Treatment of keratitis

The outer part of the human eye is most susceptible to adverse environmental effects. Therefore, it is not surprising that pathological conditions often arise here: in the conjunctiva, the eyelids, and the cornea. However, the greatest danger is keratitis - inflammation in the cornea, because they are directly associated with a decrease in visual acuity, or even a complete loss of it.

Definition of disease

Cornea - a transparent part of the outer shell of the eye, covering the pupil and the iris and having the form of a convex lens.The value of the cornea can not be overestimated - it protects the most important element of the outer part of the eyeball (pupil) and is the main medium in the optical system of the eye.

The cornea consists of 5 layers, each has its own properties and purpose, but they are closely interrelated.

Therefore, the damage even in one of them leaves an imprint on the functionality of the entire corneal layer.

Keratitis is a whole group of diseases in which, for reasons of a very different nature, different layers of the cornea can be damaged: from the upper epithelium to the deep stroma and Descemet's membrane. The severity of the course of the disease is directly dependent on the factors that provoked it.

Causes

According to the degree of defeat, the disease can be:

• Superficial- when the inflammation affects the epithelium. This type of disease, as a rule, occurs after infection of the conjunctiva or eyelids. Superficial keratitis is most often treated quickly and proceeds without complications;
• Deep- when the inflammation affects the lower layers of the cornea, so treatment is a more complicated process.

Infectious keratitis, depending on the type of pathogen, can be:

• Bacterial- as a source of infection are staphylococci or Pseudomonas aeruginosa. They develop most often with traumatic injuries or prolonged wearing of contact lenses;
• Viral- in 70% of cases, the causative agent is the herpes simplex virus. Such a lesion is one of the most severe, as it penetrates into the deepest layers of the cornea, causing complications;
• Fungal- the development of infection also occurs quite hard and often with complications, as the disease is difficult to diagnose.

Onchocerciasis keratitis is based on uncontrolled allergic reactions, in the development of which the consequences for the patient can be the heaviest and even lead to complete blindness.

Other non-infectious causes include injuries of various kinds (burns, penetration of a foreign object), exposure ultraviolet, decreased immunity due to severe systemic diseases (diabetes, rheumatoid arthritis, gout and other ).

Symptoms

The number of the earliest signs of any damage to the eyes includes feelings of discomfort: burning, burning, redness, lacrimation. Later, more severe symptoms may occur:

• Reflex blepharospasm(involuntary closing of the eyelids);
• Photophobia;
• Sharp pain in the eye;
• Sensation of "sand in the eyes
• Visual impairment: fogging, fuzziness;
• On the cornea, turbidity is visible, and the conjunctiva and eyelids can be inflamed and hyperemic.

The color of the infiltrate can be transparent, or it may cloud and even acquire a purulent shade- depending on the type of pathogen. A characteristic sign of keratitis is a violation of visual perception, as the inflammation disrupts the transparency of the cornea.

The inflammatory process can proceed almost asymptomatically and manifest itself in all its glory already in the late stages of the disease. A sign of slow inflammation is the appearance of blood vessels in the cornea. Therefore, to exclude the development of complications, it is recommended to undergo any preventive examination for any uncomfortable sensations.

Possible complications

Cornea is one of the most important eye structures, and its damage if untimely or incorrect treatment can lead to the most unpleasant consequences:

• Corneal perforation- the most severe complication that develops with the progression of the corneal ulcer and is treatable only surgically;
• Endophthalmitis- Purulent inflammation of the inner shells of the eyeball;
• Sclerite- severe destructive vision-threatening inflammation affecting the sclera and deep layers of the episclera;
• Secondary glaucoma- violation of outflow of intraocular fluid, leading to an increase in IOP and atrophy of the optic nerve;
• Corneal opacity- Reducing the transparency of the corneal layer as a result of the formation of scars and scars, as well as the development of thorns.

In addition, a progressive inflammatory process can affect the vascular membranes and other eye structures, which invariably leads to a decrease in the functionality of the eyes. The most severe consequence of inflammation of the cornea can be a complete loss of vision, and even loss of the eye.

Treatment

When diagnosing the disease, special significance, in addition to conventional studies (visometry, biomicroscopy, ophthalmoscopy), have special tests:

• Fluorescein test- use of a special dye to determine the location of damage;
• Biopsy and scraping from the cornea- to determine the nature of the pathogen and the severity of the inflammatory process;
• Method of CTR(polymerase chain reaction) - used in case of difficulty with the classification of the infectious agent.

In keratitis, differential diagnosis is mandatory to eliminate diseases such as conjunctivitis, iridocyclitis, acute attack of glaucoma. In addition, if necessary, appoint advice from the ENT, dentist, rheumatologist, allergist, phthisiatrician, etc.

Medication Therapy

Conservative treatment of keratitis is always performed in the hospital and lasts from 2 to 4 weeks, depending on the severity of the disease. In this case, medicines from the following groups can be used:

• Antibiotics:Floxal drops, parabulbar and subconjunctival injections. In severe cases, parenteral administration of cephalosporins, penicillins, aminoglycosides is possible;
• Antiviral:ointments Tebrofenovaja, Florenalovaja, Bonaflonovaja, local instilljatsii Interferon, Atsiklovira. It is mandatory to use immunomodulators inside and parenterally (preparations of thymus, levamisole);
• Antihistamines:Opatanol, Allergoodil. Used to identify the allergic nature of the disease. However, the most important point in this case is the removal of contact with the allergen;
• Corticosteroids:Dexamethasone, hydrocortisone ointment. Used to improve the absorption of opacities during the recovery phase. In acute phase, the use is contraindicated, especially with viral infections;
• Moisturizing drops:Vizin, Oftagel, Natural tear. Used for violations of production of intraocular moisture or its chemical composition.

Of particular importance in this period is the use of vitamin preparations containing vitamins C, Group B, PP. With timely and correct treatment, the most serious consequence of the disease can be expressed in reduced visual acuity. If conservative methods do not have the desired effect, then the only treatment is keratoplasty.

Surgically

In some forms of keratitis, conservative methods are powerless. EIf drug therapy does not lead to a visible improvement within a month, the doctor recommends surgical intervention. The operation can be carried out in two variations:

• Excimer laser epithelialectomy;
• Superficial keratoectomy.

  Carrying out excimer laser epilelectomy

The purpose of surgical treatment can be justified in case of the following indications: perforation threat, significant reduction in visual acuity, cosmetic defect, etc.

Folk remedies

Of course, to cure keratitis with the help of folk remedies is impossible, but in some cases they provide invaluable help in addition to conservative methods:

• Sea buckthorn oilBury 1-2 drops initially every hour, and in the following days after 3 hours. Oil has analgesic and regenerating properties and is used for burn injuries;
• Two large leaves of aloe(from a 3-year-old plant) are torn off and put in the refrigerator for at least a week. After that, grind, squeeze the juice and add a piece of mummy the size of the wheat grain. Bury 1 drop in each eye once a day for a month, after which they prepare the drug without a mummy;
• For compresses used pharmacy clay: form small cakes thick, -2 cm and superimpose on the eyes, the back of the head and the forehead. Pancakes should be moist, but do not spread. Keep the compresses to dry (, -2 h. ), after which the remains of clay are removed and removed;
• The therapeutic effect is the bread steam.To make it in a freshly baked bread make a hole, the same diameter with a glass. After that put the glass upside down, and the collected moisture (effusion) is instilled in 1 drop in the eye.

Keratitis is a dangerous disease, it tends to spread to surrounding tissues and, if improperly treated, can lead to loss of vision. Therefore, any folk remedy should be used only after consulting an ophthalmologist.

Prevention

To prevent the development of inflammation of the cornea, several simple rules must be observed:

• In a timely manner, treat inflammatory ocular diseases of any etiology;
• Avoid eye trauma;
• Keep immunity in working order, and all infectious and inflammatory systemic diseases treated on time;
• To pass regular preventive examinations with an ophthalmologist.

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conclusions

Keratitis can occur due to a variety of causes of an infectious, traumatic or simply inflammatory nature. Therefore, one of the important points of prevention is maintaining at the proper level of health of the whole organism as a whole.

Inflammation of the cornea can bring a lot of troubles of the most serious nature, so self-medication is not allowed. But timely diagnosis and treatment, as a rule, always accompanied by a favorable outcome.

Also read about the inflammation of the eyelids and conjunctiva, iridocyclitis: what is it.