What is corneal opacity?

Under the opacity of the cornea in ophthalmology is understood a whole group of specific features that have a similar etiology and features of manifestation.This is a common disease that develops due to a variety of causes: eye trauma, infection, as a complication after surgery. After appearance of typical signs, many postpone visiting a doctor, writing off everything for fatigue, but timely treatment is the only way to avoid unpleasant and sometimes irreversible complications.

Definition of disease

The opacity of the cornea is considered one of the first ophthalmic ailments, described in detail in medicine.The first mention of this defect can be found in the writings of medieval doctors. Outwardly, the disease is a pathological cicatricial change in the retina, which is directly responsible for visual acuity. There are many reasons for this problem, but regardless of the etiology, the symptoms are always identical - a person begins to distinguish badly objects that are in the immediate proximity.

If the treatment is not started on time, the disease progresses rapidly.

Among all eye diseases, corneal opacity takes one of the leading positions. According to the latest data, there are more than 290 million people suffering from this pathology in the world.

Kinds

The manifestations of corneal opacity differ depending on the degree of severity and localization of the defect. There are three main varieties of this disease:

• Cloudlet. Defect, the easiest to treat. Turbidity has a limited area and a characteristic grayish shade of tissues, which can be seen during visual inspection. If the pathology is localized in the central region of the cornea, visual acuity is almost not reduced;
• Spot. The average of the severity of manifestations is the opacity of the cornea. It can be located both in the central zone and on the periphery. Reduction of vision depends on the location of the defect;
• Belmo. Pronounced corneal opacity, associated with the presence of a scar on the surface. It can be localized both on the central part and occupy the whole area. In the diagnosis, you can see a white or grayish shade of the affected part. If the opacity is located in the center of the cornea, it changes the structure of this part of the eye. Visual acuity is always reduced, there is a risk of photophobia.

Until recently, throats were often confused with cataracts, since both diseases have a similar symptomatology. Modern diagnostic methods make it easy to differentiate these diseases.

Causes

In most cases, the disease occurs in old age due to senile changes in the structure of the eye, and also due to concomitant diseases (diabetes, rheumatism, retinal detachment). However, there are a number of factors that can cause corneal opacity in young people.

• Mechanical damage to the cornea. One of the most common causes of the appearance of ailment. As a result of injury or burn, the integrity of the surface layer of this eye structure is disturbed, and then the development of the disease is aggravated by a bacterial infection against the background of damage. There is a strong destruction of the cornea, which leads to the formation of ulcers on its surface. If the treatment is not started on time, a thorn in the eye begins to form;
• Infectious Diseases. The opacity of the cornea may begin against a background of some infectious ophthalmic diseases. As a rule, it is keratitis or viral conjunctivitis. In addition, pathology can develop as a complication against tuberculosis, hepatitis, measles and other infectious diseases;
• Consequences of surgical intervention. The cornea inside is lined with a special kind of endothelial cells, the number of which decreases with age. After some types of ophthalmic operations, there is a shortage of these cells, which leads to corneal dystrophy and the appearance of turbidity.

  Types of conjunctivitis

Some experts agree that the regular wearing of corrective contact lenses can also lead to various pathologies on the part of the cornea, including clouding.

Symptoms

First, there are typical signs for a variety of ophthalmic ailments: redness, profuse lacrimation, and unpleasant sensations when exposed to light.After the active development of pathology, opacity of the cornea can be detected with the unaided eye. A white or gray hue appears on the cornea, it becomes cloudy. Directly turbidity has a characteristic shiny and dense structure, unlike cataracts. When forming a thorn, especially large size, you can see a small scar on the surface.

Reduction of visual acuity does not always happen. It depends on some factors: age, area of ​​the affected surface and localization of the disease.In the formation of turbidity in the central and peripheral part of the cornea, not only distortion or loss of vision is observed, but astigmatism develops.

If the pathology is accompanied by increased intraocular pressure, stretching or thinning of the corneal opacity, which is commonly called an exalted canker, may occur.

Possible complications

If the disease progression is not stopped in time, the opacity of the cornea may subsequently lead to irreversible complications.Typically, this is a strong reduction in visual acuity, as well as the formation of secondary glaucoma. With a long course of the disease, there is a possibility of developing complete blindness. The opacity of the cornea, caused by a bacterial infection, can lead to concomitant infectious diseases of the eyes, for example, conjunctivitis.

In rare cases, neglected turbidity leads to irreversible corneal dystrophy, which practically does not respond to treatment, especially in the elderly. And with the formation of a thorn in the very center of the cornea, there is a possibility of the development of leukoma, in which case early and immediate treatment is required.

Diagnostics

For an accurate diagnosis, complex diagnosis is required, which always begins with a visual inspection of the structural components of the visual apparatus.Almost in all cases, biomicroscopy is used - external examination of the eye with a slit lamp. It allows not only to clearly see the source of turbidity, but also to evaluate its structure.

Corneal opacity and other degenerative processes can be detected using the Amsler lattice.And ultrasound of the organs of vision and optical coherence tomography can also be used to clarify the diagnosis.

Ultrasound examination of the eye

Features of treatment

The choice of strategy for the treatment of corneal opacity always depends on the extent of the lesion, the age of the patient and the etiology of the disease. As a therapy of mild clouding without traces of scarring, medication is usually used.

• If there is a receding inflammatory process, and a clouding affects a small area, corticosteroid agents are administered in the form of drops.For example, cortisone, prednisolone or dexamethasone. In case of severe inflammation it is necessary to additionally use hormonal preparations in the form of ointments;
• To accelerate the resolution of turbidity, it is effective to use a solution of ethylmorphine hydrochloride, which is used in the form of drops or subconjunctival injections.As an alternative, potassium iodide solution or a mercury ointment is used;
• To reduce scarring, physiological procedures are effective: ultrasound, electrophoresis with potassium iodide or hydrocortisone. As a rule, one course lasts at least a month.

  Glucocorticosteroid (GCS) for topical application in ophthalmology

The greatest difficulty is the treatment of corneal opacity, which is accompanied by concomitant eye diseases - glaucoma or cataracts. In this case, a comprehensive treatment aimed at eliminating the primary disease is selected.

Surgical methods

With the development of coarse opacity of the cornea, which has scars on the surface, and significantly reduces visual acuity, raise the issue of surgical treatment of the disease.Recently, the most common surgery for a through transplantation of the cornea. ABOUTon is to remove the damaged areas of the eye and further transplant donor tissue together with the endothelium, or only the inner layer. Despite the fact that today it is the most effective surgical method, it has a number of limitations. For example, transplantation is not possible if the patient has chronic heart disease, as well as some forms of diabetes mellitus. Therefore, the procedure is not recommended in the elderly.

Prevention

There are no reliable ways to prevent the development of corneal opacity.It is believed that simple preventive measures: the rejection of bad habits, the use of sunglasses in sunny days, adherence to a balanced diet and daily routine, as well as the use of individual of protectionin harmful production helps to reduce the risk of disease.

Of great importance is the timely treatment of eye diseases, since the opacity of the cornea has the property to develop against a background of some serious ophthalmic diseases.

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conclusions

Corneal opacity is a serious disease in the visual apparatus, which tends to progress and relapse.If the first symptoms are found, it is necessary to turn to a specialist in time, since the treatment of the disease in the early stages is much more effective. At risk are the elderly, because with age, irreversible degenerative processes in the visual apparatus, which is why after 60 years it is important to regularly undergo medical examinations in order to take necessary measures.