Hard, flat nipples in the tarsal conjunctiva

Introduction Due to the clinical manifestations of catarrhal conjunctivitis disease in spring, the conjunctival hyperemia is very dramatic at the beginning, followed by many hard and flat nipples in the upper conjunctiva, which vary in size and are covered with conjunctiva. The oval stone. The crack between the nipples is light blue, and the surface of the nipple presents a milky turbidity. There are not many secretions, it is very sticky, and it is drawn into a filament. For smear examination, it can be seen that eosinophils increase. If there is a lesion in the conjunctiva of the lower jaw, the nipple is small and small, and it is not as prominent as the conjunctiva. Spring vernal conjunctivitis is an allergic disease with a strong seasonality and often invades both eyes. Whenever the spring blossoms, the symptoms disappear and the symptoms disappear when the cold is late in the autumn. Recurrence every year, mild cases will not be issued after 3 to 4 years, severe cases can continue to relapse for more than 10 years. The disease is characterized by itchy eyes, large and flat nipples and conjunctival hyperplasia near the limbus, and a large number of eosinophils in the secretion.

Cause

The cause of the disease may be caused by an allergic reaction to free pollen or other substances in the air. The disease is more common in children and young people, more men, no contagious.

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Diagnosis is based on clinical symptoms.

The unbearable itching of the eyes is the most prominent symptom of the disease. At the same time, it can also have a burning sensation. It is even worse when it is hot or after blinking. It has mild photophobia, tearing, and a lot of secretions, but it is characterized by sticky silk. shape. In the spring, conjunctivitis is clinically divided into sacral conjunctiva, limbal and mixed type.

1, sacral conjunctival type. The lesion is characterized by conjunctival conjunctiva and does not invade the iliac crest. The lower conjunctiva is often invaded or has only mild lesions. At the beginning, the conjunctival hyperemia is very dramatic, followed by a lot of hard and flat nipples in the upper conjunctiva, which vary in size and are covered with conjunctiva, like paving pebbles (Fig. 1). The crack between the nipples is light blue, and the surface of the nipple presents a milky turbidity. There are not many secretions, it is very sticky, and it is drawn into a filament. For smear examination, it can be seen that eosinophils increase. If there is a lesion in the conjunctiva of the lower jaw, the nipple is small and small, and it is not as prominent as the conjunctiva. There are many hard and flat nipples on the upper conjunctiva, which vary in size and are covered with sacral conjunctiva.

2, the limbal type. Corresponding to the corneal edge of the cleft palate, or at the upper limbus, one or more yellow-gray gel-like bulging nodules are visible, and the conjunctival hyperemia is corresponding. These gels can be joined to each other, even completely around the limbus. The bulbar conjunctiva is often stained brown. Fine vasospasm and superficial epithelial keratitis are common in both the conjunctival and limbal types.

3, mixed type. If the above two types exist at the same time, they are mixed.

Differential diagnosis

The huge nipple of the palpebral conjunctiva: The nipple hyperplasia of the palpebral conjunctiva caused by diseases such as keratoconjunctivitis in spring, which is the giant nipple of the conjunctiva, is one of the clinical manifestations of spring conjunctivitis. Spring keratoconjunctivitis, also known as spring catarrhal conjunctivitis, seasonal conjunctivitis. Pre-puberty onset, lasts 5-10 years, mostly for both eyes, the incidence of boys is higher than girls. The disease has a high incidence in the Middle East and Africa, low incidence in temperate regions, and almost no cases in cold regions. The incidence rate in spring and summer is higher than that in autumn and winter. The more accurate name for vernal conjunctivitis is vernal keratoconjunctivitis (VKC), a bilateral chronic external eye disease in which atopic individuals can respond to antigens prevalent in the environment. The main atopic diseases include eczema, asthma and urticaria. VKC mainly affects children and young adults, and is most common in spring, so it is called "spring" conjunctivitis. The affected patients are mainly characterized by external eye diseases, and the main symptoms are itching, tearing, shame and sticky secretions. The disease is "self-limiting." Currently available drugs have topical glucocorticoids and mast cell stabilizers. Spring keratitis is a recurrent conjunctivitis that is often affected by both eyes and can damage the corneal surface. The disease is usually caused by an allergic reaction, so it is more common in spring and summer. Spring conjunctivitis is mainly seen in children. It usually begins to develop in puberty and heals itself before the age of 20.

The sputum conjunctiva appears as an off-white membrane: the appearance of an off-white film on the palpebral conjunctiva can be seen in various types of conjunctivitis, usually caused by infectious factors. Due to leakage and bleeding of the new blood vessels, scars are finally formed, forming a permanent mechanical film.

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