Clear blisters of varying sizes on the cornea

Introduction The disease caused by bullous keratopathy is characterized by the loss of luster of the corneal epithelium, and the presence of transparent blisters of varying sizes, which can recur after rupture. The state in which blisters are formed in the corneal epithelial layer is called bllous keratopathy. It used to be called macrobubble keratitis. In fact, it is not an inflammation, but a denaturation, which is the result of the abnormality of the layer, especially the endothelium, and the storage of water in the epithelial layer. Caused by abnormal or disrupted corneal endothelial cells. The number of normal corneal endothelial cells is about 3,000/mm2, which may occur when it is reduced to 500-1000/mm2. After cataract surgery, ocular trauma, advanced glaucoma, severe uveitis, Fuch's corneal dystrophy, corneal transplantation failure, etc. may cause corneal endothelial cell destruction and reduction, leading to macrofocal keratopathy.

Cause

1. There are crystal macrofocal keratopathy such as glaucoma absolute phase, late uveitis, Fuchs corneal dystrophy, and anterior iris adhesion after penetrating keratoplasty.

2. Aphagalic bullous keratopathy (abhalicbullouskeratopathy, ABK) after cataract surgery, glass contact cornea, intraoperative mechanical damage, chemical damage (saline, BSS).

3. The early factors of artificial phagocytic keratopathy (PBK) are mainly corneal endothelium damage caused by surgery itself, secondary glaucoma after surgery, and direct mechanical damage of endothelial cells by intraocular lens. The late factors are mainly chronic low-grade iritis caused by human exposure to the iris (co-occurrence rate is 1% to 10% in anterior chamber and iris fixation, and posterior chamber is less than 1%) and corneal endothelial injury caused by aging. .

an examination

Related inspection

Corneal examination

Corneal epithelial edema, loss of luster, which has one or several large bubble bulges (mostly a few millimeters), the bubble is filled with a slightly turbid liquid, due to the friction between the eye and the eyelids, the large bubble can be broken. At this time, due to corneal nerve exposure, the patient has severe irritation such as pain, shame, and tearing. The ruptured vesicles form epithelial defects or coils, and the large vesicles can recur, repeatedly rupture, and eventually end up with the formation of degenerated vasospasm.

1. Occurs in the eyeballs of glaucoma, iridocyclitis, internal eye surgery, and blindness after chemical injury.

2, there are foreign body sensation, tingling and other symptoms, long-lasting.

3, the corneal epithelium tarnish, there are transparent blisters of varying sizes, can relapse after rupture.

Differential diagnosis

1. Occurs in the eyeballs of glaucoma, iridocyclitis, internal eye surgery, and blindness after chemical injury.

2. There are symptoms such as foreign body sensation and tingling, and it will last forever.

3. The corneal epithelium is tarnished and has transparent blisters of varying sizes, which can recur after rupture.

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