135 patients were entered into a 28-day randomized double-masked multicentre study comparing the efficacy and short-term safety of lodoxamide 0.1% ophthalmic solution (Alomide--Alcon Laboratories), a mast cell stabilizer, with sodium cromoglycate 2% ophthalmic solution (Opticrom--Fisons Pharmaceuticals) in the treatment of allergic eye disease. Patients given lodoxamide 0.1% showed a significantly more rapid and greater improvement in their signs and symptoms of allergic eye disease than patients given sodium cromoglycate 2%. Both treatments were found to be safe, and side-effect profiles were comparable between the two treatment groups, although the overall incidence of side-effects in this study was found to be less frequent in the lodoxamide-treated group.

Thirty patients with first episode disciform keratitis and with no previous steroid exposure were randomly assigned to double blind treatment with 3% acyclovir ointment and 0O1% betamethasone (Betnesol) drops or acyclovir ointment and matching placebo. In the steroid group 14 of the 15 patients healed in a mean time of 21-8 days. In the placebo group eight of the 13 patients healed in a mean time of 34-5 days. The difference in mean healing time between the two groups was significant (p<005). The cumulative rate of healing was also quicker in the steroid group when compared with the placebo group (p<0-001). Other clinical parameters improved more favourably in the combination treatment group. Four patients, two in either group, experienced a mild transient punctate epitheliopathy, but no other serious adverse effects were noted. There has been no significant difference in the recurrence rate between the two groups after a mean follow-up period of approximately 3 years. (BrJ Ophthalmol 1992; 76: 711-713) Acyclovir ophthalmic ointment (3%) used five times daily has been shown to be effective in the treatment of dendritic and geographic keratitis. 12 Therapy with acyclovir has been associated with a low incidence of mild transient adverse effects, namely stinging and punctate epitheliopathy.3The aetiology of disciform keratitis is unclear but has been postulated to be viral in origin with an associated delayed type hypersensitivity reaction to herpes antigen within the stroma or endothelium." A combination of antiviral and steroid would seem to be the optimal therapeutic choice. Acyclovir is a good candidate as it is able to penetrate the intact corneal epithelium and stroma, achieving therapeutic levels in the aqueous humour.7 In a previous study we have At presentation the area of involved cornea was measured and was scored as follows; 1=0-25%, 2=25-50%, 3=50-75%, 4=75-100%. The presence of neovascularisation, either superficial or deep and in how many quadrants, was also recorded. Symptoms of pain, photophobia, lacrimation, and grittiness were scored at each visit on a four point scale (0=absent, 1=mild, 2=moderate, 3=severe). The following parameters we-re also assessed at each visit; visual acuity, conjunctival injection, epithelial oedema, stromal oedema, folds in Descemet's membrane, endothelial deposits, anterior chamber flare and cells, intraocular pressure, and corneal thickness using a Haag-Streit pachometer. A record was also made of any adverse effects potentially attributable to the treatment.Patients were randomly assigned to treatment with 3% acyclovir ophthalmic ointment and either 0-1% betamethasone drops or placebo in a double blind manner. Treatment was applied to the affected eye five times daily. The eye was not padded. If patients showed deterioration over 5 days or if the condition remained static for 14 days, they were withdrawn from the study. The keratitis was regarded as healed when the corneal thickness had returned to normal, when epithelial and stromal oedema had regressed,

No abstract

The results of a randomised double-blind clinical trial of 0.1% bromovinyldeoxyuridine (BVDU) and 1% trifluorothymidine (TFT) in 60 patients with corneal dendritic ulceration are presented. There was no significant difference between BVDU and TFT in terms of numbers of ulcers healed (p=0-61), mean healing time (p=0065), and cumulative healing rate (p=0058). No serious side effects were observed, though transient stinging was recorded in five patients receiving TFT and in three patients receiving BVDU. One patient in the group treated with TFT developed a punctate epitheliopathy.

Fifty patients with corneal dendritic ulceration were randomly entered into a double blind clinical trial comparing BVDU eyedrops with TFT eyedrops. Of those receiving TFT 100% healed in a mean time of 6.7 days, while 92% of those receiving BVDU healed in a mean time of 8.7 days. There was no statistical difference between the two groups in terms of numbers healed, but BVDU was significantly slower in terms of days to heal. After a mean follow-up period of 7.5 months there has been one recurrence in each group.