Miguel Lugo

Topical anesthetic abuse

Topical ocular anesthetic abuse is a serious disorder causing keratitis and persistent epithelial defects. It may be the result of either prescription by the patients eye care practitioner, theft from the practitioners office, or occult additives in therapeutic medications. The authors report observations of six individuals suffering from this disorder which suggest that persistent epithelial defects, corneal stromal ring infiltrates, disproportionate pain, and prescription or nonprescription substance abuse may be factors involved. Penetrating keratoplasty was required to treat corneal perforation in two patients, and permanent corneal structural damage was noted in two eyes. Two eyes had a relentless downhill course culminating in enucleation. Because five of the six patients were diagnosed and treated as having presumed Acanthamoeba keratitis during the course of their disease, topical ocular anesthetic use should be included in the differential diagnosis of chronic keratitis and may masquerade as Acanthamoeba keratitis. The authors believe that practitioners should not prescribe or dispense topical anesthetics and should avoid clinical settings which provide an opportunity for the theft of topical ocular anesthetics.

Ocular rosacea in blacks.

In three black men (57, 64, and 61 years old) with the ocular manifestations of rosacea, the diagnosis was not initially suspected because the pathognomonic skin changes of rosacea were obscured by the skin hyperpigmentation. Ocular involvement ranged from blepharitis and conjunctival hyperemia to sight-threatening problems such as corneal neovascularization, thinning, ulceration, and perforation. Treatment with oral tetracycline and topical corticosteroids appeared to be as effective in these patients as in previously described white patients.

Treatment of Neurotrophic Ulcers with Conjunctival Flaps

1. Lee, D. A., Rimele, T. ]., Brubaker, R. F., Nagataki, S., and Vanhoutte, P. M.: Effect of thymoxamine on the human pupil. Exp. Eye Res. 36:655, 1983. 2. Wand, M., and Grant, W. M.: Thymoxamine hydrochloride. An alpha-adrenergic blocker. Surv. Ophthalmol. 25:75, 1980. 3. Brogliatti, B., Rolle, T., Messelrod, M., and Boles Carenini, B.: A new alpha-blocking agent in the treatment of glaucoma. Dapiprazole. Glaucoma 7:232, 1985. 4. Grehn, F., Fleig, T., and Schwarzmuller, E.: Thymoxamine. A miotic for intraocular use. Graefes Arch. Clin. Exp. Ophthalmol. 224:174, 1986.

Computerized Scoring and Graphing of the Farnsworth-Munsell 100-Hue Color Vision Test

The Farnsworth-Munsell 100-hue test is a sensitive and accurate test of color discrimination. A major disadvantage of the test is the laborious and time-consuming calculation needed to score the results and plot them on a chart for interpretation. We present a computer program, written in Microsofts BASIC language, that performs the calculation and reports both the individual color cap error scores (from which the graph is plotted) and the total error score. If used with an IBM personal computer (or compatible) capable of graphics, the program plots a graph in a modified polar coordinate format that can be printed on a dot-matrix printer.

A Dose-Response Study of Piloplex for Duration of Action

The duration of reduction in intraocular pressure after single-dose administration of three concentrations of piloplex and the vehicle of the drug was evaluated in 12 patients with open-angle glaucoma in a randomized, double-masked, crossover study. Piloplex lowered intraocular pressure in a dose-related fashion, with a duration of action of at least 14 hours.

The Incidence of Preoperative Endothelial Dystrophy in Pseudophakic Bullous Keratopathy

To investigate the contribution of endothelial dystrophy to the subsequent development of pseudophakic bullous keratopathy, we retrospectively reviewed the clinical records and histopathologic specimens of pseudophakic patients who had undergone penetrating keratoplasty for corneal decompensation. Conclusive evidence of endothelial dystrophy was found in a majority (18 of 27, 67%) of patients who developed pseudophakic bullous keratopathy following implantation of a posterior chamber intraocular lens. By contrast, the incidence in a comparable group of 51 pseudophakic bullous keratopathy patients with anterior chamber intraocular lenses was low (six of 51, 12%) (P less than 0.01). In analyzing the relative risk of post-surgical corneal decompensation, one cannot implicate a particular intraocular lens without considering pre-existing endothelial dystrophy.

A simple database computer program for ophthalmic use

We have written a program in BASIC language which stores, recalls, and manipulates a limited amount of clinical information that we use in teaching and clinical practice. The program runs on an IBM personal computer with Microsoft DOS and BASIC. An illustrative search routine uses simple data simulation of the results of argon laser trabeculoplasty therapy for open-angle glaucoma.

A Simple Database Computer Program for Ophthalmic Use: Reply

We have written a program in BASIC language which stores, recalls, and manipulates a limited amount of clinical information that we use in teaching and clinical practice. The program runs on an IBM personal computer with Microsoft DOS and BASIC. An illustrative search routine uses simple data simulation of the results of argon laser trabeculoplasty therapy for open-angle glaucoma.