Inflammation of the cornea: symptoms and treatment

The cornea is part of the outer shell of the eye, covering the pupil and the iris.The value of the cornea in the optic system of the eye is large enough, because it is a kind of lens through which light rays pass through, and is among the refractive media of the eye. The cornea also performs a protective function, covering the main part of the outer surface of the eyeball from external influences.

Therefore, any changes in the corneal coating inevitably affect the functioning of the entire optical system.One of the most common pathologies that can occur in this part of the eye shell is keratitis or inflammation of the cornea.

Definition of disease

The size of the cornea is kept within 10 mm of the circumference throughout life.As a child, its dimensions are slightly smaller, but from the age of 4 they do not change. In the center, the thickness of the corneal layer reaches, mm, and along the edges this parameter increases almost twice and amounts to, mm.

The main tissue of the membrane is connective and is called a stroma, and two layers of cells are located on both sides of it, each of which has its own function.All layers of the cornea are transparent in a healthy state, and in the development of diseases or damage, they lose their functionality.

Often due to external influences, the outer shells of the cornea are damaged - the anterior epithelium and the Bowman membrane. It is here that inflammation occurs under the influence of external factors. However, the most dangerous endogenous keratitis are those that have arisen for internal reasons and therefore are capable of damaging the deeper layers of the corneal membrane.

Causes

Depending on the etiological factor, the following types of inflammation of the cornea are distinguished:

• Keratitis bacterialis. It develops when using contaminated lenses or with an infected injury;
• Amoebic inflammation. The causative agent is an organism from the class of the simplest acanthamoeba;
• Spring keratoconjunctivitis. It has a seasonal periodicity and appears when irritated by the pollen of trees, grasses or grasses;
• Herpetic keratitis. Develops when infected with the herpes virus;
• Photokeratitis.It is the result of burns from ultraviolet, natural or artificial;
• Fungal inflammation. It develops when infected with fungal microorganisms, can affect the deepest layers and is difficult to diagnose;
• Neuroparalytic keratitis. Occurs as a result of radiation, inflammatory or chemical damage to the trigeminal nerve;
• Keratitis traumatic. Is a consequence of chemical or mechanical trauma, as well as irradiation of the cornea;
• Keratitis in gonoblennoe. Appears when infected with gonorrhea of ​​newborns in the presence of infection in the mother.

There are also two large groups of provoking factors:

Endogenous(internal):

• Lack of vitamins;
• The pathology of the trigeminal nerve;
• Autoimmune pathologies;
• Chronic infections: herpes, syphilis, tuberculosis;
• Recurrent allergies;
• Rheumatic diseases.

Exogenous(external):

• Fungal, viral, bacterial;
• Traumatic(incl. postoperative);
• Infectiousdiseases: blepharitis, conjunctivitis, meibomite.

Symptoms

The initial symptoms of keratitis are typical for all inflammatory processes that occur in the eyes:

• Strong pain;
• Sensation of "sand in the eyes
• Photophobia and lacrimation;
• Blepharospasm.

All these signs are called "corneal syndrome but they are not the last symptoms.Later, redness of the conjunctiva, clouding and reduction of visual acuity appear. The cornea begins to grow dull - this is a consequence of the accumulation of cellular elements (infiltration). Infiltrate can accumulate in different layers of the cornea, depending on the depth of the lesion and even in the anterior chamber. With bacterial inflammation, the infiltrate can be transformed into pus.

Vestal growth(vascularization) is morelate sign of inflammation.The appearance of such a symptom plays both a positive and a negative role: resorption of the infiltrate is accelerated, however, the transparency of the cornea decreases.

When ulceration occurs, the process passes into the next, most dangerous stage, fraught with severe complications and infection of the internal eye structures.

Possible complications

If treatment is not started in time, then the development of severe complications of pathology is possible:

• Iridocyclitis. The spread of the inflammatory process to adjacent structures: the iris and ciliary body. The main provoking factor of this disease is rheumatism - the incidence in the presence of rheumatic lesions is about 40%. Treatment of iridocyclitis is to take medication and surgery;
• Scrolls.The development of inflammation in the deepest layers of the sclera - a dense outer shell consisting of collagen fibers. In this case, also the main factor in which inflammation spreads is rheumatism;

This figure schematically depicts the normal eye: the lens (1), the iris (2), the ciliary body (3), the cornea (4). The pupil (5) has a regular round shape. In severe iridocyclitis, the pupillary margin of the iris grows with the lens, and it itself is protruded into the anterior chamber of the eye (6). Irregular shape pupil

• Endophthalmitis. Inflammation of internal eye structures, characterized by the formation of purulent exudate inside the eyeball (in the vitreous body). The most serious consequence of endophthalmitis is the removal of the eyeball;
• Secondary glaucoma. As a result of inflammation along the edge of the cornea, spikes are formed, as a result of which the outflow of intraocular moisture is disturbed. Because of this, there is an increase in intraocular pressure with subsequent optic nerve atrophy;
• Panophthalmite. As a rule, it is a consequence of endophthalmitis and is accompanied by the spread of purulent inflammation to all eye structures.

One of the easiest consequences can be a partial reduction in the quality of visual perception or the spread of inflammation to adjacent structures.

Treatment

After visual examination and data collection of anamnesis, the ophthalmologist conducts a number of special studies:

• Biomicroscopy- research carried out with the aid of a slit lamp;
• Ophthalmoscopy- examination of the fundus, helping to determine the depth of lesions;
• Examination with fluorescein helps to visualize the depth of damage;
• Analgesimetry- reveals the degree of sensitivity of the cornea.

  Conduction of ophthalmoscopy

In the process of diagnostic measures, the doctor is faced with the task not only to determine the extent and depth of lesions, but also to identify the underlying disease (if any). Therefore, it is possible to attract outside experts: rheumatologist, urologist or gynecologist, venereologist, allergist, phthisiatrist, therapist.

Medication Therapy

The choice of medical tactics for the treatment of the disease depends entirely on the cause identified during the diagnosis. To eliminate inflammation in the cornea, the following drugs can be used:

• Antibacterial drops: Tobrex, Levomycetin, Floxal. Used almost always if not for treatment, then as a prophylaxis of bacterial infection;
• Systemic antibiotics. Assigned depending on the internal infection that triggered the development of inflammation. If the disease is initiated by other groups of microorganisms, then antiparasitic, antifungal, antiviral agents are used;

Tobrex is a broad-spectrum antibiotic

• Glucocorticoids(topically): Dexamethasone, Oftan-Dexamethasone, Maxido. Used for the threat of penetration of the inflammation into the deep layers of the cornea. Contraindicated in the herpetic form of the disease;
• Antiviral:drops Ocoferon, ointment Zovirax. They are used as an additional remedy for viral infection: when infected with chicken pox or herpes;

Dexamethasone has an anti-inflammatory effect

• Expanding pupil of a drop: Midratsil, Atropine, Tropicamide. Used as a preventive tool in the event of the threat of adhesions;
• Improving regeneration: Solcoseryl, Korneregel. The drugs are used to accelerate the healing of the corneal tissue in case of traumatic injuries.

Atropine - drops with relaxing effect

An essential element of therapy is detoxification - drugs or plentiful drink, as well as the use of funds to reduce allergic manifestations. To mobilize the body's internal reserves, multivitamin preparations are prescribed.

In order to accelerate the restoration of corneal damage, physiotherapeutic procedures may be prescribed: phonophoresis, magnetotherapy, electrophoresis with potassium iodide.

The most promising of conservative treatment methods to date iscross-linking- a method of eliminating inflammation with a special Sailer lamp. Focused in a special way, ultraviolet radiation completely sterilizes the cornea. The method is used only for the infectious nature of inflammation.

Surgically

In the absence of a visible effect of conservative methods or with rapid progression of symptoms, the only possible method of treatment is surgical intervention.

To treat inflammation of the cornea, the following operations can be used:

• Microthermocoagulation- a method of influencing the tissue of the cornea with the help of microelectrodes;
• Laserocoagulation- use of a laser beam as a method of coagulation at the site of damage;
• Keratoplasty- replacement of the corneal layer completely or partially with a donor or artificial implant.

  Carrying out keratoplasty

Surgical intervention is an extreme measure and can only be carried out after the patient has undergone a complete examination.

Folk remedies

Inflammation of the cornea can not be called easy in the treatment of the disease, and some folk remedies, of course, can not be cured. However, some forms of keratitis can have a prolonged course, and in this case "grandmother's" recipes can be of great help:

• Wash your eyes twice a dayinfusion of plantain: 2 h. l. crushed leaves in 200 ml of boiling water;
• Dilute honey with boiled water in a proportion of 1: 5, use for digesting three times a day in a warm form. Do not store the solution for more than a day;
• Make a compress of white clay for, h.To do this, form cakes thick about, cm, to only close the eye socket. Pellets make it damp enough and keep them before your eyes until drying out, after which gently wash off the remains of clay;
• Make infusion of 3 tbsp. l. eyebrows (grass) in 400 ml of boiling water.Cooled infusion strain and use for lotions, as drops, as well as for oral administration: 100 ml three times a day.

With the use of folk remedies, a doctor's advice is still needed - in fact many plant components can have an allergic effect, and in the presence of chronic diseases have a negative systemic effect.

Prevention

Prevention of a dangerous disease depends entirely on the patient's efforts. After all, with a careful attitude to the eyes, you can begin treatment at the very beginning and be cured quickly and without consequences. Among the preventive measures can include:

• Wearing protective and sunglasses at work and leisure;
• Proper care and wearing of contact lenses;
• Timely treatment of eye and systemic infections;
• Prevention of chemical, thermal, radiation burns.

Video

conclusions

Inflammation of the cornea with timely diagnosis and correct treatment can be cured quickly and without consequences.However, delaying the visit to the doctor ("will pass by itself") can end very sad, and the evidence for that is a list of possible complications.

With a careful attitude to the eyes and timely treatment of any infectious diseases, the risk of developing keratitis is minimal and can be reduced to zero.In this case, one should not forget about the main means of prevention - periodic examinations of the ophthalmologist.