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ISSUE 2 APRIL
Letters to the Editor

Eye infections

  • Brian Ancell, Patrick Lockie, Hector Maclean

The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.

 

Letter to the editor

Editor, Associate Professor Hector Maclean's article on 'Eye infections' (Aust Prescr 1994;17:66-8) has a misleading synopsis. It states 'although a chalazion will eventually settle spontaneously, a recurrence is an indication for a biopsy to exclude malignancy.' Infection in a chalazion may well resolve, most do not. The
chalazion itself will not resolve until it is curetted and, unless adequate treatment is carried out, will almost certainly recur. So the synopsis should read: a recurrence following adequate treatment is an indication for biopsy
to exclude malignancy.

Brian Ancell
Ophthalmologist
Adelaide, S.A.

Editor, Associate Professor Maclean points out in his article regarding eye infections that blepharitis is probably the most common external eye infection.

Whilst the treatment that he recommends cannot be criticised, by far the most common cause of severe blepharitis is in association with acne rosacea. This condition and its associated corneal ulceration is exquisitely sensitive to a prolonged course of doxycycline. This needs to be given as 100 mg per day for 4-6 weeks and provides long lasting symptomatic relief of this recurring problem.

Patrick Lockie
Ophthalmologist
Geelong, Vic.

 

Author's comments

Associate Professor H. Maclean, the author of the article, comments:

I agree with Dr Ancell's revision of the infelicitous wording in the synopsis. I hope it is clear from the full text that I agree with him.

Dr Lockie does well to remind us that blepharitis can be associated with many skin conditions, including acne rosacea. Acne rosacea seems much less common in Australia than in northern Europe and there is remarkably little about its association with blepharitis in recent literature.1 I hope Dr Lockie will be moved to put his experiences into print, and to include information as to whether he finds the same rather gloomy risk of relapse after withdrawal of tetracyclines that earlier authors have noted.

 

References

  1. HuberSpitzy V, Baumgartner I, Bohler Sommeregger K, Grabner G. Blepharitis a diagnostic and therapeutic challenge. A report on 407 consecutive cases. Graefes Arch Clin Exp Ophthalmol 1991;229:224-7.

Brian Ancell

Ophthalmologist, Adelaide, S.A.

Patrick Lockie

Ophthalmologist, Geelong, Vic.

Hector Maclean

Associate Professor (Clinical), Department of Ophthalmology, University of Melbourne, Melbourne