cannibalizing corneal ulcer
Introduction
Introduction to ectopic corneal ulcer Ulcer corneal ulcer (ulcuscornealrodens) is a chronic, painful corneal ulcer that first occurs in the peripheral part of the cornea, extends along the periphery of the cornea, and then develops toward the center. Finally, it involves the entire cornea, which can invade one or both eyes. An idiopathic corneal ulcer that is not associated with infection or systemic collagen-vascular disease. Corneal necrosis releases more antigen, and this vicious cycle continues until the corneal stroma is destroyed. basic knowledge The proportion of illness: 0.0025% Susceptible people: no specific people Mode of infection: non-infectious Complications: cataract
Cause
Causes of encroaching corneal ulcer
Virus infection (30%):
The exact cause of the disease is not well understood. Koeppe (1918) and Rodigina (1934) believe that Mooren ulcers are associated with bacterial infections. By the 1940s, many scholars believed that the disease was associated with certain viral infections, Kuriakose (1963) It was found that 6 cases of Mooren ulcers were associated with hookworm disease, so it is believed that this disease is related to intestinal parasite infection. Brown (1969) found that the collagenase activity in the conjunctival tissue of Mooren ulcer was significantly increased, so it is considered that the disease and collagen in the conjunctival tissue The activity of the enzyme is closely related.
Trauma (30%):
Corneal trauma, infection, or systemic disease alters the normal corneal antigen, leading to immune responses such as complement activation, neutrophil infiltration, and release of collagenase.
Prevention
Necrotic corneal ulcer prevention
Prevent mixed infections, use antibiotic eye drops and eye ointments, and properly add vitamins. Reasonable diets can take in some high-fiber and fresh vegetables and fruits. Balanced nutrition, including protein, sugar, fat, vitamins and trace elements. It is paired with essential nutrients such as dietary fiber.
Complication
Complications of ectopic corneal ulcer Complications cataract
Enletaging corneal ulcers may be associated with mild iritis or complicated cataracts, and anterior chamber empyema or corneal perforation is less common.
Symptom
Entangled corneal ulcer symptoms Common symptoms Corneal ulcer Eye pain Conjunctival edema and corneal ulcer scleral edema
Nervous corneal ulcer usually begins with gray-white infiltration of the surrounding cornea, and then corneal epithelial shedding and matrix dissolution occur, eventually developing into a chronic, painful, progressive, peripheral corneal ulcer with ulcer progression to the peripheral cornea and central cornea. It may involve the limbus, and the ulcer is pierced toward the edge of the central cornea. The conjunctiva and sclera adjacent to the ulcer often have inflammatory infiltration and edema.
Examine
Inspection of ectopic corneal ulcer
1. Complete blood count and classification, platelet count, erythrocyte sedimentation rate, rheumatoid factor, complement binding test, anti-nuclear antibody, anti-neutrophil cytoplasmic antibody, fluorescent spirochete antibody absorption test, etc., in order to exclude other diseases, Make a diagnosis of a corneal ulcer.
2. Pathological examination: Light microscopic observation of the conjunctiva and corneal specimens of the necrotic corneal ulcer showed that the epithelial layer and the basement membrane of the bulbar conjunctiva had a large number of lymphocytes and plasma cells infiltrated, and the deep stromal layer was intact, but there was a large amount of macrophage infiltration. The activity of fibroblasts in the middle stromal layer is increased, the arrangement of collagen layers is disordered, the blood vessels in the superficial stromal layer grow in, and the plasma cells and lymphocytes infiltrate. In some cases, inflammation may involve the sclera of the limbus.
Diagnosis
Diagnosis and diagnosis of ectopic corneal ulcer
Diagnostic criteria
Nervous corneal ulcers are idiopathic and are not associated with any systemic disease that can cause peripheral corneal ulcers. Detailed examination should be performed to find hidden systemic diseases, detailed medical history collection and physical examination, and comprehensive Laboratory tests to make a diagnosis.
1. Chronic, progressive medical history.
2. Uncontrollable eye pain, progressing along the limbus and progressing toward the center of the cornea, with clinical manifestations such as ulceration through the sneak edge.
3. Histopathological changes.
4. Exclude other diseases.
Differential diagnosis
The diagnosis of ectopic corneal ulcer is exclusive. Although corneal ulcer has a typical morphology, several peripheral corneal ulcers must be excluded because peripheral corneal lysis and annular infiltration are also seen in collagen vascular diseases such as rheumatoid joints. Inflammation, nodular arteritis, systemic lupus erythematosus, Wegeners granulomatosis, etc. In the above systemic diseases, corneal ulcers also manifest as peripheral corneal infiltration, progress along the limbus or develop to the center of the cornea, however, collagen blood vessels The history of sexually transmitted diseases and positive serological tests (including rheumatoid factor, antinuclear antibodies, anti-neutrophil cytoplasmic antibodies, etc.) are helpful in distinguishing from ectopic corneal ulcers.
