The cornea of the human eye is a complex five-layer "tool". It is represented by epithelium, boumenovaya and Descemetian membranes, stroma and endothelium. Corneal ulcer is the damage to the deep layers of tissues. On the affected area a scar (thorn) is formed.
Corneal ulcer causes
The following factors can provoke the appearance of this ailment:
- mechanical injury to the eye;
- damage to the cornea with a corrosive chemical or too hot composition;
- the result of exposure to pathogens, viruses and fungi;
- increased dryness of eyeballs due to lack of vitamins A and B or neurological disorder;
- uncontrolled use of anti-inflammatory and anesthetic drugs, produced in the form of drops.
Corneal ulcers can be caused by improper wearing of contact lenses and mistakes in caring for them. Means, designed to improve vision, can cause delicate tissues serious damage. Over time, there will begin to develop severe inflammation, which then degenerate into ulcers. Recent surgical operations increase the likelihood of this problem occurring.
Corneal ulcer - symptoms
This disease is characterized by certain signs. So, the ulcer on the eye is accompanied by the following symptomatology:
- painful sensations arising from the appearance of erosion and increasing with the progression of the disease;
- deterioration of vision due to the fact that the tissue that surrounds the place of erosion swells;
- marked photophobia and profuse lacrimation .
The corneal ulcer is differentiated according to the following criteria:
- In the course of the disease , an acute or chronic form.
- The depth of the lesion is deep or shallow.
- On the localization zone - peripheral, central or paracentral.
- For the root cause - bacterial, parasitic, fungal or not caused by infections.
Creeping corneal ulcer
This ailment can have such pathogens:
- Pneumococcus;
- staphylococcus aureus;
- streptococcus and other microorganisms.
This disease is characterized by acute development. Such a corneal ulcer has a progressive infiltrate. Behind its edge is an intense spread of the disease. There is another infiltrate, which is much less progressive. This is a regressing area. Here there is a process of tissue scarring and healing. In severe cases, the iris with a creeping ulcer of the cornea may even fall out. However, it is much more often soldered with a thorn.
Purulent corneal ulcer
Such keratitis in prevalence occupy the second place - they are conceded only by herpetic lesions. This corneal ulcer is distinguished by the severity of leakage and transience. Often it leads to loss of vision and loss of the eye. The bacterial ulcer of the cornea can have a different developmental nature:
- tissue injury;
- conjunctivitis;
- diseases of the eyelids
- operations carried on the cornea;
- incorrectly selected lenses and so on.
Peripheral ulcer of the cornea
It is an inflammatory reaction, which is non-infectious. The peripheral ulcer is caused by bacterial toxins. More often such a disease is diagnosed in those who wear contact lenses. It can be asymptomatic, but patients complain of redness of the eyes and soreness. The infiltrate itself is small in size (diameter varies from 2 to 10 mm). It is rounded.
Corneal edge ulcer
This kind of keratitis is a reaction to an inflammatory process that spreads from the edges of the eyelids or tear ducts. Such a corneal ulcer in a person has the following features:
- The formation of point infiltrates, which then merge into a single keratitis.
- If the lower eyelid does not close the eye well enough, the cornea dries out, the cells do not get enough nutrition. As a result, a grayish infiltrate forms on the surface.
Perforated corneal ulcer
This form of keratitis has its own peculiarity. Such an ulcer of the eye in a person extends to all layers of the cornea. It leaves behind a persistent haze. If untimely detection of a problem or unqualified medical care at the site of keratitis, a coarse scar is formed. The patient, who has such a pathology, faces complete blindness.
Treatment of corneal ulcer
Therapy for such a disease should be complex and conducted in a hospital. The course lasts from 2 to 5 weeks. It presupposes a corneal ulcer treatment, which should combine local, systemic and physiotherapy. Due to coherence of actions and high qualification of medical personnel, the patient quickly recovers. Local therapy includes the following:
- instillation antibacterial (Chloramphenicol, Ciprofloxacin) and anti-inflammatory (diclofenac sodium) drugs in the conjunctiva;
- administration of antibiotics (Lincomycin, Gentamicin);
- instillation of glucocorticoids (dexamethasone);
- instillation with drugs that dilate the pupils (Atropine);
- the introduction of a drug that promotes the regeneration of damaged tissues (Methyl ethylpyridinol and Dexpanthenol).
Systemic treatment involves the appointment of the following medicines:
- detoxification solutions (Dextrose + Ascorbic acid);
- anti-inflammatory drugs (Nimesulide);
- intramuscular administration of antibiotics (cephalosporins or aminopenicillins);
- with poor healing of ulcers, drugs with a regenerating effect are used;
- if the cornea becomes clouded, glucocorticoids are used.
In the most severe cases, when drug therapy is powerless, they resort to surgical intervention. During this procedure, the front eye chamber is rinsed. Antimicrobial medicines are used for this. Also keratoplasty is carried out. During this procedure, replacement of the pathologically changed cornea is performed.
Physiotherapeutic procedures are represented by such manipulations:
- electrophoresis with the use of antiviral and antibacterial drugs;
- low-frequency magnetotherapy;
- ultraphonophoresis, during which enzymes (Lidase, Fibrinolysin) are used, dissolving fibrin and contributing to tender scar tissue;
- antibacterial trays.
Practiced and reparative physiotherapy. Among its methods can be distinguished as follows:
- Low-intensity stimulation of the endocrine system, resulting in increased levels of cortisol and other hormones that abuse metabolic processes in the body.
- Effects on the affected area by short pulses of alternating current.
Cosmetic effects for corneal ulcer
In the treatment of this disease, keratoplasty is used. This is a cosmetic transplantation of damaged tissues. This procedure is performed on blind eyes, when the treatment of creeping corneal ulcer does not give the expected result. In this operation, the throat is excised and replaced with a transparent tissue. If white points remain outside the trepanation zone, they are masked with special mascara. This procedure is very similar to a tattoo.
Serums in the treatment of ulcers, corneal erosions
When treating this ailment, autologous agents are used. The chemical composition of these serums is very similar to the tear fluid. Here are the following components:
- epithelial growth factor;
- albumen;
- substance P;
- fibronectin;
- alpha-2 macroglobulin;
- insulin-like growth factor-1 and so on.
There are many methods of manufacturing such medicinal serums. One of them provides for the addition of antibiotics to the medicinal product. However, it is important that the serum is properly stored. Ultraviolet rays are fatal for some components (one of them is vitamin A). Keep the serum in a dark, cool place. The high healing efficiency that this remedy possesses allows us to conclude that the purulent corneal ulcer will be eliminated - the treatment will pass without complications.