisin (100%), gentamisin (80,95%), polimiksin (80,95%), ofloksasin (61,90%), levofloksasin (61,90%), dan kloramfenikol (42,86%); resisten terhadap kloramfenikol (23,80%), ofloksasin (9,52%), dan levofloksasin (9,52%). Berdasarkan hasil penelitian ini dapat disimpulkan bahwa tobramisin merupakan antibiotik dengan kepekaan tertinggi, diikuti gentamisin, polimiksin, ofloksasin, dan levofloksasin. Sedangkan kloramfenikol memiliki kepekaan terendah. Kata-kata kunci : konjungtivitis bakteri, pola kepekaan, antibiotik, poliklinik mata

PURPOSE To evaluate the efficacy of besifloxacin ophthalmic suspension 0.6% compared with moxifloxacin ophthalmic solution 0.5% in the treatment of bacterial conjunctivitis in an Indian population. DESIGN Multicenter, randomized, double-masked, active-controlled, parallel-group, clinical trial, including 6 clinical sites in India. METHODS Patients were randomized to receive 1 drop of besifloxacin or moxifloxacin in the infected eye(s), 3 times daily, for 5 days. Primary efficacy end points included clinical resolution and bacterial eradication at day 5. Secondary efficacy end points included clinical resolution and bacterial eradication at day 8, ocular discharge, bulbar conjunctival injection, investigator's global assessment, and bacterial eradication by species. Efficacy was analyzed using the Cochran-Mantel-Haenszel and Pearson χ2 tests. Safety was assessed by the incidence of ocular and nonocular treatment-emergent adverse events (AEs), changes in visual acuity, and biomicroscopy and ophthalmoscopy findings. Data presented are that for the subset of patients from India. RESULTS Of the 123 patients randomized at clinical sites in India, 96.7% completed the study. Day 5 differences in microbial eradication (100% besifloxacin vs 96.3% moxifloxacin) and in clinical resolution (78.9% besifloxacin vs 71.4% moxifloxacin) were not statistically significant. No statistically significant between-group differences were observed for secondary end points. All ocular AEs in both groups were mild or moderate in severity. There were no drug-related ocular AEs with besifloxacin. CONCLUSIONS Treatment of bacterial conjunctivitis with besifloxacin 0.6% produces similar antibacterial and clinical efficacy as that with moxifloxacin 0.5% in an Indian population, with no clinically meaningful safety concerns.

Актуальность. Инфекционный процесс переднего отрезка глазного яблока является одной из наиболее распространенных патологий в офтальмологии. Выбор оптимального антибактериального препарата и способа его доставки при лечении инфекционных заболеваний глаза остается актуальной задачей. Цель. Оценить эффективность глазных лекарственных пленок с моксифлоксацином в терапии бактериальных конъюнктивитов. Материал и методы. Исследование проводили на 12 кроликах (24 глаза) породы «шиншилла» весом 2,5-3,5 кг. Кролики были разделены на три опытные группы по 4 кролика (8 глаз) в каждой. Экспериментальную модель бактериального конъюнктивита вызывали взвесью суточной агаровой культуры Staphylococcus aureus (1-2*10-8 КОЕ/мл). В I группе лабораторных животных лечение проводили инстилляциями 0,5% раствора моксифлоксацина 4 раза в день. Животным II группы в конъюнктивальную полость закладывали глазную лекарственную пленку с моксифлоксацином 1 раз в сутки. Контрольной группе животных на протяжении всего эксперимента закапывали стерильный физиологический раствор. Результаты. На вторые сутки после инфицирования в контрольной группе животных наблюдалось развитие острого гнойного воспалительного процесса конъюнктивы глаза. В I опытной группе наблюдалась воспалительная реакция конъюнктивы, которая купировалась на четвертые сутки. Морфологическое исследование подтверждало наличие остаточных признаков воспалительного процесса в структурах глазного яблока. Во II опытной группе биомикроскопически воспалительных явлений глаз кроликов не обнаружили. Гистологическое исследование глаз кроликов характеризовалось отсутствием признаков воспаления глазного яблока. Выводы. Проведенные экспериментальные исследования показали, что применение глазных лекарственных пленок с моксифлоксацином оказывает выраженный терапевтический эффект по сравнению с группой, где использовали метод инстилляций данного антибиотика.

Bacterial conjunctivitis represents the major part of infectious conjunctivitis and, although it generally shows a spontaneous resolution, antibiotics speed the elimination of bacteria from the conjunctiva thus limiting the duration of the disease. The addition of anti-inflammatory drugs may potentiate the effectiveness of antibiotics in eradicating bacterial conjunctivitis. Aim of the present study is to compare the efficacy of two different eye drops based on ofloxacin without or with dexamethasone against bacterial conjunctivitis induced by Staphylococcus aureus or Pseudomonas aeruginosa.

Abhishyanda can correlate to Conjunctivitis. It is the common cause of ocular morbidity that may ultimately lead to Redness, ocular pain, discomfort, watering etc. Objective of the present study was “TO EVALUATE THE EFFICACY OF DARUHARIDRA KWATH ASCHOTAN IN THE MANAGEMENT OF ABHISHYANDA.”

Background/purposeTo date, studies examining polymicrobial infections in ocular disease have mostly been limited to keratitis or endophthalmitis. We characterized polybacterial infections compared to monobacterial infections in prior clinical studies evaluating besifloxacin ophthalmic suspension 0.6% for the treatment of bacterial conjunctivitis and report on associated microbiological outcomes.MethodsIn this post-hoc analysis, microbiological data for subjects with conjunctivitis due to one or more than one bacterial species in three previous studies (two vehicle-, one active-controlled) of besifloxacin were extracted. Bacterial species identified at baseline were deemed causative if their colony count equaled or exceeded species-specific prespecified threshold criteria. In subjects with polybacterial infections, the fold-increase over threshold was used to rank order the contribution of individual species. Baseline pathogens and their minimum inhibitory concentrations (MICs) for common ophthalmic antibiotics were compared by infection type, as were microbial eradication rates following treatment with besifloxacin.ResultsOf 1041 subjects with culture-confirmed conjunctivitis, 17% had polybacterial and 83% had monobacterial conjunctivitis at baseline. In polybacterial compared to monobacterial infections, Haemophilus influenzae and Streptococcus pneumoniae were identified less frequently as the dominant infecting species (P = 0.042 and PConclusionsApproximately one in five subjects with bacterial conjunctivitis are infected with more than one bacterial species underscoring the need for a broad-spectrum antibiotic for such infections. Besifloxacin treatment resulted in robust eradication rates of these infections comparable to monobacterial infections.Trial registrationNCT000622908, NCT00347932, NCT00348348.

Purpose: Although Chlamydia trachomatis and Neisseria gonorrhoeae are the commonest sexually transmitted infections in England, reports of ocular co-infection in the literature are limited. We report such a case which responded well to treatment, and discuss the literature and evidence currently available with regards to management of these cases. Observations: The patient is a 48-year-old bisexual gentleman who presented to the eye clinic of a UK hospital with redness, discharge and blurred vision in his left eye for one week. Initially he had mucopurulent discharge but his cornea was clear. He did not comply with prescribed treatment and returned two days later with bilateral symptoms and corneal thinning in his left eye peripherally.PCR tests for Chlamydia trachomatis and Neisseria gonorrhoeae were positive and the patient was commenced on intravenous ceftriaxone, oral and topical levofloxacin eye drops. After 48 hours of inpatient treatment the patient showed clinical improvement. Conclusions and importance: Ophthalmologists should be aware of the possibility that Chlamydia trachomatis and Neisseria gonorrhoeae can cause co-infection in adult conjunctivitis, and of the straightforward method of treatment for such individuals. Delayed diagnosis and treatment of affected patients can lead to corneal complications and potential blindness. It is advisable to discuss these cases with the local microbiology service wherever possible, and referral to a sexual health service is imperative. Keywords: Chlamydia trachomatis, Neisseria gonorrhoeae, Conjunctivitis, Adult inclusion conjunctivitis, Sexually transmitted disease, Bacterial conjunctivitis

To evaluate the efficacy and safety of a topical ophthalmic suspension combination of povidone-iodine 0.6% (PVP-I) and dexamethasone 0.1% (DEX) for infectious and inflammatory components of bacterial conjunctivitis.Randomized, double-masked, multicenter, phase 3 clinical trial.Subjects of all ages (those3 months had to be full-term) with a diagnosis of bacterial conjunctivitis were randomized 3:1:3 to either PVP-I/DEX, PVP-I alone, or placebo. The primary endpoint was clinical resolution in the study eye, and the key secondary efficacy endpoint was bacterial eradication, both at the day 5 visit. Adverse events (AEs) were documented at all visits.Overall, 753 subjects were randomized (intent-to-treat [ITT] population; PVP-I/DEX [n = 324]; PVP-I [n = 108]; placebo [n = 321]); mean and standard deviation (SD) age was 44.3 (22.9) years, and most were female (61.2%) and white (78.1%). In all treatment groups, mean treatment compliance was98%. The modified ITT population for the efficacy analysis comprised 526 subjects. In the study eye at the day 5 visit, clinical resolution was achieved by 50.5% (111/220) subjects in the PVP-I/DEX group vs 42.8% (95/222) in the placebo group (P = .127), and bacterial eradication was achieved by 43.3% (94/217) and 46.8% (102/218), respectively (P = .500). Treatment-emergent AEs were experienced by 32.8% (106/323), 39.8% (43/108), and 19.0% (61/321) of subjects in the safety population treated with PVP-I/DEX, PVP-I, and placebo, respectively (most mild in severity).In this study, PVP-I/DEX did not demonstrate additional benefit in clinical efficacy compared with placebo in subjects with bacterial conjunctivitis.

Haemophilus influenzae is a predominant pathogen for conjunctivitis, acute otitis media and acute bacterial paranasal sinusitis in children. We undertook this study to investigate the possible association among these diseases. Children younger than 18-year-old with a diagnosis of bacterial conjunctivitis plus acute otitis media and/or acute bacterial paranasal sinusitis during 2009–2018 were included. Sampling for bacterial cultures was obtained from the lower palpebral conjunctiva and/or ear discharge with cotton-tipped swabs. A total of 67 children were recruited and the age was 29.5 (± 22.4) months in average. Fifty-seven children had conjunctivitis–otitis media syndrome and eight of them had a concurrent diagnosis of acute paranasal sinusitis. Ten children had conjunctivitis and acute paranasal sinusitis simultaneously. Clusters in household were observed in 50.7% children. Most common isolates were Haemophilus influenzae (70%), Moraxella catarrhalis (18%), and Staphylococcus aureus (8%). Antibiotic resistance rate of H. influenzae was 80% for ampicillin, 18% for amoxicillin–clavulanate, and 11% for the second or third-generation cephalosporins. Apart from well-known conjunctivitis–otitis media syndrome, acute paranasal sinusitis may also be linked to conjunctivitis with a similar pathogenic process. Simultaneous presence of these infections may guide the choice of empiric antibiotics toward H. influenzae.

Conjunctivitis refers to any inflammatory condition of the membrane that lines the eye lids and covers the exposed surface of the sclera. It is the most common part of the red eye. Abhishyanda is classified as the eye disease affecting all parts of the eye. The disease kaphaj abhishyanda is Sarvagat Netra Rog expain by Sushruta Samhita In developing countries, bacterial conjunctivitis is commonest type of conjunctivitis.it can occur as sporadic and epidemics cases during monsoon season. Prevalence for chronic bacterial conjunctivitis is 25% of the general population. There are so many treatment of kaphaj abhishyanda in Ayurveda like Anjana, Snehana, Swedana, Tarpana, Putpak, Aschyotan, Nasya, Parishek, etc. but Ascyotana kalpana is very effective, safe, easily available, so I have selected shigru madhu ascyotana.

The diagnosis of acute infectious conjunctivitis can be difficult. Clinical ambiguity exists between the acute viral and bacterial as well as the allergic forms, which can confound diagnosis. Also, discrimination between viral or bacterial origins of infectious conjunctivitis based on historical, nonspecific, clinical signs and symptoms contributes to a high rate of misdiagnosis and overuse of antibiotic treatment. Therefore, in order to effectively treat acute infectious conjunctivitis, physicians must be aware of the clinical signs and symptoms and available diagnostic tests that can provide a more accurate differential diagnosis.

[THIS ARTICLE HAS BEEN RETRACTED] AIM: To evaluate the relative efficacy and safety of besifloxacin for treatment of acute bacterial conjunctivitis. METHODS: A comprehensive search in PubMed, EMBASE Web of Science, Cochrane Central Database and CNKI was undertaken for randomized controlled trials (RCTs) comparing besifloxacin with other treatments or placebo. The primary outcome measures were clinical resolution, rates of bacterial eradication, individual clinical outcomes, cure rates, and bacterial eradication rates of different kinds of pathogens. Safety outcomes were the number of adverse effects (AEs). The final search was performed on August 2018. RESULTS: Eight RCTs were included. Five studies compared the efficacy and safety of besifloxacin with placebo, 2 studies compared besifloxacin with moxifloxacin, and 1 study compared besifloxacin with gatifloxacin. A total of 3105 patients met the inclusion criteria. Besifloxacin presented higher efficacy and safety than did placebo in clinical resolution, rates of bacterial eradication, individual clinical outcomes, cure rates, bacterial eradication rates of different kinds of pathogens and the number of AEs. There was no significant difference between besifloxacin and moxifloxacin or gatifloxacin in the comparison items mentioned above. CONCLUSION: Besifloxacin is highly effective and safe for treatment of acute bacterial conjunctivitis. Further comparative trials regarding the effect of besifloxacin for treatment of acute bacterial conjunctivitis will aid in treatment decisions.

Bacterial conjunctivitis is a leading cause of ocular infections requiring short-term therapeutic treatment with frequent administration of drugs on daily basis. Topical dosage forms available in the market for the treatment of bacterial conjunctivitis such as simple drug solutions and suspensions are rapidly eliminated from the precorneal space upon instillation due to tear turn over and nasolacrimal drainage, limiting intraocular bioavailability of drug to less than 10% of the administered dose. To overcome issues related to conventional drop, an effort was made to design and evaluate prolong release ophthalmic solution of levofloxacin hemihydrate (LFH) using ion-sensitive in situ gelling polymer. Gellan gum was used as the in situ gelling agent. Formulations were screened based on in vitro gelation time, in vitro drug release, and stability towards sol to gel conversion upon storage. The prototype formulations exhibiting quick in vitro gelling time (

A 70-year-old white woman presented to her ophthalmologist with bacterial conjunctivitis resistant to treatment. The relationship between the patient's globe and superior orbital rim prompted high clinical suspicion of an occult foreign body as the cause. The following article describes the office visits preceding the discovery of two adhered soft contact lenses lodged in the superior fornix of the right eye that had been hidden for 15 years. We discuss the role her unique orbital anatomy played in successfully concealing these foreign bodies for over a decade. In addition, we present an algorithm to practice when an occult foreign body is suspected, which includes effective clinical techniques.

Irrational use of antibiotics can cause resistance to some diseases such as bacterial conjunctivitis caused by Staphylococcus aureus. Previous research said that green betel leaf (Piper betle) contains antimicrobial compounds such as eugenol, cavalry, tannins, saponins, and flavonoids which also have antiseptic power as well as antibiotics. This study aims to prove the decrease in the number of Staphylococcus aureus colonies after giving green betel leaf eye drops (Piper betle) to conjunctivitis Wistar rats (Rattus norvegicus). This research was true experimental with a pretest-posttest control group design. 25 male white Wistar rats as objects were selected by simple random sampling and grouped into 5 groups randomly. The rats were given Staphylococcus aureus, control group K+ was given 0.5% levofloxacin eye drops, and K- was given aquadest as a comparison. Treatment groups P1, P2, and P3 were given different concentrations of betel leaf eye drops. Swab pretest was done 3 days after the rats were inoculated with Staphylococcus aureus and swab post-test was done 5 days after the rats were given green betel leaf eye drops, the calculation of Staphylococcus aureus bacteria colonies used the Total Plate Count (TPC) method. There was a significant decrease (p

Consultations for infective conjunctivitis are common in primary care and account for 1% of all GP consultations in the UK.1 Between 50% and 75% of cases of infectious conjunctivitis in children are thought to be bacterial and data from the USA suggest that almost 25% of cases of bacterial conjunctivitis are in those aged 0–2 years.1 2 Although most infections are self-limiting and resolve within 7 days, treatment with topical antibiotics may be required and chloramphenicol eye drops are recommended as the first-line drug treatment.1 3 Consequently, the news that the majority of chloramphenicol eye drop products are no longer licensed for children aged under 2 years due to concerns regarding fertility has caused consternation across primary care. Unlike many safety issues that are announced by the regulatory authorities and cascaded through official channels, this one has taken doctors …

Purpose: Bacterial conjunctivitis can be due to infection with more than one bacterial pathogen. We identified pediatric patients with polybacterial infections at baseline in clinical studies of besifloxacin ophthalmic suspension 0.6% administered 3 to 7 days in the treatment of bacterial conjunctivitis and report on baseline characteristics and outcomes in this population. Methods: This was a post-hoc analysis of data from five previously conducted multicenter randomized clinical studies (four vehicle- and one active-controlled). In each of these studies, …

Abhishyanda is one of the Sarvagata Vyadhi mentioned by Acharya Sushruta. In modern science, signs and symptoms of Netrabhishyanda may be correlated with conjunctivitis, which is the inflammatory condition of conjunctiva. Kavala Dharana, Dhumrapana, Aschyotana, Sechana Putapaka etc. are various suggested regimens in Ayurvedic texts for the treatment of Netrabhishyanda. Considering this effectiveness of Palasha as mentioned by Acharya Sushruta, it is planned to study the use of Palasha Mula Arka Aschyotana in Pittaja Netrabhishyanda. 60 patients having classical signs and symptoms of Pittaja Abhishyanda (Acute Bacterial Conjunctivitis) as per Ayurvedic and modern texts were selected for the study. After completion of therapy, mean Conjunctival hyperemia was reduced to 0.2167 ± 0.4086 in Control and 0.5667 ± 0.5040 in Trial Group. Palasha Mula Arka was found effective in reduction in conjunctival hyperemia, watering and the number of culture colonies, it was also found effective in burning sensation, discharge, foreign body sensation and photophobia.

Ocular infections are widespread and they exert heavy burden on eye health. Virtually, any eye component can be infected by a diversity of bacteria. The present study was performed to determine the prevalence of external ocular bacterial infections and to find out antibiotic susceptibility pattern of bacterial isolates at eye care hospitals in Khartoum, Sudan. Two hundred and four corneal scrape and drained pus materials were received from infected eyes with clinical diagnoses of bacterial conjunctivitis, keratoconjunctivitis, keratitis, blepharo-conjunctivitis, blepharitis, dacryo-cystitis and eye abscess. Culture, microscopy with Gram’s stain of both samples, bacterial colonies and biochemical tests were carried out. Antibiotic susceptibility analysis using Kirby–Bauer disc diffusion test and standard table of antibiotic susceptibility was performed. Out of 204 samples processed, 130 (63.7%) yielded bacterial growth. The most prevalent bacterial eye infection was conjunctivitis (59.2%). Of all the isolates, 75 (57.7%) were Gram’s positive and 55 (42.3%) were Gram’s negative. Coagulase positive Staphylococcus aureus were the most prevalent, 39 (30%) followed by Streptococcus pneumonia 31 (23.8%), Haemophilus influenzae 22 (16.9%), Pseudomonas aeruginosa 13 (10%) and Neisseria gonorrheae 10 (7.7%). Gram positive bacteria were highly sensitive to vancomycin (95%), followed by chloramphenicol and ciprofloxacin (91%) and ceftriaxone (84%), while the majority were resistant to penicillin (72%). Gram-negative organisms were highly susceptible to amikacin (92.7%) followed by ceftriaxone (87.3%) and ciprofloxacin (78.2%). Major resistance was towards cotrimoxazole (82%) and ampicillin (73%). Key words: External ocular bacterial infections, bacterial isolate, antibiotic susceptibility, normal flora, pathogenic bacteria.

The current investigation aims to develop and evaluate novel ocular proniosomal gels of lomefloxacin HCl (LXN); in order to improve its ocular bioavailability for the management of bacterial conjunctivitis. Proniosomes were prepared using different types of nonionic surfactants solely and as mixtures with Span 60. The formed gels were characterized for entrapment efficiency, vesicle size, and in vitro drug release. Only Span 60 was able to form stable LXN-proniosomal gel when used individually while the other surfactants formed gels only in combination with Span 60 at different ratios. The optimum proniosomal gel; P-LXN 7 (Span 60:Tween 60, 9:1) appeared as spherical shaped vesicles having high entrapment efficiency (>80%), appropriate vesicle size (187 nm) as well as controlled drug release over 12 h. Differential scanning calorimetry confirmed the amorphous nature of LXN within the vesicles. Stability study did not show any significant changes in entrapment efficiency or vesicle size after storage for 3 months at 4 °C. P-LXN 7 was found to be safe and suitable for ocular delivery as proven by the irritancy test. The antibacterial activity of P-LXN 7 evaluated using the susceptibility test and topical therapy of induced ocular conjunctivitis confirmed the enhanced antibacterial therapeutic efficacy of the LXN-proniosomal gel compared to the commercially available LXN eye drops.

This comprehensive review summarizes the mechanism of action, pharmacokinetics, efficacy, and safety of besifloxacin ophthalmic suspension, 0.6% and examines its role in the treatment of ocular surface bacterial infections. Besifloxacin possesses balanced activity against bacterial topoisomerase II (also called DNA gyrase) and topoisomerase IV. It has shown a low potential to select for bacterial resistance in vitro and demonstrated strong in vitro activity against many Gram-positive, Gram-negative, and anaerobic organisms, including methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis (MRSA and MRSE, respectively). Ocular pharmacokinetic studies have shown that besifloxacin achieves high, sustained concentrations in the tear fluid and conjunctiva following topical administration, with negligible systemic exposure. Large randomized, controlled clinical trials have established the efficacy and safety of besifloxacin administered three times daily for 5 days for treatment of acute bacterial conjunctivitis in both adults and children, with high rates of clinical resolution (up to more than 70% by day 5) and bacterial eradication (more than 90% by day 5), and a low incidence of adverse events. Additionally, besifloxacin applied twice daily for 3 days demonstrated greater efficacy than vehicle in treating bacterial conjunctivitis. Case reports, a large retrospective chart review, and animal studies have provided supporting evidence for the efficacy of besifloxacin in the management of acute bacterial keratitis. There is some evidence to suggest that besifloxacin may provide an advantage over other current-generation fluoroquinolones in antimicrobial prophylaxis for ocular surgery. Besifloxacin is an appropriate option for treatment of bacterial conjunctivitis, and its use in the treatment of bacterial keratitis and lid disorders, as well as for surgical prophylaxis, appears promising and warrants further evaluation.

The efficacy and safety of topical Azithromycin ophthalmic solution 1.5 % has been evaluated in treatment of bacterial conjunctivitis and post-traumatic keratitis in children, and the possibility of its use for prevention of infectious complications after ocular surface trauma. Topical Azithromycin ophthalmic solution 1.5 % was used in 32 children: with bacterial conjunctivitis (21), corneal foreign body (5), traumatic corneal erosion (3), post-traumatic keratitis (3). Topical Azithromycin ophthalmic solution 1.5% was shown to have a significant antibacterial activity and a convenient dosing schedule. No side effects, including eye irritation, have been noted. Conclusion: topical Azithromycin ophthalmic solution 1.5 % could be considered as the medication of choice in treatment of bacterial conjunctivitis and post-traumatic keratitis in children. It also could be used in the complex prevention of infections complications in eye surface traumatic lesions.

Purpose To help clinicians diagnose and manage unilateral recalcitrant chronic bacterial conjunctivitis secondary to a retained soft contact lens and describe the first report of Gram-negative bacteria causing this condition. Methods Chart review of successive cases presenting with unilateral chronic conjunctivitis with positive cultures and a retained contact lens. Results Three cases were identified and described. Culturing of the retained contact lenses grew Pseudomonas aeruginosa in the first case, Achromobacter xylosoxidans in the second, and Staphylococcus epidermidis in the third. All three patients were successfully treated with removal of the retained lens and targeted antibiotic eyedrop therapy. Conclusions Unilateral chronic recurrent or recalcitrant purulent papillary conjunctivitis is rare, and a retained contact lens should be suspected in patients with a history of wearing contact lenses. Careful examination with double eversion of the upper eyelid and sweeping of the fornices can recover the offending lens. Although only Gram-positive organisms have been isolated in previous reports, two of our three cultures grew Gram-negative organisms, highlighting the importance of broad-spectrum antibiotic usage for these cases.

Conventional methods to diagnose anemia require a blood draw. This generates a great problem in patients due to the fear of contracting a disease through syringes, or sensitivity to this element. The palpebral conjunctiva is an indicator of diseases such as the hordeolum, chalazion, marginal blepharitis, bacterial conjunctivitis, trachoma, and anemia. The palpebral conjunctiva pallor is an indicator of anemia and if we wanted to develop an automatic system, for the non-invasive diagnosis of anemia based on the analysis of photographs of the palpebral conjunctiva, we would need algorithms for the segmentation and analysis of this membrane. In this sense, this research proposes and develops a method for the automatic segmentation of the palpebral conjunctiva using an Android application and image processing techniques. As a result, the success of this segmentation method is 92.2%.

Around 3% of pregnant women in Finland have genital Chlamydia trachomatis infection, which can be transmitted from mother to newborn at birth. The risk of transmission has been reported to be 10–70% in vaginal deliveries resulting in conjunctivitis in 10–30% of cases and lower respiratory tract infection in 0–20% of cases. Although usually benign, Chlamydia trachomatis infections in infancy may result in long-term consequences, including conjunctival and corneal scarring, chronic cough and abnormal lung function. Based on the transmission rates published in prior studies, chlamydial conjunctivitis should occur in approximately 200 infants and chlamydial lower respiratory tract infection in 100 infants each year in our country, but in clinical practice we rarely encounter or diagnose infants with Chlamydia trachomatis infections. To investigate the reason for this discrepancy and to improve the recognition of Chlamydia trachomatis-infected infants, we set out to study the risk of vertical transmission of Chlamydia trachomatis in a population-based setting, to describe the typical features of Chlamydia trachomatis infections in infants and to evaluate the occurrence of Chlamydia trachomatis in both neonatal conjunctivitis and lower respiratory tract infections in infants. When studying the probability of vertical transmission of Chlamydia trachomatis a search through two national health registers for 1996–2011 yielded 206 children aged less than four years with a possible Chlamydia trachomatis infection. In a cohort of 933 823 births this represented an occurrence of 0.22 per 1000 live births (95% confidence interval 0.19–0.25). The risk of vertical transmission of Chlamydia trachomatis leading to a symptomatic infection in infancy was 0.8–1.8%. A review of patient charts to evaluate the typical features of Chlamydia trachomatis infections in infants (124/206) revealed that one-third of the infants with chlamydial conjunctivitis (33/124) had spontaneous bloody discharge from the infected eyes. Almost half of the infants with chlamydial lower respiratory tract infection (15/32) had wheezing, but the characteristic staccato cough was not recorded in any of them. The median diagnostic delay from the onset of symptoms was 13 (range 4–374) days for conjunctivitis and 25 (range 10–149) days for lower respiratory tract infection. One neglected child developed bilateral corneal scars due to untreated chlamydial conjunctivitis. To investigate the occurrence of Chlamydia trachomatis in neonatal conjunctivitis, 173 neonates with clinical conjunctivitis at child health clinics were examined prospectively during 2010–2015 and none of the 163 cases tested had chlamydial or gonococcal conjunctivitis (0%; 95% confidence interval 0%–2.2%). Viral conjunctivitis was diagnosed in 8/167 cases (4.8%; 95% confidence interval 2.1%–9.2%) and non-chlamydial bacterial conjunctivitis in 58/160 (36%; 95% confidence interval 29%–44%). To investigate the occurrence of Chlamydia trachomatis in lower respiratory tract infections, 228 infants aged less than six months with lower respiratory tract infection presenting at the paediatric emergency department of Oulu University Hospital were examined prospectively over a period of a complete epidemiological year. One infant (0.4%; 95% confidence interval 0.01%–2.4%) had lower respiratory tract infection caused by Chlamydia trachomatis and another was diagnosed with whooping cough (0.4%; 95% confidence interval 0.01%–2.4%). The majority of the infants with lower respiratory tract infection (203/228) had a respiratory viral infection. It may be concluded that the risk of mother-to-child transmission of Chlamydia trachomatis leading to a clinical illness in the infant in this era of nucleic acid-based diagnostics was less than 2%, which is significantly lower than in earlier studies. The population-based prevalence of neonatal chlamydial conjunctivitis in primary care was less than 2% and that of chlamydial lower respiratory tract infection in a hospital setting less than 2.5%. The long-term prognosis for Chlamydia trachomatis infections in infancy was good. Common respiratory viruses were detected in 5% of the neonatal conjunctivitis cases. Tiivistelmä Noin 3 %:lla suomalaisista raskaana olevista naisista on klamydian (Chlamydia trachomatis) aiheuttama sukupuolitauti, joka voi tarttua äidistä lapseen synnytyksessä. Tartuntariskin on raportoitu olevan alatiesynnytyksessä noin 10–70 %. Noin 10–30 % tartunnan saaneista lapsista sairastuu silmätulehdukseen ja 0–20 % keuhkokuumeeseen. Vaikka imeväisten klamydiainfektiot ovat useimmiten lieviä tauteja, imeväisiällä sairastettu klamydiainfektio voi aiheuttaa silmän side- ja sarveiskalvon arpeutumista, pitkittynyttä yskää ja keuhkofunktion alenemaa. Aiempien tutkimusten perusteella arvioimme, että Suomessa sairastuu vuosittain noin 200 imeväistä klamydian aiheuttamaan silmätulehdukseen ja noin 100 imeväistä klamydiakeuhkokuumeeseen. Kliininen kokemuksemme on kuitenkin, että kohtaamme klamydiaa sairastavia imeväisiä varsin harvoin. Tämän ongelman ratkaisemiseksi ja klamydiaa sairastavien imeväisten paremmaksi tunnistamiseksi suunnittelimme tutkimuksen, jonka tarkoituksena on selvittää väestöpohjainen riski klamydian tarttumiselle äidistä vastasyntyneeseen, kuvata imeväisten klamydiainfektioiden tyypilliset piirteet sekä selvittää klamydian osuus imeväisten silmätulehduksissa ja alle kuuden kuukauden ikäisten imeväisten alahengitystieinfektioissa. Klamydian sairastaneet lapset poimittiin kahdesta suomalaisesta terveydenhuoltorekisteristä vuosina 1996–2011. Tuona aikana 206 lasta oli sairastanut mahdollisen klamydiainfektion, joten klamydian ilmaantuvuus oli 0,22/1000:tta elävänä syntynyttä kohti (95 % luottamusväli 0,19–0,25). Väestöpohjainen riski äidin sukupuoliklamydian tarttumiselle vastasyntyneeseen niin että lapselle aiheutuu oireinen infektio oli 0,8–1,8 %. Saatavilla olevien potilasasiakirjojen (124/206) perusteella kolmasosalla (33/124) imeväisistä, jotka sairastivat klamydian aiheuttamaa silmätulehdusta, oli oireena spontaani verinen kyynel- tai rähmäerite. Klamydiakeuhkokuumetta sairastavista puolella (15/32) esiintyi hengityksen vinkumista, mutta klamydiakeuhkokuumeelle tyypillistä hakkaavaa yskää (”staccato-yskä”) ei todettu yhdelläkään imeväisellä. Diagnostinen viive oli verrattain pitkä: 13 päivää (vaihteluväli 4–374) silmätulehduksessa ja 25 päivää (vaihteluväli 10–149) keuhkokuumeessa. Yhdelle laiminlyödylle lapselle kehittyi molemminpuoliset sarveiskalvoarvet hoitamattoman klamydiainfektion seurauksena. Vastasyntyneen silmätulehdustutkimukseen rekrytoitiin 173 alle 30 päivän ikäistä lasta Oulun kaupungin lastenneuvoloissa vuosina 2010–2015. Klamydian tai tippurin aiheuttamaa silmätulehdusta ei todettu yhdelläkään 163:sta tutkitusta vauvasta (0 %; 95 % luottamusväli 0 %–2,2 %). Viruksen aiheuttama silmätulehdus todettiin kahdeksalla vauvalla (4,8 %; 95 % luottamusväli 2,1 %–9,2 %) ja jonkin muun bakteerin kuin klamydian aiheuttama silmätulehdus 58:lla vauvalla (36 %; 95 % luottamusväli 29 %–44 %). Imeväisten alahengitystieinfektiotutkimukseen rekrytoitiin 228 alle kuuden kuukauden ikäistä imeväistä yliopistosairaalan lastenpäivystyksessä yhden epidemiologisen vuoden aikana. Klamydian aiheuttama hengitystieinfektio diagnosoitiin yhdellä imeväisellä (0,4 %; 95 % luottamusväli 0,01 %–2,4 %) ja hinkuyskä niin ikään yhdellä (0,4 %; 95 % luottamusväli 0,01 %–2,4 %). Valtaosalla (203/228) alahengitystieinfektio-oireisista imeväisistä oli viruksen aiheuttama infektio. Yhteenvetona voimme todeta, että klamydia tarttui äidistä lapseen alle 2 %:ssa synnytyksistä, mikä on huomattavasti harvinaisempaa kuin aiemmin on luultu. Klamydian aiheuttamien silmätulehdusten esiintyvyys oli alle 2 % ja alahengitystieinfektioiden alle 2,5 % alueemme lapsiväestössä. Klamydian aiheuttamat pitkäaikaishaitat olivat harvinaisia. Tavallisten hengitystievirusten osuus vastasyntyneiden silmätulehduksissa oli 5 %.