Clinical observations of pharmaceutical, physical, and visual evidence of presumed extraocular myositis and tendonitis.

OBJECTIVE

This study examines data from pharmaceutical, physical, and visual tests that support the possible diagnosis of presumed extraocular myositis and tendonitis (PEM-T).

METHODS

The presence of ocular pain derived from inflamed extraocular musculature and tendons in 60 subjects with PEM-T was detected by palpating their globes near the eye muscle insertions. The pain sensations were subjectively rated and recorded. Because the sensation of pain elicited by such palpation was most-often unilateral, the study compares the affected sidewith pain to the side tha exhibited vision disturbance during the Turville Infinity Binocular Balance (TIB) test. Lastly, an anti-inflammatory ophthalmic pharmaceutical was used to see if the pain could be resolved. Saline was used as a control. The subjects evaluated their pain after 1 and 10 minutes of the saline drop. The remaining subjects who still had pain after the saline drops were given one of two topical steroids: a hydrophilic or a lipaphilic derivative of prednisolone. Again, the subjects rated and recorded their pain after 1, 10, and 60 minutes.

RESULTS

Of 60 subjects who had headaches and associated painful areas on their globes, 5B observed the monocular blur effect (MBE) on the same side as these palpable sore spots. Of the 60 subjects with such sore areas, 10 individuals were relieved with a saline drop. Of the remaining 50 subjects, 25 received a drop of lipophilic, prednisolone acetate and 25 received a drop of hydrophilic, prednisolone sodium phosphate. Of the 50 subjects from these two groups, 39 had a significant reduction of their palpable pain sensations; the data indicate there was little difference in response between the two formulations of prednisolone.

CONCLUSIONS

The corroboration of results from pharmaceutical, physical, and visual tests supports the diagnosis of PEM-T.