Foreign body sensation in the eye

Introduction A foreign body sensation in the eye refers to an eye discomfort caused by various factors and a feeling of foreign matter. Mainly seen in chronic conjunctivitis. The concept of foreign body in the eye is very broad, there is no proliferative mass, abnormal blood vessel problems, retinal lesions, and inflammation caused by foreign matter entering the eye. See the dialectical look. Pay attention to problems caused by diseases such as trichiasis, chronic dacryocystitis, obstruction of lacrimal passage, and sputum edge.

Cause

The cause of foreign body sensation in the eye:

The main causes are infection factors, such as bacteria, Chlamydia trachomatis, viruses and other microorganisms, acute onset of chronic conjunctivitis. Non-infectious factors have adverse environmental stimuli, such as dust, sand, smoke, glare, harmful gases, etc.; eye irritation, such as trichiasis, chronic dacryocystitis, lacrimal duct obstruction, sacral light, refractive error, hidden Strabismus, etc.; bad habits, such as lack of sleep, excessive alcohol and tobacco; in addition, long-term application of certain eye drops, chronic allergic rhinitis can cause.

an examination

Related inspection

Ultrasound examination of eyeballs and eyelids by ophthalmoscopy

Examination and diagnosis of foreign body sensation in the eye:

CT examination of the eye and temporal area: CT examination of the eye and temporal area is a method of examining the eye and the temporal area by CT.

The CT scan provides a high-resolution, cut-off image and gray-scale eye image that displays the human-level image with X-rays as an energy source. At present, CT has become very popular, providing a superior examination method for the diagnosis of ophthalmic diseases. However, for various reasons, there are still many problems in CT analysis and diagnosis of ocular lesions. Diagnostic ultrasound for intraocular disease is superior to CT, and CT is superior to ultrasound in the diagnosis of orbital lesions. This article discusses some of the problems in CT diagnosis of orbital lesions, and introduces the basic knowledge of CT related to diagnosis, which is very important for comprehensive analysis of ocular CT films.

I. Eye CT scanning method:

1. Transverse scan: The patient is placed on the supine examination bed for continuous scanning from the top side of the 1cm skull below the ear line. The level of the 5mm thick layer of the straight axis requires 6-8 layers. For thin layer scanning (1 mm layer thickness), nearly 40 layers are required for all eyelids.

2. Coronal scan: The patient is supine or prone on the examination table, the head is over-extended, so that the sagittal line of the head is consistent with the bed surface. The ear lines on both sides are perpendicular to the scanning baseline, and the front ear canal is continuously scanned 4 cm in front of the ear canal. ~5mm). For CT scan of intraocular lesions, the eyeball begins to scan backwards.

3. Contrast enhancement method: The method of intravenous administration of contrast agent is to inject the contrast agent within a few minutes, and then start scanning after the full amount of injection is completed.

4. Pressing neck examination: When the internal CT scan of the internal iliac vein is not developed, or only a small part of the lesion is displayed, it is feasible to observe the whole range of the lesion and the neck pressure examination. Wrap the sphygmomanometer bag around the patient's neck, position it, pressurize it to 5.33 kPa (higher than the venous pressure), and then scan it. The balloon will be relaxed immediately after the scan.

5. Optic nerve and optic nerve scanning methods: Sometimes for detailed observation of optic neuropathy (tumor, trauma and other lesions), special CT examination is needed. First, a 1mm thin layer is needed, because the normal optic nerve is about 4mm thick, and the thicker layer is not conducive to analysis. The second special scanning angle is to make a scan line with a negative 15° to the ear line, and then let the patient's eye look upwards. At this time, the optic nerve is straight and parallel with the scan line. CT can observe the optic nerve on one level. The length of the inner section or even the inner section of the tube.

2. CT scan thickness of the eye:

The thickness of the conventional ocular CT scan is 5 mm, and the normal height of the normal eyelid is about 40 mm. Therefore, the general horizontal scanning of 8 layers can include all the intraocular structures. The lesion in the iliac crest is large in size and is suitable for a scanning surface of 5 mm thickness. However, in some special cases or lesions requiring thinner thickness scanning, such as intrabulbar lesions, extraocular muscle lesions, optic neuropathy, or estimated lesion diameter less than 5mm, 3mm or 1mm layer thickness scan is required, otherwise the thickness is thick. Small, and only one level shows lesions, which is not conducive to diagnosis and analysis, and may even miss the display of lesions. Since the thin section is less affected by the volume average, the image resolution is improved, and the lesion is more clearly displayed.

Intraocular pressure: a method of detecting glaucoma.

Ophthalmoscopy: Fundus examination should be performed in a dark room. The patient takes a seat and the doctor can take a seat or stand. The right hand held ophthalmoscope is located on the right side of the patient.

Differential diagnosis

Symptoms of foreign body sensation in the eye:

Visible cysts in the vitreous: patients with vitreous porcine cysticercosis, the vitreous is turbid to varying degrees, translucent light gray or light blue spherical capsules are visible in the vitreous, and the center often has a grayish white or yellowish white circular spot. The head of the cystic sac is sometimes seen to squirm in the vitreous. Fundus examination: visible yellow-white translucent round vesicles in the vitreous, about 2 ~ 6PD. There is a golden yellow reflective circle around it, and a bright white spotted head is visible in the vesicle. When the light is illuminated, it can cause the head to telescopically move, and sometimes the suction cup can be seen in the telescopic head. Due to the vitreous opacity, it is not easy to see the typical morphology of cysticercosis, and complications such as retinal detachment may also occur. The sacral granuloma is also called meibomian gland cyst, and the traditional Chinese medicine is called cytoplasmic nucleus. It is a chronic inflammatory mass formed by obstruction of the drainage duct of the meibomian gland and retention of glandular secretions in the tarsal plate. The disease is more common in children and adolescents, without major pain, does not affect vision, has a tendency to self-heal, and has a good prognosis.

Abnormal flash in front of eyes, increased black spots: pathological floaters are generally caused by serious diseases, which are caused by changes in the structure of the omentum, optic nerve, ciliary body and other structures near the vitreous. Feature 1 has an unusual flash. 2 The number of flying mosquitoes has increased continuously in a short time. 3 line of sight has a feeling of being blocked.

Swelling lens cortical granules in the anterior chamber: granule glaucoma, with a history of cataract surgery or a deep anterior chamber with a crystalline in vitro injury, the angle of the anterior chamber is still open, the aqueous humor is evident, and the anterior chamber contains a large amount of swelling. It also contains a small amount of large macrophages and small white blood cells, showing the adhesion around the iris.

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