Corneal erosion

Introduction Corneal erosion is a symptom of superficial punctate keratopathy. Superficial punctate keratopathy is a general term for three types of lesions of the corneal epithelium: punctate epithelial keratitis, punctate epithelial erosions, and punctate subcutaneous infiltration (punctate). Subepithalial infiltrates), they often exist at the same time, but the weight and extent of the lesion are biased and different. It is often caused by bacterial or viral infections, followed by mechanical stimulation or frequent eye irritation or UV stimulation to cause corneal epithelial erosion and inflammation.

Cause

1, bacterial infection: in a variety of bacterial conjunctivitis or blepharitis, often combined with corneal epithelial erosion and point-like epidermitis and multi-membrane edge subepithelial infiltration, these lesions are sometimes scattered on the cornea, sometimes Diffuse distribution on the whole cornea, especially in the peripheral part of the cornea.

2, viral infection: in the early stages of various viral conjunctivitis, often lead to corneal epithelial erosion.

3, frequent eye drops or UV stimulation can cause corneal epithelial erosion and inflammation.

4, mechanical stimulation, can cause epithelial abrasions, trichiasis and malnutrition can lead to epithelial erosion and inflammation.

5, other eye diseases, such as dry keratitis, spring conjunctivitis, drug allergy can cause damage to the corneal epithelium.

an examination

Related inspection

Corneal examination ophthalmoscopy

Conscious symptoms

Photophobia, tingling, sour grinding, blurred vision or fog.

Sign symptoms

The corneal epithelium is limited in roughness or abrasion, and fluorescein staining shows the boundary of the lesion; corneal epithelial changes can be absorbed within a few hours after the lesion occurs, and the patient may have no positive signs when examined. The corneal epithelium of both eyes tends to be punctate or small cystic, fingerprints, and map-like changes.

Differential diagnosis

1, punctate epithelial keratitis: according to its different causes and signs vary.

(1) simple catarrhal keratitis: more common in the elderly. A needle-like gray-white infiltration along the limbus, or a pale yellow bead-like infiltration, can further develop a crescent-shaped shallow ulcer with parallel limbus.

(2) viral punctate keratitis: due to viral infection of the corneal epithelial layer or subcutaneous epithelial opacity infiltration, adenovirus is more common, such as adenovirus type 8 caused by epidemic keratoconjunctivitis, epidemic bleeding caused by enterovirus Conjunctivitis often causes monocular or binocular involvement. The bulbar conjunctiva is mixed hyperemia and mild edema. After 1 to 2 weeks, after the conjunctivitis subsides, it can cause inflammation and infiltration in the corneal epithelium and epithelium in the pupil area, and the dots are small gray dots or The punctate star-shaped line is turbid, and the fluorescein dyeing can be colored. After 2 to 3 days, these point-like infiltrates become flat, and soon become dendritic or map-like infiltration and merge into a mass.

(3) Surface punctate keratitis: manifested as inflammation of the corneal epithelial tip of both eyes, but no epithelial infiltration, which is light and heavy, and can last for several months. Under the high-fissure microscopy microscope, the point-like coloration was oval, slightly higher than the epithelial surface, and the keratitis did not leave scar after healing.

2, the following infiltration on the dot

(1) Trachomatous subepithelial invasive keratitis: at the end of the trachoma vasospasm above the cornea, there is a thick, superficial stromal ulcer, which often leaves thin or plaque after healing.

(2) money keratitis: in the epithelium of the corneal pupil area, such as coin-like infiltration, the size varies. Slit lamp examination, the infiltration is mostly in the superficial stromal layer, and often scars after healing.

3, punctate epithelial erosion

(1) Single or multiple punctate epithelial defects, the defect area is transparent, and the corneal epithelial edema around it is not easy to find under the direct sulcus, and the eye has repeated attacks, often with eyelids and ciliary congestion.

(2) In the early cases of superficial corneal dystrophy after traumatic or chemical debridement, periodic punctate epithelial erosion often occurs. After these defects are repaired, the epithelium often has fingerprints or vortex turbidity.

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