bullous keratopathy
Introduction
Introduction to bullous keratopathy The state in which blisters are formed in the corneal epithelial layer is called bllouskeratopathy, and has been called macrobubble keratitis. In fact, it is not an inflammation, but a denaturation, which is the result of the abnormality of the layer, especially the endothelium, and the storage of water in the epithelial layer. At the time of examination, the corneal epithelial edema and tarnishing may be seen. One or several large bubble bulges (mostly several millimeters) are filled with a slightly turbid liquid. The large bubbles may rupture due to mutual friction with the eyelids during blinking. At this time, due to corneal nerve exposure, the patient has severe irritation such as pain, shame, tearing, ruptured large bubbles forming epithelial defects or coils, large bubbles can recur, repeated rupture, and eventually the blood vessels grow into denatured blood vessels. And ended up. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific people Mode of infection: non-infectious Complications: corneal squamous cell carcinoma
Cause
Causes of bullous keratopathy
1, there are crystal macrofocal keratopathy: such as glaucoma absolute period, late uveitis, Fuchs corneal dystrophy, penetrating keratoplasty and pre-irisal adhesions.
2, no crystal large vesicular keratopathy: cataract surgery after glass contact cornea, intraoperative mechanical damage, chemical damage (salt saline, BSS).
3, artificial daily vesicular keratopathy: early factors are mainly caused by the surgery itself caused by corneal endothelium injury, postoperative secondary glaucoma, intraocular lens direct mechanical damage to endothelial cells, the late factors are mainly caused by human exposure to the iris Chronic low-grade iritis (co-occurrence rate is 1% to 10% in anterior chamber and iris fixation, and posterior type is less than 1%) and corneal endothelial damage caused by aging.
Prevention
Prevention of bullous keratopathy
Superb surgical technique, gentle surgical operation can greatly reduce the incidence of this disease, corneal dystrophy, trauma and glaucoma, late uveitis and other eye diseases can also lead to the disease, should be treated according to different circumstances, to penetrate Most corneal transplants can obtain better visual prognosis.
Complication
Complications of bullous keratopathy Complications, corneal squamous cell carcinoma
Suffering from eye fog, the mildest person is the heaviest in the morning, and can be improved in the afternoon. The severe symptoms are obvious, the pain is painful, and it is difficult to blink. Especially when the corneal epithelial rupture is ruptured, there are different degrees of mixed hyperemia. The slit lamp detected thickening edema of the corneal stroma, epithelial aerosol, or vesicles of different sizes. The posterior layer of the cornea was unclear or wrinkled and turbid. The disease course was long, the corneal stromal neovascularization, stromal opacity, and obvious visual acuity Decrease.
Symptom
Symptoms of bullous keratopathy common symptoms conjunctival edema and corneal ulcers, tearing corneal burns, scratching the cornea size... Corneal ulcer corneal opacity
1, occurred in glaucoma, iridocyclitis, internal eye surgery, blind eyeball after chemical injury.
2, there are foreign body sensation, stinging and other symptoms, long-lasting.
3, the corneal epithelium tarnish, there are transparent blisters of varying sizes, can relapse after rupture.
Examine
Examination of bullous keratopathy
Corneal epithelial edema, loss of luster, which has one or several large bubble bulges (mostly a few millimeters), the bubble is filled with a slightly turbid liquid, due to the friction between the eyelids and the eyelids, the large bubble can be broken, at this time, Due to corneal nerve exposure, the patient has severe irritation such as pain, shame, tearing, etc. The ruptured large bubble forms epithelial defects or coils, and the large bubbles can recur, repeatedly rupture, and eventually end up with blood vessels growing into degenerative blood vessels.
Diagnosis
Diagnosis and differentiation of bullous keratopathy
1. Have a history of ocular trauma, intraocular surgery, advanced glaucoma or uveitis, or Fuch corneal dystrophy.
2. Significant irritation and formation of corneal epithelial vesicles.
3. Corneal endothelium counts are significantly reduced.
