Document Detail

Reflex and steady state tears in patients with latent stromal herpetic keratitis.
MedLine Citation:
PMID:  11773017     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To compare tear production in patients with stromal herpetic keratitis with that in healthy control subjects. METHODS: After instillation of 2 microL fluorescein into both eyes, the tear-fluorescein concentration was measured by fluorophotometry. During the first 10 minutes, steady state tear turnover (TTO-1) was determined. After a nasal alcohol stimulus to induce reflex tears, a second steady state tear turnover (TTO-2) was obtained during 15 minutes. The index of reflex lacrimation (IRL) was calculated as the percentage decrease in tear fluorescein concentration directly after the stimulus. TTO-1, TTO-2, and IRL were determined in the patients' affected eyes (n = 12), in the patients' healthy contralateral eyes, if possible (n = 9), and in one eye of healthy control subjects (n = 24). RESULTS: The TTO-1 in the affected and healthy eyes of patients was approximately two times lower than the TTO-1 in eyes of healthy control subjects (P = 0.012 and P = 0.024, respectively) and almost equal to the TTO-2 in eyes of healthy control subjects (P = 0.32 and P = 0.40). There were no significant differences in the values of TTO-1, IRL, and TTO-2 between affected and healthy eyes of patients (P > 0.5). IRL and TTO-2 did not differ significantly among the three groups (P > 0.5). CONCLUSIONS: Both eyes of the patients were dry. The dryness could be due to a defective reflex lacrimation under physiological conditions that can still be induced by nonphysiological nasal excitation. The cause of this may be demyelination of both trigeminal root entry zones as a result of a unilateral eye infection by the herpes virus. Another possibility is that dryness predisposes to herpetic infection or recurrent inflammation.
Sander Keijser; Jaap A van Best; Allegonda Van der Lelij; Martine J Jager
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Investigative ophthalmology & visual science     Volume:  43     ISSN:  0146-0404     ISO Abbreviation:  Invest. Ophthalmol. Vis. Sci.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-01-04     Completed Date:  2002-01-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7703701     Medline TA:  Invest Ophthalmol Vis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  87-91     Citation Subset:  IM    
Leiden University Medical Center, Department of Ophthalmology, Leiden, The Netherlands.
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MeSH Terms
Blinking / physiology*
Corneal Stroma / virology
Dry Eye Syndromes / metabolism
Fluorescein / diagnostic use
Fluorescent Dyes / diagnostic use
Herpesvirus 1, Human / physiology
Keratitis, Herpetic / metabolism*,  virology
Lacrimal Apparatus / secretion*
Middle Aged
Tears / secretion*
Reg. No./Substance:
0/Fluorescent Dyes; 2321-07-5/Fluorescein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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