What Causes Corneal Opacity?

Corneal opacity refers to the gradual decrease of corneal transparency, turbidity, and off-white, and finally the signs of pupils cannot be seen at all. For those with primary opacity, 0.5 to 2% calcium sodium edetate solution can be used for treatment. If the opacity completely covers the pupil, corneal transplantation can be considered.

Basic Information

English name

corneal opacity

Visiting department

Ophthalmology

Common locations

cornea

Common symptoms

Cornea cloudy, off-white

Causes of corneal opacity and common diseases

1. Congenital

2. Infectious: Including keratitis and corneal ulcers caused by bacteria, fungi, and viruses.

3 Traumatic: corneal perforation injury, contusion, explosion injury, chemical burns, thermal burns, etc.

4 Allergic: such as vesicular keratitis.

5. Degeneration or malnutrition: such as corneal rings, corneal band degeneration, lattice-like malnutrition, corneal softening, etc.

6. Scariness: corneal clouding, white spots, adhesion blood spots, corneal edema, etc.

7. Corneal tumors: Rarely in the primary, most of them originate from the conjunctiva or limbus.

8. Other: Corneal opacity is one of the signs of other eye diseases. Such as corneal edema, corneal deposits, corneal neovascularization. Corneal blood staining, Kayser-Fleischer (KF ring) pigment ring, pterygium, etc.

9. Common diseases and causes

(1) Corneal senile ring: It is a simple primary senile change, which is similar to the atherosclerosis of arteries in nature. It is the result of occlusion of the capillary network around the cornea and lipid infiltration of the surrounding corneal stroma. Occurs in the elderly.

(2) Banded corneal opacification: It is a corneal degeneration caused by dark glaucoma or chronic iridocyclitis.

(3) Cystic keratitis: This damage is usually caused by glaucoma, iridocyclitis, or retinal detachment, or a special corneal degeneration that occurs when the corneal chemical injuries, burns, and corneal ulcers begin to heal.

(4) Nodular corneal degeneration and reticular corneal opacity: Both types of diseases are hereditary keratopathy.

(5) Corneal edge degeneration: It is generally considered to be related to local nutritional disorders of the cornea.

(6) Kayser-Fleischer's ring: This corneal opaque ring is one of the important manifestations of hepatolenticular degeneration. The composition of the pigment ring may be attributed to the deposition of copper particles.

Corneal opacity differential diagnosis

Superficial keratitis

(1) Primary lesions: can be caused by a virus. Such as epidemic keratoconjunctivitis caused by adenovirus type VII, epidemic virus caused by epidemic hemorrhagic conjunctivitis.

(2) Inflammation secondary to adjacent tissues: such as severe acute conjunctivitis, which invades the periphery of the cornea, superficial corneal tissue infiltration, edema, and epithelial exfoliation occur, and most of them are spot-shaped and confined. Positive fluorescein staining.

Corneal stroma

Most are immune responses and can also be caused by direct invasion by pathogenic microorganisms. Congenital syphilis is the most common cause, and tuberculosis, herpes simplex, and herpes zoster can also cause the disease.

3. corneal ulcer

The cornea was infiltrated with gray and white, the state was not clear, the surface lost its luster, followed by tissue defects to form ulcers, and the fluorescein staining was positive. In severe cases, the irritation symptoms are obvious, the ciliary congestion is significant, the ulcer is large and deep, and the anterior chamber has pus, which can be perforated.

Corneal opacification

Laboratory inspection

(1) Scraper and culture: The corneal ulcer scraper quickly understands the pathogenic bacteria, and the conjunctival sac secretion is used for bacterial or fungal culture.

(2) Cytological examination: ulcer scrape cytological examination, the virus showed a three-dimensional oval shape. The cytoplasm and nuclei infected with a fluorescent microscope showed yellow-green fluorescence.

(3) Serological examination: meaningful for the diagnosis of herpes simplex keratitis.

2. Instrument inspection

Slit lamp microscope with fluorescein staining helps diagnosis.

Corneal opacity treatment principles

Corneal elderly ring treatment can be treated as anti-aging. Banded corneal opacities may only be considered for removal of eyeballs in the presence of severe irritating pain. For those with primary opacity, 0.5 to 2% calcium sodium edetate solution can be used for treatment. If the opacity completely covers the pupil, corneal transplantation can be considered. Cystic keratitis is usually treated with 3% boric acid ointment or hypertonic glucose solution. Nodular corneal degeneration and lattice-shaped corneal opacities can be used for corneal transplantation if it significantly affects vision.