corneal abrasion
Introduction
Introduction to corneal abrasions Abrasion of the cornea: Some external objects, especially solid surfaces with rough surfaces, may cause different degrees of abrasion of the cornea, such as corneal epithelial defects or exfoliation, when they are in contact with or rubbed against the surface of the cornea. Simple shallow abrasions, the treatment effect is good. If only the corneal epithelial lesion or the epithelial layer is peeled off from the front elastic layer, most of them can be repaired within 12 hours, and those with larger ranges take longer. However, if the treatment is improper or infection occurs, it will not only prolong the course of the disease, but also leave different degrees of corneal opacity. The main symptom is that the patient suddenly has obvious pain, tears, eyelids and other irritating symptoms, and the pain is aggravated when the blinking or the eyeball rotates. Even if no foreign matter remains, the patient has a significant foreign body sensation. basic knowledge Sickness ratio: 0.05% Susceptible people: no specific population Mode of infection: non-infectious Complications: vitreous hemorrhage
Cause
Causes of corneal abrasion
Caused by trauma, blunt contusion caused by mechanical blunt force, masonry, fists, balls, falls, traffic accidents and shock waves of explosions, is the most common cause of blunt trauma.
Prevention
Corneal abrasion prevention
Corneal abrasions and contusions, if properly treated, generally have a good prognosis, but if secondary infection, corneal rupture and eye content prolapse are poor prognosis, seriously affecting vision, so in the diagnosis and treatment process, strictly according to aseptic operation Avoid rubbing your hands, and do not use unsterilized handkerchiefs or paper towels to wipe your eyes. Specific dietary recommendations need to consult a doctor according to the symptoms, a reasonable diet, to ensure that the nutrition is comprehensive and balanced, diet should be light, do not eat spicy spicy food, add more protein, vitamins, such as eggs, milk, vegetables, fruits and so on.
Complication
Corneal abrasion complications Complications, glass volume, macular hole
Blunt contusion can cause damage to the eye appendage or eyeball, causing multiple structural lesions in the eye, such as retrograde corner, anterior chamber or vitreous hemorrhage, lens dislocation, choroidal rupture, macular hole and scleral rupture, etc. In severe posterior segmental injury, there may be no or only a slight anterior segmental injury.
Symptom
Corneal abrasion symptoms Common symptoms Eyelid tear corneal burns and scratches
Because the sensory nerve endings are exposed, the patient suddenly has obvious pain, tears, eyelids and other irritating symptoms, and the pain is aggravated when the blinking or the eyeball rotates. Even if no foreign matter remains, the patient has a significant foreign body sensation.
Examine
Corneal abrasion examination
Check what you see:
Some corneal foreign bodies are obviously easy to see, and the foreign matter can be seen by the oblique illumination of the focus light; some are not easy to find, and must be checked by slit lamps, especially small and transparent foreign objects, which must be carefully searched for, necessary When fluorescein is added, the cornea around the foreign matter is colored to make the foreign matter easy to find. Pay attention to the depth of the foreign object when inspecting, and deeper foreign matter can partially enter the anterior chamber. Some corneal foreign bodies, especially those caused by explosive injuries, often have traumatic corneal endothelium within 24 to 48 hours after injury, but disappear within a few days.
Auxiliary inspection:
The corneal epithelial defect can be found by oblique illumination of the focus light (such as a flashlight source). At the same time, attention should be paid to the presence or absence of cornea or conjunctival foreign bodies. In particular, the aforementioned conjunctival foreign body not only has symptoms similar to corneal abrasion, but is often the cause of corneal abrasion, and if the epithelial defect is not found by oblique irradiation, fluorescein staining can be used. The method is to use a 20% fluorescein sodium sterile solution, drop into the conjunctival sac, and the patient closes the eye for 5 minutes, then pauses for a while, then the patient's tears can wash away the remaining dye in the conjunctival sac (if there are still more The dye can be removed by washing with physiological saline, and it is easy to find out because the corneal epithelial defect is stained green.
In addition, since the aqueous solution of fluorescein is a good medium for Pseudomonas aeruginosa and is easily contaminated by such bacteria, causing serious infection of the corneal wound surface, it has recently been dyed with fluorescein paper, that is, a disinfecting fluorescein paper tape, Drop a drop of sterile saline and contact one end with the sacral conjunctiva. In addition, if fluorescein is not used, small inconspicuous scratches can be detected by means of projection. Then, with a good focus light source to cast the cornea, it can be seen that there is a projection on the surface of the iris in the epithelial defect area. If the angle of projection is changed, the projection has a corresponding reverse movement. If the patient is in contact with a hospital in an ophthalmic device, it is of course more convenient to perform a slit-like microscope.
Diagnosis
Corneal abrasion diagnosis
diagnosis
It can be diagnosed based on clinical symptoms and laboratory data.
Differential diagnosis
First of all, attention should be paid to the presence or absence of corneal or conjunctival foreign bodies, especially conjunctival foreign bodies, which not only have symptoms similar to corneal abrasions, but also often cause corneal abrasions. Corneal abrasions are caused by focal light (such as flashlight light source). The corneal epithelial defect can be found. If the epithelial defect cannot be found by oblique irradiation, fluorescein staining can be used. If the patient is in contact with the hospital for ophthalmic equipment, the examination of the fracture-like microscope is more convenient.
