Allergic conjunctivitis eye drops prescription,how to get rid of virus for free download youtube,how to get rid of razor bumps and scars on bikini line area - How to DIY

admin | What Cures Bv | 13.01.2014
Consumption of this product is responsibility of the person who uses and recommends, consult your doctor before taking any medication. Department of Ophthalmology, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania. Why is allergic eye disease, and vernal keratoconjunctivitis (VKC) in particular, a problem for eye workers and patients in hot climates? Over a quarter of 2,250 children seen at a tertiary referral paediatric eye clinic in East Africa had vernal keratoconjunctivitis. Typically a child seen with VKC is given one bottle of a mast cell stabiliser and is seen again a few months later apparently no better. Up to 10% of patients develop corneal ulcers, which may lead to visual loss due to corneal changes.
By recognising the features of the disease, particularly potentially blinding complications. Ensuring that these patients get adequate continuous treatment through good patient education and regular, long-term follow-up.
Symptoms include intense itching, irritation, photophobia (sensitivity to light) and burning. In order to elicit the signs, patients should be examined using a slit lamp or magnifying loupes. The clinician also needs to be constantly on the lookout for the other major complications of cataract and glaucoma especially with prolonged steroid use. We examine and counsel the many children coming to the free district eye clinics in groups. Children with signs of allergic eye disease and those presenting to the tertiary referral centre who tend to have more severe disease are examined in more detail and counselled individually. Counselling stresses the chronic nature of the disease, that sodium chromoglycate drops take time to work and need to be continued once the child feels better. Those with milder symptoms and no corneal involvement may be given mast cell stabilisers such as sodium chromoglycate or newer agents such as alomide and nedocromil.
The mast cell stabilisers must be used regularly three to four times daily, even when there are no symptoms in order to stabilise the mast cells and prevent the release of histamine.
Those presenting with corneal involvement and more severe disease should be managed at secondary and tertiary level where they may be given topical steroid drops (e.g.
Those not responding to conventional treatment may be given supratarsal injection of steroids4 by an eye specialist (Figure 5). Supportive therapy like artificial tears, cold compresses and sunglasses often help and are commonly overlooked. The authors are grateful to Dr Amos Kibata for helpful comments on a draft of this manuscript. Note the marked conjunctival hyperaemia, Trantas’ dots and invasion of cornea by thickened gelatinous pannus.


Alternatively steroids are used, without a mast cell stabiliser and no counselling about the disease. It is characterised by conjunctival hyperaemia and papillae at the corneal-scleral (limbal) border and Trantas’ dots.
Those with no signs of allergic eye disease are given advice on frequent face washing and cold compresses. Individual counselling, backed up by patient information leaflets, is critical in breaking the cycle of inadequate treatment and resulting frustration. They are of no value when used only when symptoms occur because their effect is not immediate.
Both long-acting steroids such as triamcinalone and shorter-acting steroids (dexamethasone) have been found to be effective in bringing about resolution of the eye signs.
Dr Debbie Carmichael set up the protocols for effective management of VKC at KCMC and prepared a patient information leaflet.
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Note the dilated, injected conjunctival vessels, Trantas’ dots, and corneal scarring and vascularisation. One week after supratarsal triamcinalone injection: the eye is quiet and comfortable with resolution of all signs of inflammation. Note the needle is parallel to the superior tarsal border – entering from the temporal side. Quite often children move from one clinic to another picking up another bottle of steroids when the symptoms become unbearable. Other patients will have visual impairment due to glaucoma and cataract2or extensive cornea pannus (Figure 2 and Figure 6). The disease affects children between three to 16 years of age though it may appear earlier than that and continue into adulthood (Figure 1). They should not be given a bottle of steroid or chromoglycate drops, tempting as this might be.
The need to use these for only a short period of time in order to avoid complications is explained. This is the same girl as in Fig.8 one month after supratarsal subconjunctival triamcinalone under local anaesthetic drops.
Some studies suggest that the recurrence rate of the disease is lower following the use of longer-acting steroids like triamcinolone. Vernal keratoconjunctivitis revisited: a case series of 195 patients with long-term follow-up.
Efficacy of supratarsal dexamethasone versus triamcinalone injection in recalcitrant vernal keratoconjunctivitis. The white tissue in the nasal portion of the pupil is posterior capsule opacification, following cataract surgery.


In the palpebral form, giant, flat-topped papillae of the upper tarsal conjunctiva lead to a clinical picture of ‘cobblestones’.
Note the lid swelling, increased skin pigmentation around the lid and the injected conjunctiva. 8 and 9 one month after supratarsal subconjunctival triamcinalone under local anaesthetic drops. They do not have any of the side effects of steroids and can therefore be used for a prolonged period. Steroids should be used frequently initially and then tapered to a stop once the acute stage of the disease is stabilised (usually a few weeks).
Theoretically there is an increased risk of persistent elevation of intraocular pressure with the longer acting steroids. Although the name vernal suggests a seasonal spring time occurrence, frequently the disease persists throughout the year. Corneal involvement has been reported in as many as 50% of the patients with the palpebral type of the disease. As a result, many patients return for review before drops have run out and the symptoms and signs worsened. He came to us complaining that the eyes were now red and sore and felt worse when the drops were put in.
Corneal involvement may range from superficial punctate keratopathy to shield-like ulcers.2 These may heal leaving a vascularised scar.
Conjunctival changes include hyperpigmentation (Figure 2), subconjunctival fibrosis, keratinisation and symblepharon. The thickened vascularised gelatinous pannus has resolved leaving a mildly pigmented flat scar. However, with good use of local anaesthesia and careful counselling, children as young as 12 may be safely injected without recourse to general anaesthesia (Figures 8 – 10). Her left eye which appeared to be relatively normal before, evidently has moderate vernal keratoconjuctivitis too. The vascular pannus accompanying the pannus has resolved apart from the one larger nasal feeder vessel.
Far too often the offending drug has been given for a minor symptom because the patient expects drops.
She is so pleased with the response in her right eye she is requesting an injection for her left eye.



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