Corneal detachment

Introduction The cornea can not fall off, the so-called corneal peeling is actually the retinal detachment. Retinal detachment is the separation of the neuroepithelial layer of the retina from the pigment epithelial layer. There is a potential gap between the two layers, and the liquid retained in the gap after separation is called subretinal fluid. According to the cause, it can be divided into rhegmatogenous, traction and exudative retinal detachment.

Cause

The disease is more common in middle-aged or elderly people, most of them have myopia, and both eyes can be followed. The causes of the disease include lattice-like and cystic degeneration in the peripheral part of the retina, vitreous liquefaction and retinal adhesion. These factors are related to age, heredity, trauma and other factors. The traction of the vitreous to the retina is more important in the pathogenesis. Nowadays, the number of young people is increasing, and even the pupils who are under the age of ten have appeared. Most of the causes of the disease are trauma or excessive use of the eye.

an examination

Related inspection

Ophthalmoscopy, ophthalmologic examination, eye function examination, fundus examination

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

Point epithelial keratitis

Signs vary according to their etiology.

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, more common with adenovirus, such as adenovirus type 8 caused by epidemic keratoconjunctivitis, epidemic caused by enterovirus Hemorrhagic 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: the performance of the corneal epithelial needle size inflammation, but no epithelial infiltration, light and heavy, 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.

Infiltrated below

1, trachoma subepithelial invasive keratitis: at the end of the trachoma vasospasm above the cornea, there are thick spots of superficial matrix ulcers, often left with thin or plaque after healing.

2, money keratitis: in the corneal pupil area of the epithelium 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.

Point 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 fingerprint-like or vortex-like turbidity.

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