As you know, there are many diseases of the organ of vision. Eye pathologies are occupied by an ophthalmologist. According to most people, inflammation of the organs of vision is associated with the penetration of infection. However, this is not always the case. Some eye diseases are endogenous in nature. An example is filamentous keratitis. This pathology develops due to the drying of the cornea. Most often, the disease has a chronic course and requires constant eye care.
Keratitis - what is it?
The organ of vision has a complex anatomical structure. The cornea of the eye is a convex shell, which is one of the refractive media. In addition to the fact that this structure of the organ of vision conducts light rays, it has a protective function. The cornea of the eye is a kind of lens, thanks to which a person can see the surrounding objects as needed. In addition, it protects the internal structures of the organ of vision from infection. Inflammation of the cornea is called keratitis. There are several varieties of this disease. The classification of keratitis is based on the etiological factor.
One of a kindpathology is dry inflammation of the cornea. In another way, it is called filamentous keratitis. The essence of the disease is that the cornea is not sufficiently moistened with tear fluid, leading to the "dry eye" syndrome. The manifestations of this form of keratitis include pain and pain, foreign body sensation and photophobia. With the progression of the disease leads to deterioration of vision. The treatment of pathology consists in the constant moistening of the cornea.
Classification and pathogenesis of dry keratitis
Depending on the etiological factors, dry inflammation of the cornea is divided into 2 types. Primary keratitis develops due to endogenous causes. Among them are immune and endocrine disorders. Secondary dry keratitis occurs as a result of damage to the organ of vision. Examples are chemical burns and eye injuries.
The opinion that tears are released only when a person cries is not true. In fact, the eyes are constantly moisturized. Lacrimal fluid is produced by special glands and consists of 3 layers. Outside - it is represented by lipids that help reduce the friction of the cornea on the conjunctiva. The next layer of the lacrimal fluid contains organic compounds and electrolytes that saturate the structures of the eye with oxygen and have antimicrobial activity. The last component is mucin. It has a protein nature and protects the cornea from the penetration of foreign bodies.
Hormonal changes and depletion of the body's defenses lead to a change in the compositionlacrimal fluid. As a result, the protective film becomes unstable and often damaged. The mechanism of development of secondary keratitis is to reduce or stop the production of lacrimal fluid. This is facilitated by damage to the corneal epithelium by physical or chemical influences. Also, such reasons can prevent the transport of tear fluid into the conjunctival cavity.
Causes of keratitis
The causes of filamentous keratitis are divided into 2 large groups. The first is endogenous factors that prevent the formation of tears or change its composition. These include:
- Autoimmune pathologies.
- Liver disease.
- Severe immunodeficiency.
- Endocrine disorders.
- Age-related atrophy of the lacrimal glands.
The next group of causes causes secondary dry keratitis. It is represented by exogenous factors. Among them are bacterial and viral infections of the eyes, surgical interventions (extirpation of the lacrimal glands, laser exposure), taking hormonal drugs, burns and penetration of foreign bodies.
Among the endogenous causes of the development of keratitis, Sjögren's disease is of the greatest importance. This disease refers to autoimmune pathologies and is accompanied by damage to the exocrine glands. In addition to keratitis, the disease leads to impaired saliva production and systemic inflammation syndrome. Among the pathologies of the liver, chronic hepatitis and biliary cirrhosis are distinguished. In addition, keratitis is often diagnosed in women during menopause or postmenopause. It has to do with hormonal changes.organism.
In addition to the listed exogenous factors, frequent exposure to a room with a fan or air conditioning, sitting at a computer, improper care of contact lenses and the use of low-quality cosmetic products lead to filamentous keratitis.
Clinical picture in corneal disease
The clinical picture of this disease is dominated by: dry eye syndrome and inflammation of the cornea. How does filamentous keratitis manifest itself? Symptoms of the disease are as follows:
- Stinging in the eyes, aggravated by concentration.
- Itching and foreign body sensation. Most patients complain of feeling like they have sand or dust in their eyes.
- Discomfort in bright light.
- Inflammatory reaction - eye redness and vascular injection.
- Rapid fatigue of the organs of vision when watching a movie or working at a computer.
- Small release of tears when crying, and subsequently - their absence.
In the initial stage of keratitis, reddening of the conjunctiva and cornea occurs and a mucous exudate appears, resembling threads. With the progression of the disease, small gray foci of clouding in the eyes are noted. Then, areas of hyperkeratosis appear on the cornea. Subsequently, keratinization of the epithelium occurs, leading to visual impairment.
Methods for diagnosing keratitis
In order to confirm the presence of dry keratitis, not only an ophthalmicresearch, but also consultations of such specialists as an endocrinologist and a rheumatologist. The ophthalmologist conducts material sampling and microscopy of the mucous secretion. At the same time, desquamation and hyperkeratosis of the epithelium are detected. Also, an instillation test using fluorescein is performed. The contrast agent helps to improve the quality of microscopy. To assess the work of the lacrimal gland, Norn and Schirmer tests are performed.
In Sjögren's disease, in addition to corneal damage, symptoms such as dryness of the mouth and nasal cavity, impaired sweating are revealed. In addition, with autoimmune pathologies, arthralgia, muscle spasm and changes in the skin are noted.
Filamentous keratitis: treatment of the disease
Treatment of the disease should be aimed at eliminating the etiological factor. This will help eliminate hormonal and autoimmune filamentous keratitis. Drugs in such cases are prescribed by a rheumatologist or endocrinologist. Sjogren's syndrome and other autoimmune processes require hormonal therapy. The drugs "Hydrocortisone" and "Methylprednisolone" are used.
Symptomatic treatment is aimed at preventing the progression of the disease. For this purpose, moisturizing drops and ointments for the eyes are prescribed. In addition, medications with disinfecting properties are required to prevent infection of the cornea. If the disease progresses, surgical treatment is performed. It consists in the plastic of the lacrimal canals. For this, collagen or conjunctival tissue is used.
Product "Artificial tear" - eye drops
To avoid dryness of the cornea, it is required to replace the natural tear fluid with its analogues. This can be achieved with moisturizing drops, which should be used constantly. The main medicine from this group is the drug "Artificial tear". Eye drops, which are its analogues, are the medicines "Optiv", "Vizin", "Lakrisin". These drugs promote the regeneration of the corneal epithelium, and replace the natural tear film.
Methods for the prevention of dry keratitis
Often, dry keratitis is rarely completely cured. This is due both to the autoimmune nature of the disease and to eye injuries leading to sclerosis of the epithelium. To achieve long-term stabilization of the disease, constant monitoring by an ophthalmologist is required. It is possible to avoid exacerbations by following the recommendations of the doctor. These include: proper nutrition, the use of moisturizing contact lenses and the use of drops. Also, eye infection, dust particles and foreign bodies should be avoided.
