What Are the Different Types of Corneal Disease?

Keratopathy is an important cause of vision loss. It makes the transparent cornea appear grayish-white turbidity, which can cause blurred vision, loss of vision, and even blindness. It is also one of the important eye diseases that cause blindness.

Basic Information

nickname

Corneal lesions

English name

keratopathy

Visiting department

Ophthalmology

Common causes

Trauma and infection

Common symptoms

Corneal opacification, bulbar conjunctival edema, ciliary congestion

Causes of corneal disease

1. The effects of corneal adjacent tissue disease

The cause of corneal disease may be the effect of corneal disease on corneal disease. For example, acute conjunctivitis can cause superficial punctate keratitis, scleritis can cause sclerosing keratitis, and uveitis can also cause keratitis. Excessive keratitis can occur when the eyelid defect is accompanied by incomplete closure of the palpebral fissure.

2. Systemic disease

The cause of corneal disease may also be a systemic disease. Is an intrinsic factor. Such as tuberculosis, rheumatism, syphilis and other allergic keratitis. Systemic malnutrition, especially keratomalacia caused by vitamin A deficiency in infants and children, and keratitis caused by trigeminal nerve palsy. In addition, there are still autoimmune diseases such as ulcerative corneal ulcers for unknown reasons.

3. Trauma and infection

Trauma and infection are the most common causes of keratitis. When the corneal epithelium is damaged by mechanical, physical, and chemical factors, bacteria, viruses, and fungi come in, and infection occurs. The invading pathogenic microorganisms can come from both external wounds and various pathogenic bacteria hidden in the eyelid or conjunctival sac, especially chronic dacryocystitis, which are risk factors for corneal infection.

Corneal disease clinical manifestations

Bulbar conjunctival edema

Severe keratitis can cause varying degrees of bulbar and conjunctival edema.

2. Ciliary congestion

When the cornea becomes inflamed, the anterior ciliary vascular network around the limbus dilates and congests, which is called ciliary congestion. When conjunctiva and ciliary congestion occur at the same time, it is called mixed congestion.

3. Corneal opacity

Caused by corneal infiltration, edema, or ulcers.

4. Corneal neovascularization

In the process of corneal inflammation or ulcer, when a capillary network around the congested limbus protrudes from a new blood vessel branch into the cornea, it is called a corneal neovascularization. Subepithelial neovascularization, from the superficial vascular network, is dendritic, bright red, and connected to the conjunctival vessels. The anterior stromal neovascularization originates from the deep vascular network, and the posterior stromal neovascularization comes from the branch of the iris artery ring and radial iris vessels extending to the limbus. The deep neovascularization is brush-like, dark red. The appearance of new blood vessels on the cornea is a manifestation of the body's repair function.

In the inflammatory phase, corneal neovascularization is easy to see. After the inflammation subsides, neovascularization remains on the relatively transparent cornea. Only the lumen has no blood, which is called shadow vessels, which is more difficult to find. Corneal neovascularization, on the one hand, can cause the cornea to lose transparency, and on the other hand, it can cause corneal tissues to undergo biochemical changes, from the state of immune pardon that does not participate in the overall tissue to participating in the immune response, which may cause rejection during corneal transplantation.

Keratopathy examination

In order to select the most effective treatment plan, laboratory examination is very important to determine the causative factors. For bacterial or fungal corneal ulcers, a scrape test can often give clues. Microbial culture and drug sensitivity experiments are more helpful for diagnosis and treatment.

Medical history consultation

Are there any corneal irritation symptoms and trauma history, whether corticosteroids have been used locally and systemically? Are there any eye diseases such as chronic dacryocystitis and varus catarrh and related systemic diseases?

2. Eye examination

Severe irritation symptoms, especially in children, can be checked with a topical anesthetic. For those who are in danger of perforation, do not compress the eyeballs during the inspection. For corneal surface damage, it is easy to see with fluorescein staining method, and it is easier to find the corneal lesions and shapes with a magnifying glass or a slit lamp. If necessary, do corneal perception tests and tear secretion function tests.

Keratopathy diagnosis

Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.

Keratopathy treatment

Eliminate incentives

Such as timely treatment and treatment of ectropion, trichiasis, chronic dacryocystitis, conjunctivitis.

2. Controlling infection

According to pathogenic microorganisms, appropriate antibiotics are used to formulate eye drops or eye ointments of different concentrations. For severely infected cases, broad-spectrum antibiotics such as 0.4% gentamicin, 0.5% kanamycin, and 0.25% chloramphenicol can be used first. If necessary, it can be used for subconjunctival injection and systemic administration. Can be used alone or in combination.

3. Mydriasis

Anyone with symptoms of scleral irritation, such as dilated pupils, slow response to light, and iridocyclitis, should be dilated. Commonly used mydriatic drugs are 0.5 to 3% atropine and eye ointment; if necessary, the mydriatic mixture can be injected under the conjunctiva.

4. hot pack

Using moist heat compress can make the blood vessels in the eye dilate, promote and improve local blood circulation, reduce irritation symptoms, promote inflammation absorption, and enhance tissue repair ability. Hot compress can be applied 2 to 3 times a day for 15 to 20 minutes each time.

5. Application of corticosteroids

Only after allergic keratitis or corneal ulcer heals, the corneal stroma still has infiltration and edema. For corneal epithelial damage or corneal ulcers caused by various reasons, in principle, corticosteroids are disabled to prevent the ulcer from worsening or delay the healing of epithelial damage.

6. Bandage

Covering the affected eye with sterile gauze can avoid light stimulation, reduce the friction of the eyelid on the corneal surface, protect the ulcer wound, reduce pain, promote ulcer healing and prevent secondary infections. You can also wear a therapeutic soft contact lens, but it is contraindicated for those with conjunctivitis and purulent discharge. If necessary, wear colored glasses.

7. Supportive Therapy

Many vitamins are available, such as vitamins C, E and A, D.