What does persistent clouding of the cornea mean? Clouding of the cornea of ​​the eye of the vitreous body of the lens

Despite the age of the process, in the presence of residual inflammatory infiltration in the area of ​​the walleye or around it, local anti-inflammatory and resolving treatment is carried out. Of the nonspecific anti-inflammatory drugs, corticosteroids are used in the form eye drops: 1% cortisone suspension, 1% hydrocortisone suspension, 0.3% prednisolone solution, 0.1% dexamethasone solution, dexamethasone oftan 3-4 times a day. For the same purpose, instillations of a 2% solution of amidopyrine are prescribed. Ointments containing corticosteroids are also used - 0.5% hydrocortisone, 0.5% prednisolone 2-3 times a day. Of absorbable agents, instillations of 1-2% solutions of ethylmorphine hydrochloride are used. Every 2-3 weeks the concentration of solutions is gradually increased to 6-8%. Apply 1-2% ointment of ethyl morphine hydrochloride. Courses of treatment are usually repeated. Priscol, divascol, pridazol, tolazoline are also prescribed in the form of installations of a 10% solution and 10% eye ointment. Priskol is a vasodilator local action improves blood circulation in the anterior part of the eye.

Ethylmorphine hydrochloride is also used in the form of subconjunctival injections: a 2% solution is administered in 0.2-0.3-0.4-0.5 ml every other day. Locally prescribed instillations of a 3% solution of potassium iodide or sodium iodide, 0.1% solution of lidase, the introduction of 1-2% yellow mercury ointment into the conjunctival sac. For resorption of corneal opacities, collalisin (a proteolytic enzyme) is also used, which is injected under the conjunctiva. eyeball at a dose of 10 KE in 0.2 ml of 0.5% novocaine solution. The course of treatment is 7-10 injections.

Before treatment with collalisin, it is necessary to check the patient's sensitivity to the drug, for which 1 KE is first injected under the conjunctiva. With absence allergic reaction within 48 hours, treatment is carried out with the above doses.

When corneal opacities are formed, for more gentle scarring, electrophoresis with hydrocortisone (0.1% solution) for 15 minutes or phonophoresis with 0.5% hydrocortisone solution (5 minutes) daily is prescribed, 15 procedures per course. For resorption of corneal opacities, ultrasound is used at an intensity of 0.1-0.2 W / cm2 daily or every other day, a total of 15 procedures; electrophoresis with lidase through a bath electrode (32 units per procedure) every other day, per course - 15 procedures; vitreous electrophoresis (ampoule solution), 3% potassium iodide solution, aloe (ampoule solution). Electrophoresis and phonophoresis of collalizin are also used (50 KE per 10 ml of distilled water). The duration of electrophoresis - 10 minutes, phonophoresis - 5 minutes. The course of treatment - 10 procedures. Treatment courses are repeated after 1.5-2 months. With repeated courses of electrophoresis, it is advisable to change the drugs.

As a resolving agent, 1-2 ml of oxygen is injected under the conjunctiva of the lower transitional fold. The procedure is repeated after 1-2 days, 10-20 injections per course. From common funds that promote the resorption of corneal opacities, biogenic stimulants are used (liquid aloe extract, FiBS, peloid distillate for injection, vitreous body, peat, etc.) in the form of subcutaneous injections of 1 ml, 30 injections per course. Peat is also administered under the conjunctiva, 0.2 ml every other day, in total 15-20 injections. Intramuscularly, lidase injections are prescribed at 1 ml (64 units) every other day, 10-15 injections per course. Treatment courses are repeated 2-3 times a year. In case of clouding of the cornea due to a specific process (tuberculosis, syphilis, etc.), vigorous treatment of the underlying disease is necessary. With the development of secondary glaucoma - instillation of 1-2% solution of pilocarpine hydrochloride, 0.25-0.5% solution of optimol, inside diacarb 0.125-0.25 g 2 times a day.

Treatment of patients with rough thorns is ineffective. With appropriate indications, surgical intervention is performed.

B.I. Morozov, A.A. Yakovlev

- This is one of the most ancient and common eye diseases. It was mentioned in their works by medieval doctors, including the legendary Avicenna. In our time, people, unfortunately, suffer from the disease almost as often as in the Middle Ages. Only now this disease is called differently. Its medical name is clouding of the cornea of ​​the eye. Initially, this disease is not very dangerous and causes nothing but discomfort and partial deterioration of vision. But if it is not cured in time, then complications can be very serious, up to complete loss of vision in one eye.

What are corneal opacities?

This disease is divided into 3 types depending on the size and intensity of turbidity. It is interesting that earlier all species were called thorns, but now only one of them. So here are the categories.

A thorn in the eye of a man

1. cloud. This is the name of a small limited grayish opacity, which is not easy to see with the naked eye. Such clouds are most often located closer to the center of the cornea, but because of their small size, they do not significantly affect a person's ability to see.
2. Spot. So it is customary to call limited opacities of a higher intensity than cloud ones. They are both in the center and on the periphery of the eye. Due to its high intensity, this type of clouding seriously affects the ability to see.
3. Belmo. This is the most serious type of disease. Such persistent opacity usually appears during scarring and can occupy both part of the cornea and its entirety. Belmo is the only type of ailment that can cover the entire eye.

Causes of corneal opacities

This disease has a whole list possible causes. These include inflammatory and infectious diseases of the eyes, injuries, as well as serious shortcomings in the hygiene of the visual organs. Full list possible reasons are:

• (shown in the photo);

• infections (most often - conjunctivitis);
• herpes affecting the surface of the eyes;
• injuries of the organs of vision (chemical, mechanical, as well as caused by various foreign objects);
• complications after surgical operations on sight;
• complications of certain diseases (syphilis, measles, and tuberculosis);
• lack of vitamin A in the body;
• errors when working with lenses (sleep in lenses, care for them not according to instructions);
• getting dirt on the surface of the eyes and its long stay there.

Important! Blurring may occur without visible reasons. This is very rare, but it does happen sometimes. Therefore, even if there were no visible reasons for the onset of the disease, if vision deteriorates, you should immediately go to the doctor.

Symptoms

The disease is easy to identify by the following symptoms:

• a cloudy spot that interferes with the ability to see normally (however, a cloud may not be noticed during a visual inspection - an example is in the photo);
• a significant deterioration in vision in the affected eye, and sometimes its complete loss;
• reddened whites;
• increased fear of light;
• tearing;
• an unpleasant feeling as if a foreign object had got into the eye;
• increasing discomfort when blinking.

Important! Ophthalmologists say that the presence of one symptom is already a sufficient reason to go to the clinic. If there are 2 or more symptoms, you should consult a doctor as soon as possible.

Possible Complications

If the treatment of corneal opacity is not started in time, then several complications may occur:

• increased discomfort in the eye;
• appearance pain, aggravated by blinking;
• a serious deterioration in vision, much more significant than at the beginning of the disease;
• complete loss of vision in the affected eye.

To avoid irreparable complications, treatment should be started in a timely manner - as soon as the disease has made itself felt.

How is the disease diagnosed?

There are several generally accepted methods for diagnosing corneal opacity.

All diagnostic procedures are absolutely painless and do not cause discomfort. Therefore, there is absolutely no need to be afraid of diagnostics. Compared to the discomfort of clouding, the diagnosis will seem even pleasant.

Types of treatment

By contacting an ophthalmologist in a timely manner, the disease can be effectively cured. The treatment process can be divided into 2 categories:

• the use of medicines;
• surgery.

This table compares both treatments. In short, the operation will be needed only in advanced cases, when the patient came to the doctor too late or when the medicines did not help.

If the patient needs surgery, then medication should not be abandoned either. Preparations provide the organs of vision with the necessary support, contribute to rapid healing after surgery and reduce the risk of postoperative complications.

Important! You need to be very careful with your eyes, so self-medication with folk remedies is not best idea. They can be used, but only in combination with traditional medicine as adjunctive therapy. You should also make sure that the selected prescriptions do not conflict with the drugs prescribed by the doctor.

Medical treatment

It is always possible to treat corneal clouding with medicines (except when there is an allergy to drugs). But such treatment is self-sufficient only for early stages illness. On the late stage medicines must be combined with surgery, otherwise a complete cure cannot be achieved.

The most common and effective types medical treatment are.

1. To eliminate the symptoms of the disease and relieve inflammation, use eye drops and eye ointments. Most effective drugs those that contain corticosteroids. Examples of such drugs are Defislez, Korneregel.
2. With thorns, scarring of the cornea is almost inevitable. To get rid of scars, the patient is given injections of potassium iodide, a little less often - ethylmorphine hydrochloride. Also, drugs with proteolytic enzymes are sometimes injected. Often biogenic stimulants are administered. All this is aimed at resorption of scars.
3. Often, vasodilators are used, as improved blood circulation contributes to a quick recovery.
4. Many ophthalmologists combine medications hormonal drugs, as well as with natural products(for example, with aloe extract). The combination of such means with physiotherapy - electrophoresis, phonophoresis is especially effective.

Important! Self-medication is strictly not recommended. The maximum that you can afford is an ointment with corticosteroids, and then only in case you can’t urgently see a doctor.

Surgical intervention

If the doctor recommends surgery, you should not refuse. Under anesthesia, the procedure will be painless, it will take a little time. Of course, then you will have to lie in the hospital with a bandage over your eyes for some time, but the result of the difficulties you have endured will be complete cure from illness and good eyesight.

There are 2 types of surgery:

• keratoplasty (pictured);
• operation using a laser.

Keratoplasty refers to the transplantation of tissues - the donor cornea. This organ takes root well, because it does not have independent vessels. Antibodies capable of rejecting foreign tissues (a common problem in transplanting, say, a kidney) simply do not pass through the cornea. This allows surgical intervention be successful almost 100% of the time.

Concerning laser surgery, then with the help of a laser, the surgeon removes the affected area from the cornea. This method is used for a small lesion that can be repaired without an organ transplant. Accordingly, at big spots and belmakh already keratoplasty is necessary.

Important! Sometimes there are contraindications to surgery. They may be associated with the age of the patient or with some special diseases. In such cases, it remains only to wear contact lenses for cosmetic correction of turbidity and use medications to prevent the disease from progressing.

ethnoscience

Apart from traditional treatment, one should not forget about folk remedies. They can also be quite effective, especially when combined with drug treatment. Here are some good, time-tested recipes.

Important! Any folk methods treatment should be discussed with an ophthalmologist before proceeding with their use. Self-medication can be fraught with aggravation of the disease, burns of the cornea of ​​​​the eye, and allergies.

Prognosis for treatment

The prognosis for the treatment of this disease differs, based on its stage, the age and health of the patient, as well as the cause of the disease.

1. Small opacities somewhere on the periphery that do not interfere with vision do not require serious treatment. All they need is therapy and regular medical supervision.
2. Large walleyes provoked various diseases(not "eye"), do not need surgical treatment if their root cause has been eliminated. If a person is cured of a disease, then ordinary medicines will help him remove the thorn.
3. Surgical intervention is required at advanced stages of the disease, as well as if the patient has an allergy or intolerance medical preparations. As mentioned above, the transplanted cornea easily takes root, and therefore the prognosis of such treatment is very positive.
4. The least favorable prognosis is for cataracts resulting from burns and serious injuries. If the eye was affected very badly, then it is unlikely that it will be possible to restore vision to 100%, and treatment will be reduced to minimizing the consequences and symptoms.

Video - Corneal dystrophy. Eyesore

Important! In any situation, for any cause of turbidity, treatment will be much more successful if it is started immediately, without delaying a day after the disease has been discovered.

How to take care of your eyes? Prevention of corneal clouding

Preventive measures aimed at avoiding clouding of the cornea will be a good prevention for other "eye" ailments. These measures include:

• protection from direct sunlight into the eyes;
• UV protection;

• protective equipment for professional activities (glasses, mask, etc.) is an indispensable tool for any chemist, woodcarver, welder and representatives of many other professions;
• exercises (especially necessary for those who spend a lot of time behind a monitor or books);
• regular visits to the doctor (at least once every 6 months);
• the use of foods that improve vision (everyone knows blueberries and carrots, as well as foods with vitamin A).

Foods that are good for your eyesight

If a person wears contact lenses, then he should not forget to remove the lenses at night, change them at least as often as indicated in the instructions, and wash them only with a special solution, without the use of improvised means.

Conclusion

Clouding of the cornea of ​​​​the eye is a very serious visual pathology. It can be cured without consequences only with a timely visit to the doctor. If you let things take their course and turn to a doctor too late, visual impairment can remain with a person for life.

Careful attitude towards one's own eyes, the use of protective equipment and personal hygiene is effective prevention clouding of the cornea. If you regularly visit a doctor and take care of visual organs, then there will be no talk of any clouding, as well as other eye diseases.

Video - Treatment of walleye (clouding of the cornea of ​​the eye)

It is formed under the influence of various factors: trauma, burn, viral or other infection, surgery or cornea. The risk of developing diseases of the organ of vision, which can lead to clouding of the cornea, increases with prolonged wear. It is worth remembering that the likelihood that the cornea of ​​the eye will sooner or later become cloudy increases with the use of lenses for permanent wear, which do not need to be removed before going to bed.

Types of corneal opacities

• A cloud is a limited haze gray color, which is barely visible on examination. If such opacities are located in the central zone of the cornea (in the projection zone of the macula), then they can somewhat reduce visual acuity.
• The spots are persistent limited opacities that are quite intensely colored. They can be located either in the center of the cornea or on its periphery. Turbidities located in central departments cornea, can significantly affect visual acuity.
• Due to cicatricial changes, persistent opacities of the cornea are formed, which are called thorns. They can occupy part of the cornea or all of it.

Symptoms of corneal clouding

When the cornea is damaged, the following symptoms of the disease may appear:

• eye;

Corneal opacity in most cases can be seen with the naked eye. An eyesore is always colored in White color. It either remains a local scar, or the cornea becomes completely cloudy. Visual impairment depends on the area of ​​the wound surface of the cornea. Such changes can be located either in the center of the eye or on its periphery. They contribute to the distortion of vision and development. With damage to the central (optical) part of the cornea, vision suffers more.

Opacities consist of remnants of inflammatory infiltration, as well as elements of degeneration and dystrophy of corneal tissues. As a result of their scarring, a thorn is formed. The turbidity is usually white or gray in color and has a shiny, dense surface. When it is vascularized, they speak of a vascular walleye. With a central location of a dense walleye, vision is reduced to light perception.

A rough scar with subsequent formation of a walleye develops after corneal ulcers, accompanied by perforation. It is sometimes spliced ​​with (spliced ​​walleye). Such a thorn is the cause of the secondary. Due to the increase in intraocular pressure, the thorn is stretched and thinner. It takes the form of a staphyloma of the cornea and is called "ectatic cataract".

Treatment

Local absorbable and anti-inflammatory therapy is prescribed, regardless of how long the thorn began to develop and how long the process is. For this purpose, patients are prescribed eye drops with glucocorticoids (cortisone, hydrocortisone or dexamethasone) or eye ointments with hydrocortisone or prednisolone.

In order to better dissolve the scars, instillations of 1-2% solution of ethylmorphine hydrochloride are prescribed. This drug can also be administered under the conjunctiva by injection. Do one injection of a 2% solution every other day. Also prescribe eye drops with potassium iodide and instillations of lidase solution.

In the conjunctival sac lay 1-2% yellow mercury ointment. Proteolytic enzymes, which are administered under the conjunctiva of the eye, also contribute to the resorption of corneal opacities. 10 injections are prescribed for one course of treatment.

If cicatricial opacities have formed, then electrophoresis with hydrocortisone will help to make them less rough. Also, electrophoresis with the vitreous body, ultrasound and electrophoresis with lidase, aloe or potassium iodide solution are used to resolve opacities. The course of treatment should be carried out with a two-month break. Medicines for electrophoresis each time it is advisable to change.

For resorption of corneal opacities in the form of subcutaneous injections, biogenic stimulants are used (liquid aloe extract, FiBS, Peat, Peloid distillate for injection, and other drugs). If corneal clouding occurs due to a specific process (tuberculosis, syphilis), there is a need for adequate treatment of the underlying disease. When secondary glaucoma develops, instillations of timolol or pilocarpine solutions are prescribed, and diuretics (Diacarb) are administered orally.

Conservative therapy of patients who have rough thorns is ineffective. They are shown surgical intervention. Perform either through, during which a part of the cornea is removed to the full depth and the donor cornea is transplanted along with the endothelium, or a transplant, in which only the inner layer of the cornea is replaced, in which the endothelium is preserved.

In the presence of clouding of the cornea, time should not be wasted. It is necessary to contact competent ophthalmologists who have experience in treating this pathology. Only timely and adequate treatment can prevent vision loss.

Moscow clinics

Below are the leading ophthalmological clinics in Moscow, where you can undergo the diagnosis and treatment of corneal opacity.

Corneal clouding in ophthalmology is understood as a whole group of specific signs that have a similar etiology and features of manifestation. This is a common disease that develops due to many reasons: eye injuries, infections, as a complication after surgery. After the appearance of typical symptoms, many put off visiting a doctor, attributing everything to fatigue, but timely treatment is an the only way avoid unpleasant and sometimes irreversible complications.

Disease Definition

Clouding 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 changes the retina of the eye, 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 poorly distinguish between objects that are in close proximity. If treatment is not started on time, the disease progresses rapidly.

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

Kinds

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

Until recently, cataracts were often confused with cataracts, since both diseases have similar symptoms. Modern methods diagnostics 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, as well as due to concomitant diseases (diabetes mellitus, rheumatism, retinal detachment). However, there are a number of factors that can cause clouding of the cornea in young people.

Some experts agree that regular can also lead to various pathologies from the cornea, including opacification.

Symptoms

Initially, there are typical signs for many ophthalmic ailments: redness, profuse lacrimation, as well as discomfort when exposed to light. After the active development of pathology, corneal clouding can be detected naked eye. A white or gray tint appears on the cornea, it becomes cloudy. The clouding itself has a characteristic shiny and dense structure, in contrast to cataracts. When forming a walleye, especially a large one, you can notice a small scar on the surface.

Decreased visual acuity does not always occur. It depends on some factors: age, the area of ​​the affected surface and the localization of the disease. When clouding forms in the central and peripheral parts of the cornea, not only a distortion or decrease in vision is observed, but it also develops.

If the pathology is accompanied by increased intraocular pressure, then stretching or thinning of the clouding of the cornea, which is commonly called an exalted thorn, can occur.

Possible Complications

If the progression of the disease is not stopped in time, corneal clouding can subsequently lead to irreversible complications. As a rule, this is a strong decrease in visual acuity, as well as education. At long course diseases, there is a possibility of developing complete blindness. clouding of the cornea caused by bacterial infection, may lead to associated infectious diseases eyes, such as conjunctivitis.

In rare cases, neglected opacification leads to irreversible corneal dystrophy, which is practically untreatable, especially in old age. And with the formation of a walleye in the very center of the cornea, there is a possibility of developing leukoma, in which case early and immediate treatment is required.

Diagnostics

For an accurate diagnosis, it is necessary complex diagnostics, which always starts with a visual inspection of the state structural components visual apparatus. In almost all cases, biomicroscopy is used - an external examination of the eye with a slit lamp. It allows not only to clearly see the focus of turbidity, but also to evaluate its structure.

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

Ultrasound examination of the eye

Features of treatment

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

The greatest difficulty is the treatment of corneal opacity, which is accompanied by comorbidities eyes - glaucoma or cataracts. In this case, select complex treatment aimed at eliminating the primary disease.

Surgical methods

With the development of gross clouding of the cornea, on which there are scars on the surface, and visual acuity is also significantly reduced, the question of surgical treatment illness. AT recent times The most common operation is penetrating corneal transplantation. It consists in removing the parts of the eye damaged by clouding and further transplanting the donor tissue together with the endothelium, or only the inner layer. Although it is by far the most effective surgical method, it has some limitations. For example, transplantation is not possible if the patient has chronic diseases cardiac system, as well as some forms diabetes. 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: rejection bad habits, usage sunglasses on sunny days, observance balanced nutrition and daily routine, as well as the use of personal protective equipment in hazardous work, help reduce the risk of illness.

Timely treatment of eye diseases is of great importance, since corneal clouding tends to develop against the background of some serious ophthalmic diseases.

Video

findings

Corneal clouding is a serious one that tends to progress and recur. If the first symptoms are detected, it is necessary to consult a specialist in time, since the treatment of the disease in the early stages is much more effective. Older people are at risk, because with age, irreversible degenerative processes in the visual apparatus begin, which is why after 60 years it is important to regularly undergo medical examinations to take the necessary action in time.