SUMMARY Topically applied anaesthetics may lead to a serious keratopathy. Three patients presented to us with disciform keratitis, peripheral corneal ring, and stromal infiltration following the topical use of oxybuprocaine. All three patients developed marked decrease in vision secondary to corneal scarring. In all three patients oxybuprocaine was dispensed over the counter by a pharmacist. Legislation for the restriction of over-the-counter sale of topical anaesthetics, steroids, and antibiotics is essential in the prevention of many of the self-induced ocular disorders seen in developing countries.Topical anaesthetics are commonly used by ophthalmologists for minor procedures and ocular examinations. The adverse side effects of their longterm topical use have been previously reported.'2 Fuchs' showed that intensive use of topical anaesthetics produced severe changes in the corneal epithelium and delayed recovery from corneal diseases.The indiscriminate use of topical eye drops, the lack of control of prescription drugs, and the availability of over-the-counter topical anaesthetic eye drops are common factors in the predisposition to abuse of topical anaesthetics in developing countries. We present here three cases of oxybuprocaine keratopathy.Case reports CASE 1A 42-year-old Saudi male presented with a history of pain, photophobia, and redness of the eyes for two days. He had sustained a welding arc flash injury three days earlier, and a pharmacist gave him a bottle of oxybuprocaine 04% (Novesin), which he used every half-hour without ophthalmological surveillance. On examination he was found to have a visual acuity of 20/200 in each eye. A large central epithelial defect was noted in each eye. Oxybuprocaine was discontinued and both eyes were patched.Despite the discontinuation of the topical anaesthetic the patient persisted in having corneal epithelial 202defects and developed corneal oedema and a subepithelial peripheral ring infiltrate. He was admitted to hospital and put on topical dexamethasone 0 05% eye drops without preservative to both eyes every three hours and topical atropine 1% eye drops once daily. ' The corneal epithelial defects showed slow but progressive improvement and evidence of re-epithelialisation. The peripheral corneal ring infiltrate persisted in the left eye and partially resolved in the right eye (Fig. 1). The patient was discharged from hospital, and over the next six days the right corneal epithelial defect healed, leaving residual stromal oedema. The left cornea showed a central corneal ulcer, and corneal scrapings contained Staphylococcus epidermidis. Steroids were discontinued and the ulcer responded to topical antibiotics. His final best corrected vision was counting fingers at 5 feet (1.5 m) in the right eye and 20/80 in the left eye. CASE 2A 39-year-old Saudi male presented with a history of foreign body in the left eye. He had gone to a pharmacy where he received a bottle of oxybuprocaine 0-4% (Novesin). He instilled the eye drops in the left eye once every hour. On ex...
Several studies have shown the effects of IOP reduction after practicing aerobic and anaerobic physical activities (1)(2)(3)(4) . The causes of such changes have been the target of many studies. An increase in lactic acid and in plasmatic osmolarity, and also a decrease in blood pH are considered the main causes of these IOP variations (5)(6) . Hyperventilation was also pointed out as a cause of IOP decrease after exercising (7) . An increase in IOP after the Valsalva maneuver was demonstrated when this maneuver was employed aiming to simulate weight lifting, but not weight lifting itself (8) . Marcus et al. have shown the effect of IOP reduction after isometric muscular contractions, as well as an inverse correlation with lactic acid and pH serum levels (9) . An IOP decrease was also found after physical exercises by employing isometric muscular contractions (in which the size of muscular fiber remains constant, while the tonus and the resistance against which the muscle works increase) and isokinetic muscular contractions (in which the size of the muscular fiber varies during the exercise, while the speed at which the exercise is made remains constant)(1) . Despite the above mentioned studies, there are no reports in the literature -as far as this author knows -on the variations of IOP after weight lifting itself (isotonic muscular work, in which the size of muscular fiber decreases during contraction and the speed of the exercise does not remain constant). P U R P O S ETo study IOP variations after isotonic exercise of weight lifting in the supine position, in hypertrophy work, by healthy male young individuals. Keywords: Intraocular pressure/etiology; Weight lifting; SportsThe accute effects of resistance exercise on intraocular p r e s s u r e Purpose: To study intraocular pressure (IOP) variations in healthy volunteers after weight lifting, in the supine position. Methods: A descriptive study was designed. Thirty-four individuals were preselected for this study, and a group of 25 volunteers fulfilled the inclusion criteria for joining the initial phase of this research. All of them were healthy without glaucoma. They were asked to lift an 85% top load in the supine position for 8 times. IOP was measured before and after the exercise. Student's t test was used to analyze the IOP variations. Results: A small, but significant IOP decrease (1.61 mmHg) was obtained after exposing 25 individuals (49 eyes) to a specific physical effort. Conclusions: After a session of weight lifting in the supine position with 85% top load for 8 repetitions, there is a small, but significant IOP decrease.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.