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Infectious diseases may lead to ocular complications including uveitis, an ocular inflammatory condition with potentially sight-threatening sequelae, and conjunctivitis, inflammation of the conjunctiva. Emerging infectious pathogens with known ocular findings include Ebola virus, Zika virus, Avian influenza virus, Nipah virus, severe acute respiratory syndrome coronaviruses, and Dengue virus. Re-emerging pathogens with ocular findings include Toxoplasma gondii and Plasmodium species that lead to malaria. The concept of One Health involves a collaborative and interdisciplinary approach to achieve optimal health outcomes by combining human, animal, and environmental health factors. This approach examines the interconnected and often complex human-pathogen-intermediate host interactions in infectious diseases that may also result in ocular disease, including uveitis and conjunctivitis. Through a comprehensive review of the literature, we review the ophthalmic findings of emerging infectious diseases, pathogenesis, and One Health perspectives that provide further insight into the disease state. While eye care providers and vision researchers may often focus on key local aspects of disease process and management, additional perspective on host-pathogen-reservoir life cycles and transmission considerations, including environmental factors, may offer greater insight to improve outcomes for affected individuals and stakeholders.

Infectious keratitis is a leading cause of corneal blindness worldwide with little information known about causative etiologies in Malawi, Africa. This area is resource-limited with ophthalmologist and microbiology services. The Department of Ophthalmology at the Kamuzu College of Health Sciences in Blantyre, Malawi, is a participating site of an international corneal ulcer consortium, capriCORN (Comprehensive Analysis of Pathogens, Resistomes, and Inflammatory-markers in the CORNea). In this study, 50 patients with corneal ulcers were swabbed for pathogen identification using RNA-sequencing. Corneal trauma was reported in 41% and 19% of the patients worked in agriculture. A pathogen was identified in 58% of the cases. Fungal pathogens predominated, followed by viruses and bacteria. Aspergillus, Fusarium, HSV-1, and Gardnerella were the most common pathogens detected. 50% of patients reported treatment with an antibiotic before presentation. Pathogens unusual for infectious keratitis, such as Subramaniula asteroids, Aureobasidium pullulans, and Gardnerella vaginalis, were also detected.

BACKGROUND: Infectious keratitis secondary to fungus or acanthamoeba often has a poor outcome despite receiving the best available medical therapy. In vitro rose bengal photodynamic therapy (RB-PDT) appears to be effective against fungal and acanthamoeba isolates (Atalay HT et al., Curr Eye Res 43:1322-5, 2018, Arboleda A et al. Am J Ophthalmol 158:64-70, 2014). In one published series, RB-PDT reduced the need for therapeutic penetrating keratoplasty in severe bacterial, fungal, and acanthamoeba keratitis not responsive to medical therapy. METHODS: This international, randomized, sham and placebo controlled 2-arm clinical trial randomizes patients with smear positive fungal and acanthamoeba and smear negative corneal ulcers in a 1:1 fashion to one of two treatment arms: 1) topical antimicrobial plus sham RB-PDT or 2) topical antimicrobial plus RB-PDT. DISCUSSION: We anticipate that RB-PDT will improve best spectacle-corrected visual acuity and also reduce complications such as corneal perforation and the need for therapeutic penetrating keratoplasty. This study will comply with the NIH Data Sharing Policy and Policy on the Dissemination of NIH-Funded Clinical Trial Information and the Clinical Trials Registration and Results Information Submission rule. Our results will be disseminated via ClinicalTrials.gov website, meetings, and journal publications. Our data will also be available upon reasonable request. TRIAL REGISTRATION: NCT, NCT05110001 , Registered on November 5, 2021.

PURPOSE: This study sought to identify the sources of differential performance and misclassification error among local (Indian) and external (non-Indian) corneal specialists in identifying bacterial and fungal keratitis based on corneal photography. METHODS: This study is a secondary analysis of survey data assessing the ability of corneal specialists to identify acute bacterial versus fungal keratitis by using corneal photography. One-hundred images of 100 eyes from 100 patients with acute bacterial or fungal keratitis in South India were previously presented to an international cohort of cornea specialists for interpretation over the span of April to July 2021. Each expert provided a predicted probability that the ulcer was either bacterial or fungal. Using these data, we performed multivariable linear regression to identify factors predictive of expert performance, accounting for primary practice location and surrogate measures to infer local fungal ulcer prevalence, including locality, latitude, and dew point. In addition, Brier score decomposition was used to determine experts reliability (calibration) and resolution (boldness) and were compared between local (Indian) and external (non-Indian) experts. RESULTS: Sixty-six experts from 16 countries participated. Indian practice location was the only independently significant predictor of performance in multivariable linear regression. Resolution among Indian experts was significantly better (0.08) than among non-Indian experts (0.01; P < 0.001), indicating greater confidence in their predictions. There was no significant difference in reliability between the two groups ( P = 0.40). CONCLUSION: Local cornea experts outperformed their international counterparts independent of regional variability in tropical risk factors for fungal keratitis. This may be explained by regional characteristics of infectious ulcers with which local corneal specialists are familiar.

To provide an overview on the incidence of Acanthamoeba keratitis (AK). Although being a sight-threatening cause of infectious keratitis, a comprehensive assessment of the incidence of AK is lacking. Incidence of AK was computed as the number of eyes with AK per health care center, per year (annualized center incidence [ACI]). Two meta-analytical ratios also were calculated: (1) the ratio of eyes with AK to the count of eyes with nonviral microbial keratitis (MK) and (2) the ratio of eyes with AK to the overall population (i.e., the total number of people in a nation or region, as indicated by the authors in each study). Center was defined as the health care facility where the study took place. Actual and projected estimates of the number of eyes with AK in years were calculated multiplying the ratio of eyes with AK to the total population and the corresponding population estimates, sourced from the United Nations Population Prospects. Overall, 105 articles were included, published between 1987 and 2022. The total number of eyes identified was 91 951, with 5660 eyes affected by AK and 86 291 eyes affected by nonviral MK. The median ACI was 1.9 eyes with AK per health care center per year (95% confidence interval [CI], 1.5–2.6 eyes), with no statistically significant differences among continents. The ratio of eyes with AK to the total number of eyes with MK was 1.52% (95% CI, 1.03%–2.22%), whereas the ratio of eyes with AK in relationship to the entire population was estimated at 2.34 eyes per 1 000 000 people (95% CI, 0.98–5.55 per 1 000 000 people). The projected increase in the numbers of eyes with AK indicated an increase of 18.5% (n = 15 355 eyes with AK) in 2053 and 25.5% (n = 16 253 eyes with AK) in 2073, compared with the baseline of 2023 (n = 12 953 eyes with AK). Acanthamoeba keratitis emerged as a relatively low-incident disorder, and no significant differences in terms of its incidence were found among different continents. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. [ABSTRACT FROM AUTHOR]

Penetrating orbit injury is a rare but complex and life-threatening occurrence that may easily be overlooked. Management in the emergency department requires an early multidisciplinary approach but still lacks standard guidelines. This narrative review aims to provide a systematic approach to the management of penetrating orbital injuries for emergency clinicians. Mortality and morbidity are significant due to the orbit's proximity to numerous anatomical structures. Complications may be infectious, ocular, or cerebro-vascular. Their incidence depends on the mechanism of injury, entry point, and object's characteristics such as its shape, composition, and velocity. Non-occult cases are often associated with medial orbital rim or medial eyelid penetration, whereas occult cases mainly present with trivial lateral eyelid injury and could be overlooked. Radiological workup consists of computed tomography or magnetic resonance according to the object's composition. Treatment in the emergency department focuses on initial resuscitation, broad-spectrum antibiotics, and tetanus immunization. Subsequently, early removal of the foreign object in a controlled environment and other specific treatments must be discussed with a multidisciplinary team. Penetrating orbital injury is an uncommon but complex type of head trauma that may be challenging to diagnose. Systematic and multidisciplinary management in the emergency department is crucial to improve overall prognosis. [ABSTRACT FROM AUTHOR]

ABSTRACT: Aim: It was thought that resistance acquired during treatment of systemic diseases can lead to resistant bacteria in eye infections. However, evidences are showing emergence of bacterial resistance owing to prior topical antibiotic usage. In the current study, we intended to promote evidence-based usage of antibiotics during outbreak of epidemic keratoconjunctivitis. Methods: A descriptive study was designed. First 50 patients who visited the outpatient department of ophthalmology with signs and symptoms of EKC during the outbreak in the months of July-August, 2023 in a tertiary hospital in northern India were included in the study. Prior usage of topical antibiotics during this epidemic outbreak was the exclusion criteria. Conjunctival swabs were taken and subjected to Gram staining and Culture and sensitivity, for any bacterial infection. Results: Only two slides of gram stain showed gram-positive cocci. These two samples were positive for Methicillin resistant Staphylococcs Aureus (MRSA). Rest of the 48 samples were negative for any bacterial growth. P value for no growth in bacterial cultures was <0.05, which is significant. Conclusions: Our study suggests restrain from overusage of topical antibiotics in outbreaks of EKC until microbiological outcomes suggest otherwise. In view of presence of MRSA in neo-natal sample, and its known serious complications, we suggest prophylactic use of topical antibiotic and its modifications once reports of culture and sensitivity are available. [ABSTRACT FROM AUTHOR]

Summary: Background: The conjunctiva of the eye is a mucosal surface that is colonised by various bacteria. Following surgery, trauma or other underlying conditions the normal flora may cause eye infection such as conjunctival and corneal infections, or endophthalmitis. Objectives: This study aimed to investigate the bacterial population and antibiotic resistance of the conjunctiva in healthy horses. Study design: Random sampling of ocular samples from 20 horses during the winter (2019). Methods: Swab samples were collected from the eyes of 20 healthy horses of different breeds, ages and sexes in Tehran province, Iran. The swabs were cultured on blood agar and MacConkey agar and incubated at 37°C for 24–48 h. The isolated bacteria were characterised using cellular morphology, gram‐staining and biochemical tests. Sensitivity and resistance to 10 different antibiotics were measured using an antibiogram test. Results: Results showed that the bacterial population consisted of various species, with Bacillus cereus being the most frequent. There were no significant differences in the frequency of isolated bacteria between sexes and age groups. There were no significant differences in the sensitivity of the bacterial flora of the eyes to colistin, ceftiofur, florfenicol, amoxicillin and ampicillin between either different age groups or different sexes of the horses (p > 0.05). However, sensitivity to enrofloxacin and ciprofloxacin was significantly correlated with the age groups of the horses (p > 0.05). A significant difference in sensitivity to trimethoprim‐sulfamethoxazole between various sexes of horses was observed. Main limitations: The nonuniformity of the follow‐up examination, reliance on owners or caregivers of the horse for follow‐up information and lack of adequate financial resources to study more horses. Conclusions: The study suggests that the frequency of individual bacteria comprising the bacterial flora in horses' eyes is influenced by housing and management conditions rather than age and sex. [ABSTRACT FROM AUTHOR]

Background: Chlamydia trachomatis (CT), a Gram-negative intracellular bacterium, is differentiated into three biovars associated with distinct clinical syndromes, ranging from trachoma, the world's cause of preventable blindness, to the most common sexually transmitted infection. This variability underscores CT's significant impact on public health, particularly in low-resource settings. In Kenya, where the demographic is predominantly younger, the burden of CT remains poorly understood and potentially underestimated. Objectives: This study aimed to assess the prevalence of both sexually transmitted and ocular CT across various regions and populations within Kenya. Eligibility criteria: Articles on CT population testing and laboratory detection, from 2014 to date, in English or Swahili only. Sources of evidence: Electronic databases of PubMed and Google Scholar were used. Design: A scoping review. Charting methods: This study conducted a systematic scoping review, following Arksey and O'Malley's framework and adhering to PRISMA guidelines for scoping reviews (PRISMA-ScR). Results: This study incorporates findings from 19 original studies on sexually transmitted CT and seven on ocular CT. CT prevalence for four identified populations: sexually active females 2%–13%, men who have sex with men 1.3%–51%, pregnant women 2.5%–14.9% and other population groups 2.8%–16.4%. By contrast, studies on ocular CT, all performed in rural settings, found prevalence surpassing the WHO's 10% threshold primarily amongst children and mothers. Conclusion: The variability in CT prevalence across different demographics and geographical regions emphasizes the impact of socio-economic, environmental and diagnostic factors on disease transmission and detection. The insights gained here can serve as a foundation for evidence-based health policies and interventions aimed at mitigating the burden of CT in Kenya. [ABSTRACT FROM AUTHOR]

PurposeStudy DesignLocation and Duration of StudyMethodologyResultConclusionTo determine the patterns of uveitis evident in patients presenting at the Uveitis Department of a tertiary care eye hospital located in Karachi, Pakistan.Prospective cross-sectional studyThis study was conducted at Layton Rahmatullah Benevolent Trust (LRBT) Tertiary Teaching Eye Hospital-Korangi, Karachi, Pakistan from August 2020 to July 2023.This prospective study was conducted at the Uveitis Department of LRBT Tertiary Teaching Eye Hospital, Karachi, Pakistan, from August 2020 to July 2023, following ethical review board approval. Patients underwent detailed history-taking, clinical examination by a uveitis specialist. Informed written consent was obtained. Demographic data were recorded, excluding post-opendophthalmitis cases. Laboratory tests and ocular investigations were performed when necessary.In this study, 5791 patients were analysed, with a predominance of females (55.4%) and a mean age of 38.22 ± 13.06 years. Bilateral eye involvement was found in 60.4% of cases, and the most common uveitis types were anterior (35.1%) and pan-uveitis (28.9%). Non-infectious uveitis (72.14%) was more prevalent, with idiopathic uveitis being the most common cause (33.2%). Significant associations were found between anatomical locations of uveitis and various clinical characteristics (age, gender, eye involvement and infection status). For instance, anterior uveitis was more commonly associated with unilateral eye involvement, while bilateral eye involvement was more frequent in cases of pan-uveitis and posterior uveitis. Additionally, infectious aetiology was more prevalent in pan-uveitis and posterior uveitis (p < 0.001).The primary aim of this study was to determine the patterns of uveitis cases observed at a tertiary eye care hospital in Karachi, Pakistan. The predominant aetiology identified was idiopathic uveitis. Nevertheless, it is essential to recognize that the determined prevalence may be subject to the inherent limitations of this study, notably pertaining to financial barriers and limited availability of diagnostic modalities. [ABSTRACT FROM AUTHOR]

Purpose: Although 5% povidone-iodine (PVP-I) is frequently used as an ocular antiseptic agent, there is a lack of consensus regarding the effects of PVP-I concentration, storage after opening, and compounded preparation on PVP-I antisepsis. We performed a series of in-vitro experiments to determine the impact of these factors on PVP-I's inhibition of common causes of post-procedural eye infection. Methods: Inhibition of microorganism growth was measured in-vitro as a function of active PVP-I exposure time. In control experiments, PVP-I was inactivated before microorganism exposure. Tested PVP-I solutions varied in concentration (0.6%, 5%, or 10%), length of storage after opening (0, 7, or 30 days), and preparation (commercial vs.compounded from stock PI solution). Tested pathogens included S. epidermidis, S. viridans, P. aeruginosa, methicillin-resistant S. aureus, methicillin-sensitive S. aureus, and C. albicans. Results: PVP-I solutions inhibited all bacterial growth by 3 min and fungal growth by 15 s. Compared to 5% PVP-I, the 0.6% PVP-I was less effective in inhibiting S. viridans growth (200 ± 0 colonies vs. 7 ± 8 at 30 s, P = 0.0004; 183 ± 21 vs. 0 ± 0 at 1 min, P = 0.018), but more effective in inhibiting P. aeruginosa (30 ± 20 vs. 200 ± 0 at 15 s, P = 0.019). Compared to commercial and newly-opened PVP-I solutions, compounded preparations and solutions stored for 7 or 30 days after bottle opening either preserved or improved antiseptic efficacy against tested microorganisms. Conclusions: Concentration of PVP-I solution affects antiseptic efficacy within 1 min of exposure, but all solutions performed equivalently at 3 min. In contrast to results of prior studies investigating dilute PVP-I, the 0.6% PVP-I did not demonstrate a uniformly equivalent or superior anti-septic effect. Compounded preparation and storage length after bottle opening did not decrease PVP-I antiseptic activity. [ABSTRACT FROM AUTHOR]

Orthokeratology (OK) lenses are designed to reshape the cornea overnight, allowing users to see clearly during the day without glasses. However, prolonged wear increases the risk of microbial contamination and eye infections. Even with cleaning techniques, the surface of OK lenses can become contaminated due to residual bacterial debris. Therefore, developing self-cleaning antibacterial technology for OK lens surfaces is an urgent clinical challenge. Herein, we integrated the temperature responsiveness of PNIPAM molecular chains with the surface contact-killing mechanism of AMP into the surface of OK lenses for the first time, constructing an intelligent OK lens with synergistic antibacterial and self-cleaning properties. The modified OK lenses can achieve over 95% bacterial efficiency against Staphylococcus aureus and Pseudomonas aeruginosa. More importantly, in both worn and removed states, the modified OK lenses can achieve a surface bacterial debris self-cleaning efficiency of 50–75%. These research findings provide important references and insights for the future development of more efficient self-cleaning lens materials. [ABSTRACT FROM AUTHOR]

A prerequisite of genetic rescue in endangered and genetically depauperate populations is to pre‐evaluate between possible pros and cons of hybridization for the life history and survival of the target population. We hybridized the critically endangered Saimaa landlocked salmon (Salmo salar m. sebago) with one of its geographically closest relatives, anadromous Baltic salmon from River Kymijoki. In two similar experiments, conducted in semi‐natural streams during overwintering (at age 1.5) and in early summer (age 2+), we studied how hybridization and eye parasite infection (Diplostomum pseudospathaceum) affected survival from predation by Northern pike (Esox lucius). Additionally, we recorded movements of the juvenile salmon using passive integrated telemetry to gain insights into the effect of hybridization and infection on antipredatory behaviour (movement activity and habitat use). Among the uninfected groups, we found significantly lower mortality of hybrid salmon (mortality ± S.E. 14.5% ± 5.4%) compared to purebred landlocked salmon (37.2% ± 9.4%), supporting a positive effect of hybridization under predation risk. This benefit, however, was cancelled out by the parasite infection, which impaired vision and increased the susceptibility to predation. The negative effects of infection were particularly pronounced in the anadromous salmon due to lower infection resistance, compared to the landlocked salmon. Hybridization per se did not affect the activity levels of salmon, but overwintering activity correlated positively with eye cataract coverage, and summer activity was highest in anadromous salmon. These results demonstrate that controlled supplementation of a small animal population with genetically more diverse hybrids could entail both positive and negative implications, at least in the first crossbred generation. [ABSTRACT FROM AUTHOR]

Thelaziasis is generally a zoonotic disease that affects the eyes of domestic and wild animals. It is transmitted by flies belonging to the Drosophilidae family. While rare in humans, there have been occasional reported cases in low-socioeconomic families living in rural areas. An 83-year-old male farmer with a history of trauma and previous loss of vision in one eye presented with complaints of itching in the affected eye. Upon examination, worm-like parasites were observed in the inferior fornix of the affected eye, leading to a referral to our center. Two worms were mechanically extracted from the right eye. The diagnosis was confirmed as Thelazia spp. through parasitological laboratory testing. This case holds significance as it represents Türkiye's first reported human case of ocular thelaziasis. [ABSTRACT FROM AUTHOR]

Purpose: To describe the ophthalmological findings of dry eye disease and its relation to the quality of life of COVID-19 survivors. Methods: COVID-19 survivors who had previously been hospitalized at Hospital das Clínicas de Ribeirão Preto complex underwent an ophthalmological evaluation, which included a dry eye disease questionnaire, break-up time, fluorescein staining, and Schirmer test. We collected the presenting and best-corrected visual acuity, sociodemographic data, personal medical history, and scores from a self-reported quality of life questionnaire (WHOQOL-bref). According to the severity of the acute phase of the disease, the patients were classified into mild-to-moderate, severe, and critical groups. Results: Ninety-five patients (190 eyes) were evaluated 100 ± 44 days after the onset of COVID-19 symptoms. Of these, 83 patients (87.3%) completed the WHOQOL-bref questionnaire. Ten patients (12.0%) had mild-to-moderate COVID-19, 41 (49.4%) had severe COVID-19, and 32 (38.6%) had critical COVID-19. The median best-corrected visual acuity was logMAR 0 (0-1). Approximately 26.3% patients had a history of dry eye disease or severe dry eye symptoms (frequent or constant ocular dryness and irritation). There was an association between the proportion of patients with dry eye disease and the quality of life (p=0.014) and health (p=0.001). Furthermore, there was a significant trend between the proportion of patients with dry eye disease and how they rated their health and quality of life (p=0.0004 and 0.0027, respectively. Conclusions: There is a significant negative correlation between the proportion of patients with dry eye disease and their self-reported quality of life [ABSTRACT FROM AUTHOR]

The use of ocular inserts (OS) as vehicles for the delivery of antimicrobial agents to the eye is rapidly growing. In fact, the intraOS can deliver the antibiotics to the ocular surface after ophthalmic surgeries i.e., cataract. This was a rational progress of pharmaceutical field given that the conventional dosage forms i.e., drops present many limitations. Considering this fact, in this study novel nanofibrous inserts based on poly(ε-caprolactone) and poly(lactic acid) prepared via electrospinning process and used to load an antibiotic drug, moxifloxacin. The used aliphatic polyesters are biocompatible but do not present mucoadhesion which is essential for ocular drug delivery. Therefore, two known mucoadhesive agents, hyaluronic acid and xanthan gum, were blended in various concentrations (0.1 and 0.2%) and used for the coating of the fibers. The fibrous inserts have mean diameters in the range 500–1000 nm. The inserts showed stability over time, improved water uptake and improved mechanical properties. In vitro cytotoxicity studies revealed the biocompatibility of the structures. From in vitro release studies, a controlled release rate was depicted while the inserts demonstrated desirable antimicrobial properties. It can be concluded that the coated OS can be potent ocular delivery carriers of moxifloxacin battling against eye infections. [ABSTRACT FROM AUTHOR]

Background: Thelaziasis is a zoonotic disease mainly caused by Thelazia callipaeda (Spirurida, Thelaziidae, Thelazia), which can cause mild to severe signs and lesions, such as foreign body sensation, itching, tearing, eye pain, conjunctival bleeding, conjunctivitis, corneal ulcers, and even blindness. Thelaziasis cases have been reported mainly in agricultural areas and areas with high potential for contact with domestic animals [1]. Case presentation: We report a case of Thelazia callipaeda infection in the right eye of a 41-year-old woman working in an office. The patient presented with persistent foreign body sensation, pruritus, and redness despite initial treatment with polyethylene glycol and levofloxacin eye drops. Subsequent examination revealed the presence of multiple Thelazia callipaeda worms, which were successfully removed. Postoperative treatment with gatifloxacin eye ointment resulted in significant symptom relief with no recurrence over two months. Conclusions: This case highlights the thelaziasis in urban settings, emphasizing the need for ophthalmologists to consider parasitic infections in differential diagnosis even in well-maintained environments. Then, we provided an overview of human thelaziasis in China by mining publicly available databases from 2014 to 2023, suggesting a difference in regional distribution that warrants further epidemiological studies. [ABSTRACT FROM AUTHOR]

The article highlights common and uncommon ocular infections and the challenges in diagnosing and managing these infections. Topics include case of a 73-year-old woman with two days of left eye watery drainage, redness, pain and visual changes and a five-day history of vesicular rash on the left forehead, clinical syndromes, causative pathogens and treatment strategies for infections causing conjunctivitis/keratitis, and a discussion on endophthalmitis associated with injection drug use.

In order to comprehend the dynamics of disease propagation within a society, mathematical formulations are essential. Examining how hand contamination might induce pink eye infection (conjunctivitis virus) and treating it early with immunizations is the goal of this research. An immune system-boosting mathematical model is established, and it is converted to a fractional order model by using the Caputo fractional operator. To find the steady position of a recently constructed system SEVIR, a qualitative and quantitative analysis is conducted. Reliable bounded findings are ensured by assessing the generated system's boundedness, positivity, and uniqueness all crucial characteristics of epidemic models. The proposed non-linear system is verified to be present, and a unique solution is shown using fixed-point theorems to validate reliable solutions. Reproductive number with sensitivity analysis of parameters are also determined to verify the rate of spread and see how rate of change of each parameter is most sensitive. Using Lyapunov first derivative functions, the system is examined for local and global stability in order to evaluate the overall effect of early detection strategies and vaccination programs for people with weakened immune systems. Caputo operator is utilized for reliable solution using power law kernel with different fractional values for continuous monitoring of spread of pink eyes infection. Simulations have been made to see the real behavior and effects of pink eyes (conjunctivitis virus) infection to verify that the low immune individuals become strengthen due to early detection and vaccination combine measures. Also identify the true behavior for the control of pink eyes (conjunctivitis virus) infection after early detection and treatment as well as vaccination due to strong immune system of the patients. Investigating the transmission and management of diseases, as well as creating novel control techniques based on our validated findings to stop the conjunctivitis virus from spreading, would be aided by this kind of research. [ABSTRACT FROM AUTHOR]

Immune responses can be energetically expensive and subject to trade-offs. Prior work on the freshwater zooplankton, Ceriodaphnia cornuta , demonstrated an association between eye size and infection, leading to questions about whether investment in eyes trades off against investment in immunity. We used the crustacean host, Daphnia dentifera, and its fungal parasite, Metschnikowia bicuspidata , to investigate the relationships between eye size, parasite resistance and infection. In the field, we found a negative correlation between size-corrected eye area (SCEA) and Metschnikowia infection, suggesting that either SCEA decreases infection (thereby indicating resistance) or that infection decreases SCEA. Controlled laboratory experiments reinforced the latter result: exposure to the fungal parasite decreased a host's SCEA, regardless of the parasite dose or host genotype. We also uncovered significant plasticity in this trait—both host age and resource level increased SCEA. Identifying causality in physiological correlations is challenging. Our results suggest that negative associations between parasitism and energetically-expensive traits can arise through plasticity. [ABSTRACT FROM AUTHOR]

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(1) Background: Microbial keratitis is a serious eye infection that carries a significant risk of vision loss. Acanthamoeba spp. are known to cause keratitis and their bacterial endosymbionts can increase virulence and/or treatment resistance and thus significantly worsen the course of the disease. (2) Methods and Results: In a suspected case of Acanthamoeba keratitis, in addition to Acanthamoeba spp., an endosymbiont of acanthamoebae belonging to the taxonomic order of Holosporales was detected by chance in a bacterial 16S rDNA-based pan-PCR and subsequently classified as Candidatus Paracaedibacter symbiosus through an analysis of an enlarged 16S rDNA region. We used Oxford Nanopore Technology to evaluate the usefulness of whole-genome sequencing (WGS) as a one-step diagnostics method. Here, Acanthamoeba castellanii and the endosymbiont Candidatus Paracaedibacter symbiosus could be directly detected at the species level. No other microbes were identified in the specimen. (3) Conclusions: We recommend the introduction of WGS as a diagnostic approach for keratitis to replace the need for multiple species-specific qPCRs in future routine diagnostics and to enable an all-encompassing characterisation of the polymicrobial community in one step. [ABSTRACT FROM AUTHOR]

Simple Summary: Feline herpesvirus-1 (FHV-1) is a major cause of infectious diseases in cats, leading to respiratory and eye infections. In this study, we investigated the early genetic changes that occur in Crandell-Rees Feline Kidney (CRFK) cells after being infected with FHV-1. Using RNA sequencing (RNA-seq) techniques, we analyzed the molecular interactions between the virus and the host cells. Our results identified important immune response genes that become active shortly after infection, highlighting pathways related to FHV-1 and host interactions. These findings provide a better understanding of the early stages of FHV-1 infection and offer a foundation for future research aimed at improving the diagnosis and treatment. FHV-1 is a highly contagious pathogen that significantly threatens feline health and contributes to rising pet healthcare costs. The mechanisms underlying FHV-1 and host interactions remain poorly understood. For the first time, we conducted a systematic analysis of transcriptomic changes in CRFK cells following FHV-1 infection using RNA-seq. The differentially expressed genes (DEGs) displayed significant associations with cellular components, particularly the chromatin structure. Pathway analysis of the DEGs highlighted key host immune responses, including Toll-like receptors (TLRs), IL-17, TNF, MAPK, and Rap1 signaling pathways. By integrating the RNA-seq and RT-qPCR results, we identified CXCL8, CXCL10, MMP1, MMP9, CSF2, CSF3, CCL20, TLR2, TLR3, TLR4, TNF, and FOS as potentially important genes in the host's immune response to FHV-1. These findings provide valuable insights into the mechanisms underlying FHV-1 and host interactions. [ABSTRACT FROM AUTHOR]

Background General practitioners (GPs) face the challenge of diagnosing conjunctivitis accurately and confidently. Conjunctivitis and red eye are common presentations that confer diagnostic uncertainty. GPs are pivotal in diagnosing and managing conjunctivitis-like symptoms, making them a critical first port of call for patients. Accurately identifying and treating this common eye infection can help ensure the best possible outcomes. Objective This article presents an overview of conjunctivitis, exploring its causes and how to accurately assess and diagnose. We also discuss how to safely refer patients for investigation and provide appropriate safety netting. Discussion Conjunctivitis can be secondary to a range of conditions, commonly viral, bacterial and allergic pathogens. It tends to be a self-limiting disease; however, symptoms might persist for up to three weeks. Accurate clinical diagnosis for conjunctivitis is difficult, and thus it can be useful to send a swab for polymerase chain reaction and culture to confirm the diagnosis. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance (AMR) is a serious public health issue which is exacerbated by increased inappropriate use of antibiotics for common eye infections. This cross sectional survey was to assess the appropriate use of antibiotics for eye infections in an ambulatory clinic in Ghana and possible determinants. Method: The medical records of all patients who sought eye care between January 2022 to December 2022 and were prescribed antibiotics were extracted from the hospital's electronic database. Descriptive, bivariate and multivariate analyses were then conducted. Results: A total of 1925 patient medical records were extracted, whose median age was 40 years (IQR 26–69), and were mostly females (58.91%, n = 1134/1925). The eye condition commonly treated with antibiotics was bacteria conjunctivitis (33.51%, n = 645/1925). The most prescribed antibiotic was gentamycin (22.96%, n = 442/1925) followed by ciprofloxacin (16.78%, n = 321/1925). These were mostly topical dosage forms (82.13%, n = 1581/1925). Systemic antibiotics prescribed were mostly from the WHO 'Access' class (83.33%, n = 280/338). The appropriate choice of antibiotic prescribed was 42.44% (n = 817/1925) and this was positivity associated with age (p<0.001), number of antibiotics prescribed (p <0.001), the prescription of topical dosage forms (p <0.001), and WHO 'Access' antibiotic class (p <0.034). Conclusion: The level of appropriateness of antibiotic prescriptions for eye infections was sub-optimal. Antimicrobial stewardship programs, including prescriber education on guidelines and prescription audit to address associated factors, must now be instigated in this hospital to improve future antibiotic use and prevent the rise of AMR. [ABSTRACT FROM AUTHOR]

In the last few years, the conjunctivitis adenovirus disease has been investigated by using the concept of mathematical models. Hence, researchers have presented some mathematical models of the mentioned disease by using classical and fractional order derivatives. A complementary method involves analyzing the system of fractal fractional order equations by considering the set of symmetries of its solutions. By characterizing structures that relate to the fundamental dynamics of biological systems, symmetries offer a potent notion for the creation of mechanistic models. This study investigates a novel mathematical model for conjunctivitis adenovirus disease. Conjunctivitis is an infection in the eye that is caused by adenovirus, also known as pink eye disease. Adenovirus is a common virus that affects the eye's mucosa. Infectious conjunctivitis is most common eye disease on the planet, impacting individuals across all age groups and demographics. We have formulated a model to investigate the transmission of the aforesaid disease and the impact of vaccination on its dynamics. Also, using mathematical analysis, the percentage of a population which needs vaccination to prevent the spreading of the mentioned disease can be investigated. Fractal fractional derivatives have been widely used in the last few years to study different infectious disease models. Hence, being inspired by the importance of fractal fractional theory to investigate the mentioned human eye-related disease, we derived some adequate results for the above model, including equilibrium points, reproductive number, and sensitivity analysis. Furthermore, by utilizing fixed point theory and numerical techniques, adequate requirements were established for the existence theory, Ulam–Hyers stability, and approximate solutions. We used nonlinear functional analysis and fixed point theory for the qualitative theory. We have graphically simulated the outcomes for several fractal fractional order levels using the numerical method. [ABSTRACT FROM AUTHOR]

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Eye infections are a global health and economic problem that affect people of both sexes at any age. Topical application of anti-infectives is widely used in the treatment of these types of infections. However, little is known about the current status and trends of the use of topical ocular anti-infectives in Spain. In the present work, we evaluated the use of this type of drug in the Spanish autonomous community of Galicia and described the variability in its consumption between Galician provinces between 2020 and 2023. In addition, the possible existence of a deviation in consumption at a seasonal level was evaluated, as well as possible changes during the study period. A descriptive, cross-sectional and retrospective study of the use of drugs belonging to the subgroups S01A (anti-infectives) and S01C (anti-inflammatory agents and anti-infectives in combination) of the Anatomic Therapeutic Chemical Classification was carried out. This work demonstrated that the most used topical ocular anti-infective in Galicia was tobramycin and that the use of these types of drugs in our region varied according to the provinces. This study also revealed that the consumption of these medications has remained stable during the period 2020–2023, with no significant seasonal differences observed. [ABSTRACT FROM AUTHOR]

A novel ophthalmic delivery system utilizing levofloxacin-loaded, preservative-free, nanofiber-based inserts was investigated. Polyvinyl alcohol (PVA) and Poloxamer 407 (Polox)were employed as matrix materials, while hydroxypropyl-beta-cyclodextrin (HP-β-CD) was a solubilizer. The formulations were prepared via electrospinning and characterized for fiber morphology, drug dissolution, cytotoxicity, and antimicrobial activity. Scanning electron microscopy confirmed uniform fibrous structures. Fourier Transform Infrared spectroscopy and X-ray diffraction analyses demonstrated the amorphous state of levofloxacin within the fibers. In vitro dissolution studies revealed a rapid (within 2 min) and complete drug release, with higher HP-β-CD levels slightly delaying the release. Cytotoxicity tests showed increased HP-β-CD concentrations induced irritation, that was mitigated by sodium hyaluronate. The antimicrobial efficacy of the nanofibers was comparable to conventional eye drops, with lower minimum inhibitory concentrations for most tested strains. The nanofibrous formulation prepared from a PVA–Polox-based viscous solution of the drug:CD 1:1 mol ratio, containing 0.4% (w/w) sodium hyaluronate) was identified as a particularly promising alternative formulation due to its rapid and complete dissolution, good biocompatibility, and effective antimicrobial properties. Its gelling properties indicate that the residence time on the eye surface can be increased, potentially reducing discomfort and enhancing therapeutic outcomes. The nanofibrous formulations enhanced antimicrobial efficacy, providing a preservative-free alternative that minimizes the potential eye irritation that might occur because of the preservative agent and reduces the administrated dose frequency by extending the drug's retention time on the eye's surface. Subsequently, it improves patients' adherence, which would reflect positively on the bioavailability. The levofloxacin-HP-β-CD nanofibers demonstrate promise as an alternative to traditional eye drops, offering advantages in solubility, stability, and patient compliance for ocular infection treatment. [ABSTRACT FROM AUTHOR]

Keratitis is defined as infectious and non-infectious eye disease in human medicine and ulcerative and nonulcerative disease in veterinary medicine. The corneal epithelium is the transparent anterior part of the eye that covers the iris and pupil. It acts as a transparent membrane that allows light to pass through the eye. A healthy cornea prevents bacteria invasion of the eye via anatomical, mechanical, immunological, and microbiological mechanisms. Failure of these defenses and trauma, immunosuppression, and neurological or iatrogenic factors predispose the cornea to ulcerative keratitis and bacterial eye infections. Inadequate tear secretion and eyelid dysfunction lead to insufficient corneal protection, and the combination of these reasons with endogenous causes triggers excessive epithelial damage. [ABSTRACT FROM AUTHOR]

Carbon quantum dots (CQDs), an emerging nanomaterial, are gaining attention in ophthalmological applications due to their distinctive physical, chemical, and biological characteristics. For example, their inherent fluorescent capabilities offer a novel and promising alternative to conventional fluorescent dyes for ocular disease diagnostics. Furthermore, because of the excellent biocompatibility and minimal cytotoxicity, CQDs are well-suited for therapeutic applications. In addition, functionalized CQDs can effectively deliver drugs to the posterior part of the eyeball to inhibit neovascularization. This review details the use of CQDs in the management of ophthalmic diseases, including various retinal diseases, and ocular infections. While still in its initial phases within ophthalmology, the significant potential of CQDs for diagnosing and treating eye conditions is evident. [ABSTRACT FROM AUTHOR]

PURPOSE: To summarize the evidence base on the use of topical corticosteroids for infectious keratitis. METHODS: Narrative review. RESULTS: Infectious keratitis is a painful condition that often results in visually significant corneal stromal scarring, even when antimicrobial therapy is successful. Corticosteroids may reduce inflammation and subsequent scar formation and while relieving the acute ocular pain associated with a corneal ulcer. However, corticosteroids also reduce the host immune response, which could hinder the ability to clear infection. The safety and effectiveness of corticosteroids depends to a large part on the efficacy of the antimicrobials being used to treat the underlying infection. Randomized trials have found that corticosteroids are safe and effective for herpetic keratitis when used with appropriate antiviral therapy, and are safe for bacterial keratitis when used with broad spectrum topical antibiotics. The effectiveness of corticosteroids for bacterial keratitis has not been shown conclusively, although more advanced bacterial corneal ulcers may do better with corticosteroids. No randomized trials have assessed the safety and effectiveness of steroids for fungal or acanthamoeba keratitis. Animal studies suggest corticosteroids may be harmful in fungal keratitis, and observational human studies have found that steroids are harmful for fungal and acanthamoeba keratitis when started prior to anti-amoebics. CONCLUSIONS: Topical corticosteroids, when used as an adjunct to antimicrobial therapy, may be beneficial if the antimicrobial being used can effectively clear or suppress the infection, such as in bacterial and herpetic keratitis. Randomized trials would be helpful to further delineate the role of corticosteroids for infectious keratitis.

PurposeInfectious keratitis is a vision-threatening condition requiring close follow-up and disciplined eye drop administration to achieve resolution. Although patients presenting to county hospitals often have more severe presentations, there is a paucity of risk and outcomes data in this setting. This study investigates risk factors predicting loss to follow-up (LTFU), medication noncompliance, and poor outcomes for infectious keratitis in the county hospital setting.MethodsThis was a retrospective case-control study at Zuckerberg San Francisco General Hospital and Trauma Center. Inclusion criteria were patients who had corneal cultures for suspected infectious bacterial or fungal keratitis between 2010 and 2021. Exclusion criteria were patients with viral keratitis only. Multivariable logistic regression was used to analyze the relationship of social and medical risk factors with LTFU, medication noncompliance, worsened visual acuity (VA), and delayed resolution time.ResultsOf 174 patients with infectious keratitis in this analysis, 69 (40.0%) had LTFU. Unemployment was associated with increased risk of LTFU (odds ratio 2.58, P = 0.049) and worse final VA ( P = 0.001). Noncompliance trended toward an association with homelessness (odds ratio 3.48, P = 0.095). Increasing age correlated with longer resolution time, with each 1-year increase associated with delayed resolution by 0.549 days ( P = 0.042).ConclusionsPatients experiencing unemployment, homelessness, or increased age demonstrate higher risk for treatment barriers including loss to follow-up and medication noncompliance, resulting in worse VA and delayed time to resolution. These risk factors should be considered when determining the need for more deliberate follow-up measures in patients with infectious keratitis.

Glaucoma, a blinding eye disease with optic neuropathy, is usually associated with elevated intraocular pressure (IOP). The currently available pharmacological and surgical treatments for glaucoma have significant limitations and side effects, which include systemic reactions to medications, patient non-compliance, eye infections, surgical device failure, and damage to the eye. Here, we present Sensor-Actuator-Modulator (SAM), an engineered double mutant version of the bacterial stretch-activated mechanosensitive channel of large conductance (MscL) that directly senses tension in the membrane lipid bilayer of cells and in response, transiently opens its large nonspecific pore to release cytoplasmic fluid. The heterologously expressed mechanosensitive SAM channel acts as a tension-activated pressure release valve in trabeculocytes. In the trabecular meshwork (TM), SAM is activated by membrane stretch caused by elevated IOP. We have identified several SAM variants that are activated at physiologically relevant pressures. Using this barogenetic technology, we have demonstrated that SAM is functional in cultured TM cells, and successfully transduced in vivo in TM cells by use of AAV2/8. Further, it is effective in enhancing aqueous humor outflow facility leading to lowering the IOP in a mouse model of ocular hypertension. [ABSTRACT FROM AUTHOR]

Throughout history, medicinal plants have been used to treat different ailments. About 70 to 80% of the world population rely on medicinal plants for healthcare and some use it for income generation. The annual sale of medicinal plants increases over time. In plants, Berberis vulgaris f. lycium (Royle) Parsa (Berberis lycium), also called boxthoran barberry, Indian barberry, or Indian lyceum contains key alkaloids such as berberine, camptothecin, koumidine, salutaridine, luteanine, palmatine, and protopine. Significant steroidal compounds include sitosterol and B‐sitosterol. The plant is rich in flavonoids such as isorhamnetin, formononetin‐7‐O‐glucoside, and velutin and anthocyanins such as cyanidin‐3‐glucoside and delphinidin‐3‐glucoside. It also includes phenolic compounds such as chlorogenic acid, caffeic acid, vanillic acid, and quercetin. B. lycium possesses dual utility due to its delicious fruit and has high value with known history in treatment of different disease and use in folklore medicines. Ethnobotanical surveys reveal that the B. lycium is used to treat jaundice, hepatitis, typhoid, fever, tuberculosis disorders, eye lotion, chronic diarrhoea, tonic, skin diseases, blood purifier, piles, eye infections, gum problems, diabetes, and kidney problems. Experimental studies have demonstrated that the B. lycium possesses antibacterial, antihyperlipidaemia, antidiabetic, anticolitis/inflammatory, anticancer activities, antiviral activities, and anthelminthic activities. According to our literature survey, there is no review with a mechanistic summary on B. lycium; therefore, the current review is an effort to provide the available literature on B. lycium in summary form for future research. [ABSTRACT FROM AUTHOR]

Lactobacillus acidophilus is usually considered nonpathogenic and widely distributed in the human gastrointestinal and vaginal tract. In rare cases, lactobacilli may cause eye infections. We report a 71-year-old man who experienced unexpected ocular pain and decreased visual acuity for one day after cataract surgery. He presented with obvious conjunctival and circumciliary congestion, corneal haze, anterior chamber cells, anterior chamber empyema, posterior corneal deposits, and pupil light reflection disappearance. This patient underwent the standard three-port 23-gauge pars plana vitrectomy and received the intravitreal perfusion of vancomycin at 1 mg/0.1 mL. The culture of the vitreous fluid produced Lactobacillus acidophilus. Acute Lactobacillus acidophilus endophthalmitis can occur after cataract surgery, which should be taken into consideration. [ABSTRACT FROM AUTHOR]

• In the observational study, infectious diseases were associated with an increased short- and long-term risk of subsequent Parkinson disease (PD). • The greatest PD risk was observed in neurological/eye infection, with lower respiratory tract infection ranked second. • A dose–response relationship between infection burden and risk of incident PD was observed within each genetic risk score tertile. • We used Two-sample Mendelian randomization analyses to further confirm the causal association between infections and PD development. Experimental and cross-sectional evidence has suggested a potential role of infection in the ethology of Parkinson's disease (PD). We aim to examine the longitudinal association of infections with the incidence of PD and to explore whether the increased risk is limited to specific infection type rather than infection burden. Based on the UK Biobank, hospital-treated infectious diseases and incident PD were ascertained through record linkage to national hospital inpatient registers. Infection burden was defined as the sum of the number of infection episodes over time and the number of co-occurring infections. The polygenic risk score (PRS) for PD was calculated. The genome-wide association studies (GWAS) used in two-sample Mendelian Randomization (MR) were obtained from observational cohort participants of mostly European ancestry. Hospital-treated infectious diseases were associated with an increased risk of PD (adjusted HR [aHR] 1.35 [95 % CI 1.20–1.52]). This relationship persisted when analyzing new PD cases occurring more than 10 years post-infection (aHR 1.22 [95 % CI 1.04–1.43]). The greatest PD risk was observed in neurological/eye infection (aHR 1.72 [95 % CI 1.32–2.34]), with lower respiratory tract infection (aHR 1.43 [95 % CI 1.02–1.99]) ranked the second. A dose–response association was observed between infection burden and PD risk within each PD-PRS tertile (p-trend < 0.001). Multivariable MR showed that bacterial and viral infections increase the PD risk. Both observational and genetic analysis suggested a causal association between infections and the risk of developing PD. A dose–response relationship between infection burden and incident PD was revealed. [ABSTRACT FROM AUTHOR]

Coxsackievirus A24 (CV-A24) is a human enterovirus that causes acute flaccid paralysis. However, a Coxsackievirus A24 variant (CV-A24v) is the most common cause of eye infections. The causes of these variable pathogenicity and tissue tropism remain unclear. To elucidate the phylodynamics of CV-A24 and CV-A24v, we analyzed a dataset of 66 strains using Bayesian phylodynamic approach, along with detailed sequence variation and epistatic analyses. Six CV-A24 strains available in GenBank and 60 CV-A24v strains, including 11 Taiwanese strains, were included in this study. The results revealed striking differences between CV-A24 and CV-A24v exhibiting long terminal branches in the phylogenetic tree, respectively. CV-A24v presented distinct ladder-like clustering, indicating immune escape mechanisms. Notably, 10 genetic recombination events in the 3D regions were identified. Furthermore, 11 missense mutation signatures were detected to differentiate CV-A24 and CV-A24v; among these mutations, the F810Y substitution may significantly affect the secondary structure of the GH loop of VP1 and subsequently affect the epitopes of the capsid proteins. In conclusion, this study provides critical insights into the evolutionary dynamics and epidemiological characteristics of CV-A24 and CV-A24v, and highlights the differences in viral evolution and tissue tropism. [ABSTRACT FROM AUTHOR]

Background Carbapenemase-producing, carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) are extensively drug-resistant bacteria. We investigated the source of a multistate CP-CRPA outbreak. Methods Cases were defined as a US patient's first isolation of P. aeruginosa sequence type 1203 with carbapenemase gene bla VIM-80 and cephalosporinase gene bla GES-9 from any specimen source collected and reported to the Centers for Disease Control and Prevention during 1 January 2022–15 May 2023. We conducted a 1:1 matched case-control study at the post–acute care facility with the most cases, assessed exposures associated with case status for all case-patients, and tested products for bacterial contamination. Results We identified 81 case-patients from 18 states, 27 of whom were identified through surveillance cultures. Four (7%) of 54 case-patients with clinical cultures died within 30 days of culture collection, and 4 (22%) of 18 with eye infections underwent enucleation. In the case-control study, case-patients had increased odds of receiving artificial tears versus controls (crude matched OR, 5.0; 95% CI, 1.1–22.8). Overall, artificial tears use was reported by 61 (87%) of 70 case-patients with information; 43 (77%) of 56 case-patients with brand information reported use of Brand A, an imported, preservative-free, over-the-counter (OTC) product. Bacteria isolated from opened and unopened bottles of Brand A were genetically related to patient isolates. Food and Drug Administration inspection of the manufacturing plant identified likely sources of contamination. Conclusions A manufactured medical product serving as the vehicle for carbapenemase-producing organisms is unprecedented in the United States. The clinical impacts from this outbreak underscore the need for improved requirements for US OTC product importers. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the efficacy and safety of intravitreal dexamethasone implants in the treatment of ocular toxocariasis (OT). A retrospective analysis was performed on 6 cases in which laboratory tests diagnosed OT. All patients were administered with intravitreal dexamethasone implants with or without vitrectomy. The average follow‐up time was 19.7 months. All operated eyes achieved anatomic success, and all patients' visual acuity was improved. Five of these six had a visual acuity of 20/100, and three had final acuity of 20/40 or even better. Intravitreal dexamethasone implants can be used to treat different types of OT, which not only effectively control inflammation and improve the patient's vision but also reduce the use of systemic glucocorticoids. [ABSTRACT FROM AUTHOR]