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Prickly pear spine keratoconjunctivitis.

Odat TA, Al-Tawara MJ, Hammouri EH - Middle East Afr J Ophthalmol (2014 Jan-Mar)

Bottom Line: Glochids were most commonly found in the upper subtarsal conjunctival space (47.6%) followed by inferior palpebral conjunctiva in 23.8% eyes.Superior corneal epithelial erosions or ulcer were found in 33.3% patients, inferior corneal epithelial erosions in 19.1% patients, and diffuse epithelial erosions in 9.5% patients.Glochids were found in other parts of the body in 38.1% patients.

View Article: PubMed Central - PubMed

Affiliation: Ophthalmology Clinic, Prince Rashid Bin Al- Hassan Military Hospital, Irbid, Jordan.

ABSTRACT

Objectives: To study the ocular and extra-ocular features, clinical presentation, and treatment of prickly pear glochids.

Materials and methods: This retrospective study included 23 eyes of 21 patients with ocular prickly pear spines who were seen between August and October 2011 in the outpatient ophthalmic clinic at Prince Rashid Bin Al Hassan military hospital in Jordan. Medical records of patients including age, gender, history of exposure to prickly pear plants, and ocular examination were reviewed. All glochids were localized and removed with forceps under topical anesthesia with the patient at the slit lamp. Patients were followed up after one week.

Results: The mean age of patients was 37.1 years with a male to female ratio of 1.6: 1. Involvement of the right eye was seen in 61.9% patients, left eye in 28.6% patients, and bilateral involvement in 9.5% patients. Glochids were most commonly found in the upper subtarsal conjunctival space (47.6%) followed by inferior palpebral conjunctiva in 23.8% eyes. The most common complaint was eye irritation in 95.2% patients. Pain was a complaint in 57.1% patients. Superior corneal epithelial erosions or ulcer were found in 33.3% patients, inferior corneal epithelial erosions in 19.1% patients, and diffuse epithelial erosions in 9.5% patients. Glochids were found in other parts of the body in 38.1% patients.

Conclusion: Although prickly pear glochid ocular surface injury is not uncommon in the region during summer, it should be considered in patient with eye pain during that period. Farmers who are in close contact with prickly pears should use protective eyeglasses and gloves.

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A glochid penetrating the skin of the distal phalanx of the left ring finger
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Figure 5: A glochid penetrating the skin of the distal phalanx of the left ring finger

Mentions: The mean age of patients was 37.1 years with a male to female ratio of 1.6: 1 [Table 1], which shows the demographic data, location of the glochid in the eye, clinical picture, and extra ocular locations. Involvement of the right eye was seen in 13 (61.9%) patients, left eye in 6 (28.6%) patients, and bilateral involvement in 2 (9.5%) patients. The prickly pears spines were most commonly found in the upper subtarsal conjunctival space in 10 (47.6%), [Figure 2] followed by inferior palpebral conjunctiva in 5 (23.8%) eyes, [Figure 3] superior bulbar conjunctiva in 3 (14.3%) eyes, forniceal conjunctiva in 2 (9.5%) eyes, temporal and nasal bulbar conjunctiva in 2 (9.5%) eyes, and superior palpebral conjunctiva in 1 (4.8%) eye. The most common complaint was eye irritation in 20 (95.2%) patients, and this symptom was absent only in patient with forniceal conjunctival prickly pear spines. Pain was a complaint in 12 (57.1%) patients and photophobia in 9 (42.9%) patients. All patients had conjunctival congestion. Superior corneal punctate epithelial erosions or ulcer was found in 7 (33.3%) patients, [Figure 4] inferior corneal punctate epithelial erosions in 4 (19.1%) patients, and diffuse punctate epithelial erosions in 2 (9.5%) patients. Prickly pear spines were found in other parts of the body in 8 (38.1%) patients [Figure 5].


Prickly pear spine keratoconjunctivitis.

Odat TA, Al-Tawara MJ, Hammouri EH - Middle East Afr J Ophthalmol (2014 Jan-Mar)

A glochid penetrating the skin of the distal phalanx of the left ring finger
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3959044&req=5

Figure 5: A glochid penetrating the skin of the distal phalanx of the left ring finger
Mentions: The mean age of patients was 37.1 years with a male to female ratio of 1.6: 1 [Table 1], which shows the demographic data, location of the glochid in the eye, clinical picture, and extra ocular locations. Involvement of the right eye was seen in 13 (61.9%) patients, left eye in 6 (28.6%) patients, and bilateral involvement in 2 (9.5%) patients. The prickly pears spines were most commonly found in the upper subtarsal conjunctival space in 10 (47.6%), [Figure 2] followed by inferior palpebral conjunctiva in 5 (23.8%) eyes, [Figure 3] superior bulbar conjunctiva in 3 (14.3%) eyes, forniceal conjunctiva in 2 (9.5%) eyes, temporal and nasal bulbar conjunctiva in 2 (9.5%) eyes, and superior palpebral conjunctiva in 1 (4.8%) eye. The most common complaint was eye irritation in 20 (95.2%) patients, and this symptom was absent only in patient with forniceal conjunctival prickly pear spines. Pain was a complaint in 12 (57.1%) patients and photophobia in 9 (42.9%) patients. All patients had conjunctival congestion. Superior corneal punctate epithelial erosions or ulcer was found in 7 (33.3%) patients, [Figure 4] inferior corneal punctate epithelial erosions in 4 (19.1%) patients, and diffuse punctate epithelial erosions in 2 (9.5%) patients. Prickly pear spines were found in other parts of the body in 8 (38.1%) patients [Figure 5].

Bottom Line: Glochids were most commonly found in the upper subtarsal conjunctival space (47.6%) followed by inferior palpebral conjunctiva in 23.8% eyes.Superior corneal epithelial erosions or ulcer were found in 33.3% patients, inferior corneal epithelial erosions in 19.1% patients, and diffuse epithelial erosions in 9.5% patients.Glochids were found in other parts of the body in 38.1% patients.

View Article: PubMed Central - PubMed

Affiliation: Ophthalmology Clinic, Prince Rashid Bin Al- Hassan Military Hospital, Irbid, Jordan.

ABSTRACT

Objectives: To study the ocular and extra-ocular features, clinical presentation, and treatment of prickly pear glochids.

Materials and methods: This retrospective study included 23 eyes of 21 patients with ocular prickly pear spines who were seen between August and October 2011 in the outpatient ophthalmic clinic at Prince Rashid Bin Al Hassan military hospital in Jordan. Medical records of patients including age, gender, history of exposure to prickly pear plants, and ocular examination were reviewed. All glochids were localized and removed with forceps under topical anesthesia with the patient at the slit lamp. Patients were followed up after one week.

Results: The mean age of patients was 37.1 years with a male to female ratio of 1.6: 1. Involvement of the right eye was seen in 61.9% patients, left eye in 28.6% patients, and bilateral involvement in 9.5% patients. Glochids were most commonly found in the upper subtarsal conjunctival space (47.6%) followed by inferior palpebral conjunctiva in 23.8% eyes. The most common complaint was eye irritation in 95.2% patients. Pain was a complaint in 57.1% patients. Superior corneal epithelial erosions or ulcer were found in 33.3% patients, inferior corneal epithelial erosions in 19.1% patients, and diffuse epithelial erosions in 9.5% patients. Glochids were found in other parts of the body in 38.1% patients.

Conclusion: Although prickly pear glochid ocular surface injury is not uncommon in the region during summer, it should be considered in patient with eye pain during that period. Farmers who are in close contact with prickly pears should use protective eyeglasses and gloves.

Show MeSH
Related in: MedlinePlus