Wilson F M
Trans Am Ophthalmol Soc. 1983;81:854-965.
New knowledge of adverse external ocular reactions to topical ophthalmic medications was obtained by means of a computerized epidemiologic study, laboratory studies, and clinical observations. Listed below are the major findings and conclusions that represent facts or concepts that were previously unknown, uncertain, misunderstood, or forgotten: The incidence of clinically important drug reactions among all cases was at least 13.09% and may have been as high as 16.02%. Among treated patients it was at least 16.26% to 19.90%. Taken together, drug reactions were the second most common external disease diagnosis. The incidence of each kind of drug reaction was determined. Toxic papillary reactions accounted for 79.10% of drug cases and 10.35% of all cases. Toxic papillary keratoconjunctivitis was the third most common single diagnosis. The following epidemiologic factors were found to be related to the development or presence of drug reactions: number and variety of treating practitioners, number of practitioners consulted, number of practitioners consulted who treated, specific ophthalmologist consulted (8.24% of ophthalmologists referred 39.55% of all drug cases and showed a tendency habitually to overtreat), number and kinds of patients' symptomatic complaints, number of medications prescribed and used, number of days of treatment, particular drugs and preservatives used (but not their strengths or vehicles), underlying (primary) diagnoses, and inaccuracy of referring ophthalmologists' diagnoses. Patients with dry eyes were especially at risk for the development of toxic papillary reactions. Among all cases, the incidence of reactions to preservatives (mainly thimerosal) in contact lens solutions was 0.39% to 1.95%, depending on whether definite or probable cases, respectively, were considered. The incidence among the 54 patients who used daily-wear lenses (excluding extended-wear therapeutic and optical contacts) was 7.41% for definite reactions and 37.04% for probable ones. Factors relating to the development of papillary contact-lens reactions were daily wear, number of days of wear, and, especially, the preservatives to which the patients were exposed. Reactions occurred more often with soft lenses than with hard ones. Of patients with drug reactions, 5.22% had two different ones simultaneously. Coexisting reactions to pharmacologically active agents were also present in 15% of patients who reacted to preservatives in contact lens solutions. The ocular tissues that were affected by each kind of drug reaction were tabulated, and the relative degrees and sequences of involvement were discussed. The frequencies with which particular drugs, physical ag
通过计算机化的流行病学研究、实验室研究和临床观察，获得了关于局部眼科用药引起的眼部不良外部反应的新知识。以下是主要发现和结论，它们代表了以前未知、不确定、误解或被遗忘的事实或概念：在所有病例中，具有临床重要意义的药物反应发生率至少为13.09%，可能高达16.02%。在接受治疗的患者中，这一比例至少为16.26%至19.90%。综合来看，药物反应是第二常见的外部疾病诊断。确定了每种药物反应的发生率。毒性乳头反应占药物病例的79.10%，占所有病例的10.35%。毒性乳头角膜结膜炎是第三常见的单一诊断。发现以下流行病学因素与药物反应的发生或存在有关：治疗医生的数量和种类、咨询的医生数量、接受治疗的咨询医生数量、咨询的特定眼科医生（8.24%的眼科医生转诊了39.55%的所有药物病例，且有过度治疗的习惯性倾向）、患者症状性主诉的数量和种类、开处方和使用的药物数量、治疗天数、使用的特定药物和防腐剂（但不是其强度或载体）、潜在（主要）诊断以及转诊眼科医生诊断的不准确程度。干眼症患者发生毒性乳头反应的风险尤其高。在所有病例中，隐形眼镜护理液中防腐剂（主要是硫柳汞）反应的发生率为0.39%至1.95%，这取决于分别考虑的是确诊病例还是疑似病例。在54名使用日戴型镜片（不包括长戴型治疗性和光学隐形眼镜）的患者中，确诊反应的发生率为7.41%，疑似反应的发生率为37.04%。与乳头型隐形眼镜反应发生相关的因素包括日戴、佩戴天数，尤其是患者接触的防腐剂。软性镜片比硬性镜片更容易发生反应。在有药物反应的患者中，5.22%同时出现两种不同的反应。在对隐形眼镜护理液中防腐剂有反应的患者中，15%还存在对药理活性剂的共存反应。列出了受每种药物反应影响的眼部组织，并讨论了受累的相对程度和顺序。特定药物、物理因素的发生频率…… （原文最后似乎不完整）
