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Optimizing the care of the red eye patient: a new treatment direction

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Mrukwa-Kominek E.
OphthaTherapy
|
2024
|
vol. 11
|
issue 3
259-264
EN
Eye redness may be the result or symptom of various eye diseases or may appear for no apparent reason. In the case of red eye, therapeutic treatment is based on the correct diagnosis and, if possible, on causal treatment. Therapeutic strategies in the treatment of local conjunctival hyperemia are also based on preventing vasodilation and thus reducing the red eye symptom. Vasodilation is dependent on α-adrenergic receptors. Two classes of adrenergic receptors in the eye: α1- and α2 adrenergic receptors, which are responsible for the vascular tone of the conjunctiva. The end result of binding of agonists to α1- and α2-adrenergic receptors is vasoconstriction. However, the use of vasoconstrictor drugs is associated with the occurrence of tachyphylaxis, i.e. a decrease in effectiveness with long-term use and a rebound effect defined as hyperemia, which becomes even more severe after discontinuation of treatment. The introduction of brimonidine, which is a selective α2-adrenergic agonist, into the treatment resulted in a reduction of these effects, which is also due to its effect on venous vessels and not causing the symptoms of tissue hypoxia. Compared to other vasoconstrictor drugs, it offers hope for patients with red eye symptoms to improve the local condition and their quality of life.
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Contact lens-related combined Pseudomonas aeruginosa, Acanthamoeba and Candida keratitis among adolescents girls

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Świerczyńska M., Tronina A., Bogocz M., Mrukwa-Kominek E., Filipek E.
OphthaTherapy
|
2022
|
vol. 9
|
issue 1
36-44
EN
Background: We present a case of combined Pseudomonas aeruginosa, Acanthamoeba and Candida keratitis and clinical course of treatment in two adolescents girls who did not follow the rules of proper use of soft contact lenses. Case reports: Two teenage contact lens users sought medical attention, reporting visual impairment, redness and pain of the eye. Slit lamp examination showed unilateral corneal ulcer. Confocal microscopy revealed images compatible with amoebic cysts and yeasts cells, whereas the results of conjunctival swabs confirmed the presence of Pseudomonas aeruginosa. After topical and general treatment in the first patient, the corneal defect was healed, and visual acuity improved. The girl remains under the constant supervision of an ophthalmological clinic. The medications were gradually reduced, but with time she developed crystalline keratopathy. Regrettably, the second patient, despite the applied treatment had recurrent inflammation and progressive corneal thinning, which required amniotic membrane transplantation to prevent perforation. Conclusion: The early identification of the pathogen as well as adequate treatment is crucial, as contact lens-associated keratitis are potentially sight threatening. Patient and caregiver education, adequate contact lens hygiene and consistent follow-up are important to prevent serious complications.
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