Filamentous keratopathy
Introduction
Introduction to filamentous keratopathy The corneal epithelium is partially exfoliated and has a filament-like shape. One end is attached to the surface of the cornea, and the other end is free. It is called filamentary keratopathy. Remove the cause of the disease, local application of corneal lubricant, mucolytic agent (acetylcysteine) and 5% normal saline. The ineffective time can be under the slit lamp, and after surface anesthesia, the silk is removed with a cotton swab and physiological saline. It can also be rubbed with diethyl ether, 1% to 2% silver nitrate or 10% zinc sulfate, and then immediately rinsed with normal saline, and covered with eye mask to cover the eye for one day. Wearing a soft contact lens has a certain effect. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: conjunctival hyperemia
Cause
Cause of filamentous keratopathy
May be related to the following factors: 1 abnormal proliferation of epithelial cells; 2 abnormal connection between basement membrane and preelastic membrane; excessive formation of 3 types of mucus, more common in dry eye and viral infection (adenovirus, HSV, etc.), also seen in neurotrophic Sex keratitis, scar keratitis (trachaete, pemphigus, etc.), in addition to corneal abrasions, wearing contact lenses, can also cause this lesion after intraocular surgery.
Prevention
Filamental keratopathy prevention
Patients should pay attention to adequate rest. Let your eyes get in contact with fresh air for recovery. Listening to easy music is also good for relieving eye pain and local irritation.
Eat more vegetables and fruits rich in vitamins and cellulose. Eat more high-calorie, high-protein foods such as beans, soy products, lean meat, and eggs to facilitate corneal repair. You should quit smoking and alcohol, do not eat fried, spicy, fatty and sugary foods. It is very important to nurse the spirit in this disease. It is most irritating, so as not to aggravate the liver fire and adversely recover. However, it is not advisable to talk too much about ridicule, to be comfortable and quiet.
In order to prevent keratitis, care should be taken to establish a healthy lifestyle. Because patients with herpes simplex keratitis are poisoned for life, any factors that affect immune fluctuations can cause recurrence of old diseases. Patients should live a regular pattern and avoid the incentives of staying up late, drinking, overeating, colds, sun exposure, etc., in order to reduce the risk of recurrence of old diseases. Once the old disease recurs, it is necessary to go to the hospital for medical treatment and consultation in time, and do not use drugs indiscriminately, so as not to complicate the disease and increase the difficulty of treatment.
Complication
Complications of filamentous keratopathy Conjunctival congestion
Conjunctival hyperemia, abnormal tear film, corneal epithelial punctate defect.
Symptom
Symptoms of filamentous keratopathy Common symptoms Corneal dendritic changes Corneal epithelial erosion Corneal dry corneal burns Scratch glaucoma
1, have a long history of blindfold, or suffering from corneal dryness, absolute glaucoma and so on.
2, the lighter only has a foreign body sensation in the eye, and the severe corneal irritation is obvious.
3, the surface of the cornea epithelium is coiled, can be as thin as a needle tip, or as thick as sesame, one end attached to the epithelium, the other end free, more common in the vicinity of the upper corneal margin.
Examine
Examination of filamentous keratopathy
1. Medical history consultation
There are no corneal irritation symptoms and trauma history, local or systemic use of corticosteroids; with or without chronic dacryocystitis, varus and other eye diseases and related systemic diseases.
2. Eye examination
If the symptoms are severe, especially in children, the topical anesthetic may be administered first. For those who are at risk of perforation, avoid oppression of the eye when inspecting. The corneal surface damage is easily detected by fluorescein staining, and the corneal lesions and morphology are more easily detected by a magnifying glass or a slit lamp. If necessary, perform corneal sensation examination and tear secretion function check.
Diagnosis
Diagnosis and diagnosis of filamentous keratopathy
diagnosis
According to the history and typical morphological changes of the cornea, combined with the results of the auxiliary examination can be diagnosed.
Differential diagnosis
Mainly differentiated from corneal opacity and corneal scar.
Corneal opacity: The turbid cornea is grayish white and is significantly thicker. It is 2 to 3 times thicker than the unturbid cornea, and has small wrinkles on the surface. Under the light microscope, the surface of the squamous epithelium is uneven and some fall off. The outermost layer of the intrinsic film (ie, the Bowman film) has a blurred structure, and the collagen fibers in the lamina propria are swollen, contain vacuoles, and have reduced cellular components. The innermost layer of the intrinsic membrane (ie, the descement membrane) is swollen and the endothelial cells are shed.
Corneal scar: refers to the formation of opaque connective tissue due to corneal inflammation, trauma and other corneal diseases deep into the corneal stromal layer, corneal connective tissue hyperplasia after healing, repair of defects caused by inflammation or trauma. Corneal scars can cause varying degrees and extent of corneal opacity and varying degrees of visual impairment.
