Some viruses provoke strong inflammation of the cornea of the eye. One of these infections is herpes, which often becomes the cause of keratitis. This is a dangerous pathology that can cause irreversible visual impairment and other negative consequences.
Forms of herpetic keratitis
The described disease is classified into several groups according to the localization of inflammation and its severity. Herpetic keratitis of the eye exists in the following forms:
- primary;
- stromal;
- metaherpetic;
- discoid.
Primary herpetic keratitis
This type of infection occurs mainly in childhood (from six months to 5 years). Primary epithelial herpetic keratitis proceeds in a mild form in the form of blepharoconjunctivitis. Only the eyelids and mucous membranes are affected without spreading to the cornea of the eye. The herpetic keratitis is easily cured, often spontaneously. Healing of lesions occurs quickly and without scarring.
Stromal keratitis
This type of viral disease occurs due to inadequate activity of the immune system and the spread of infection. Sometimes the cause is epithelial superficial keratitis, especially if its therapy has proved ineffective. The stromal form of inflammation of the cornea provokes other types of ailment:
- card-shaped;
- discoid;
- ulcerative;
- bullous;
- interstitial.
Metaperpetic keratitis
This type of disease is a severe degree of corneal damage. It is characterized as a recurring deep keratitis of the eye, often flowing into keratoiridocyclitis. The described type of pathology is accompanied by a pronounced clinical picture and rapid progression. This herpetic keratitis causes numerous ulcers of the corneal stroma, prone to enlargement and spread. The presented type of the disease is difficult to treat, especially if there are concomitant visual impairments and rapid development of the infection.
Discoid keratitis
This form of the disease leads to a thickening of the cornea and the formation of a focus of inflammation in its center. Disc herniated keratitis combined with ingrowth in the stroma of deep blood vessels, followed by scarring of damaged tissues. This process quickly becomes chronic, proceeds with complications. Often there is a sharp deterioration of eye functions.
Herpetic keratitis - symptoms
Primary viral inflammation of the cornea of the eye can pass almost without symptoms. The only manifestations are fever, malaise and conjunctivitis . If such herpetic keratitis is not cured arbitrarily, it passes into the post-primary stage. In this case, the cornea is covered with characteristic viral vesicles, which burst and leave behind ulceration and erosion. They slowly heal and scar, which looks like a branchy pattern on the iris and pupil (herpetic dendritic keratitis).
Other symptoms of the post-primary form of the disease:
- uncontrolled lacrimation ;
- fear of bright light;
- redness of proteins;
- sensation of the presence of a foreign object in the eye;
- blepharospasm;
- deterioration of acuity or blurred vision;
- pain syndrome;
- rash on the skin of the eyelids and mucous eyes;
- acute purulent conjunctivitis;
- an increase in the proximal lymph nodes (behind the ears, under the jaw);
- cataract;
- uveitis ;
- secondary glaucoma;
- suppuration inside the eye.
Herpetic keratitis - diagnosis
To confirm the suspicion of the described disease ophthalmologists often have enough and the presence of specific symptoms. Additional studies are required if complicated keratitis of the eye is suspected or whether a strain of the herpes virus should be elucidated. The following methods are used for diagnostics:
- biomicroscopy of the cornea;
- sensitivity test;
- keratometry;
- linked immunosorbent assay;
- pachymetry;
- examination of scraping;
- polymerase chain reaction;
- corneal biopsy;
- confocal intravital microscopy;
- measurement of intraocular pressure.
Herpetic keratitis - treatment
The therapy of the pathology under consideration depends on its shape. The primary epithelial type of the disease is provoked by a living virus, so in this case it is advisable to use anti-herpetic medications. The rest of the disease is a negative immune response. To stop it requires a comprehensive approach with an intense anti-inflammatory effect.
It is worse to treat chronic complicated herpetic keratitis of the eye - treatment in such situations may involve even surgical intervention. In most cases, the operation is limited to a quick and simple outpatient procedure. With deep damage to the cornea and progressive scarring of tissues, a through transplant is recommended.
The drug with herpetic keratitis
The basis of treatment of the described disease are systemic and local (drops, ointments) immunomodulators and antiviral medicines:
- Acyclovir ;
- Trifluridine;
- Ganciclovir;
- Idoxiouridine;
- Reaferon;
- Zovirax;
- Interferon;
- Virolex and others.
Corticosteroid hormone drugs are prescribed if a complicated progressive herpetic keratitis is found - Combinil, Dexamethasone and analogues. Additionally recommended:
- vitamins, especially group B;
- antiseptics;
- immunostimulants ;
- antibiotics;
- non-steroidal anti-inflammatory drugs;
- antihistamine medicines;
- mydriatica;
- reparative drugs.
Herpetic keratitis - treatment with folk remedies
Independent therapy, especially in alternative ways, is extremely dangerous, therefore ophthalmologists forbid the use of any prescription of alternative medicine. Rarely can a doctor allow some folk remedies as an auxiliary treatment, but only if uncomplicated superficial herpetic keratitis is detected. Manipulation should be carried out under the strict supervision of the doctor and with his permission.
Folk remedy for keratitis
Ingredients:
- lower fleshy leaves of aloe (over 3 years old) - 2 pcs .;
- mummy - 1 grain the size of a grain of wheat;
- sea buckthorn oil - 30-40 ml.
Preparation, use :
- Leave the plant cut, wash and put in the refrigerator for 8 days, pre-wrapped in parchment paper.
- After this time, squeeze out the juice from the raw material and filter it.
- The resulting liquid is mixed with the mummy in a glass container.
- For 2 months to instill the eyes with this mixture - 1 drop 1 time per day.
- From the 9th week of therapy, use pure aloe juice.
- In the presence of pain and photophobia, bury the sea buckthorn oil in the eyes (1 drop every hour).
Recurrences of herpetic keratitis - treatment regimen
The virus that provokes the presented disease is in the body constantly, with the deterioration of the functions of immunity, it is activated. Herpetic recurrent keratitis is hard to treat, so you can not exercise it yourself. The fight against infections is carried out in 2 stages, which are developed by the ophthalmologist individually for each patient in accordance with the severity of the inflammation and the depth of the cornea lesion.
Treatment of herpetic keratitis during exacerbation includes the use of the following medicines:
- antiviral;
- antibiotics;
- reparative drugs;
- immunosuppressors (corticosteroids);
- replacements of tear fluid.
Throughout therapy, a doctor can change medications to prevent adaptation of the infection to the drugs used. After 3 months, the entire course will have to be repeated, even if the symptoms of keratitis are absent. This is necessary to prevent subsequent relapses. Supportive treatment in the form of the use of vitamins and artificial tears is prescribed for a long time, not less than 1 year.
What is dangerous keratitis?
Constant exacerbations and incorrect therapy provoke the progression of infectious inflammation and damage to the cornea. With superficial and mild forms of pathology, this leads to minor concomitant problems that do not affect the functions of the eyes. Danger is complicated, deep keratitis, herpetic keratitis, the consequences of which can become irreversible:
- decreased quality of vision;
- the throat;
- formation of maculae and scarring ulcers on the cornea;
- glaucoma.