bacterial corneal ulcer
Introduction
Introduction to bacterial corneal ulcer Cellular corneal ulcer (bacterial corneal ulcer) is caused by Streptococcus pneumoniae after infection, staphylococcal, Pseudomonas aeruginosa, Neisseria gonorrhoeae and Moraxella causing corneal suppuration, crops, nail scratches, Iron scrap foreign body injury, contact lens abrasion is a cause of injury in recent years. Pseudomonas aeruginosa in rural areas and Pseudomonas aeruginosa in the harvest season are the main pathogens. The disease needs to be differentiated from fungal corneal ulcers. Fungal corneal ulcer: Fungal corneal ulcer is caused by fungal direct invasion of corneal infection. Sputum is scraped on the ulcer surface of the infected cornea for smear examination, and fungal hyphae can often be found. The necrotic tissue is inoculated on the fungal medium to have fungal growth. There are dozens of fungi that are pathogenic to the human cornea. Mainly Aspergillus, followed by Fusarium. There are two types of post-corneal sediments, one is brown-gray powder or fine granules. In the early stage of ulcers, in small cases, most of the anterior chamber has no pus or a small amount of empyema. basic knowledge The proportion of illness: 0.3% Susceptible people: no specific population Mode of infection: non-infectious Complications: keratitis
Cause
Cause of bacterial corneal ulcer
Crops, nail scratches, iron filings, and contact lens abrasions are the cause of injury in recent years. Streptococcus pneumoniae in rural areas, Pseudomonas aeruginosa is the main pathogen in the autumn and summer harvest season.
Prevention
Bacterial corneal ulcer prevention
"Bacterial corneal ulcer" is often caused by corneal trauma. The symptoms are: eye pain, tearing, fear of light, vision loss, corneal ulceration when eye examination, surface depression, grayish white turbid around, corneal congestion, severe cases With limited face swelling, conjunctival clear congestion and edema, anterior chamber empyema.
Nursing points
Apply medication to patients on time, and apply 0.5% chlortetracycline or 0.5% erythromycin eye ointment at night.
To bandage the affected eye, first cover it with a sterile sand cloth on the closed eye face, then fix it with a line eye mask. Both ends of the line can be used as a set of headgear on the ear to facilitate taking, wearing, and paying attention. When the eye is attacked, it should be wrapped all day (day, night).
If there is severe pain in the eye, the ulcer will rapidly expand and there will be a large yellow-green pus and anterior chamber empyema. It should be considered as Pseudomonas aeruginosa infection and should be sent to the hospital immediately.
After the drug is used, the ulcer is still uncontrolled, and it expands to the deep layer. The posterior corneal elastic membrane bulges forward. This is a precursor to corneal perforation and should be sent to hospital for treatment.
Complication
Bacterial corneal ulcer complications Complications keratitis
If the condition is effectively controlled, it can lead to perforation of the cornea, which can further cause endophthalmitis and even total ocular inflammation.
Symptom
Bacterial corneal ulcer symptoms Common symptoms Purulent secretions photophobia eye pain corneal or ulcer visual impairment tearing pain eyelid corneal ulcer
Conscious symptoms
Significant photophobia, acute eye pain, visual impairment, eyelids, tearing and other irritating symptoms.
2. Signs
(1) Highly ciliary congestive corneal central abscess, the structure is ambiguous, there are different degrees of empyema in the anterior chamber, yellow or light green.
(2) According to the different strains, the formation of ulcers on the cornea is not ring-shaped, and the edema of the surrounding cornea is glassy. The ulceration of the corneal ulcer is grayish yellow, the edge is sneak, and the cornea around it Still transparent.
(3) The surface of the ulcerative ulcer has gray-yellow pus adhesion, and a large amount of yellow-green purulent secretion adheres to the surface of the Pseudomonas aeruginosa ulcer.
(4) The ulcer develops in the depth to make the posterior elastic layer bulge, and the ulcer can be perforated in 2 to 5 days.
Examine
Examination of bacterial corneal ulcers
Ophthalmology routine examination, combined with the actual situation of the patient to determine the examination. Suffering from eye pain or affecting ipsilateral headache, photophobia, and visual impairment. The crescent-shaped gray-white aponeurosis can be seen on the edge of the black eye. The surrounding area is high, the central depression is shaped like a petal, and the red or red eyes are mixed. There are also recurrent episodes of polyspores, and the condition worsens, and the stars collapse and fuse and ulcerate. In severe cases, it causes dark eyes to break through. The yellow liquid is rushing, and the scorpion is tight.
Diagnosis
Diagnosis and identification of bacterial corneal ulcer
Pay attention to the identification of fungal corneal ulcers.
Fungal corneal ulcer: Fungal corneal ulcer is caused by fungal direct invasion of corneal infection. Sputum is scraped on the ulcer surface of the infected cornea for smear examination, and fungal hyphae can often be found. The necrotic tissue is inoculated on the fungal medium to have fungal growth. There are dozens of fungi that are pathogenic to the human cornea. Mainly Aspergillus, followed by Fusarium. There are two types of post-corneal sediments, one is brown-gray powder or fine granules. In the early stage of ulcers, in small cases, most of the anterior chamber has no pus or a small amount of empyema.
