vesicular keratoconjunctivitis
Introduction
Introduction to vesicular keratoconjunctivitis Phlyctenularkeratoconjunctivitis is a delayed-type allergic disease caused by microbial proteins, which occurs mainly in the spring and summer. It is characterized by recurrent nodular-like cell infiltration under the conjunctiva and limbal epithelium. The central corpse of the lesion is detached and forms an ulcer, and localized hyperemia is present around the nodule. The disease can heal itself, but it is very easy to relapse. Especially in patients with both eyes, the lesions alternate and repeat, up to several months. The general prognosis is good. When the lesion is located in the central part of the cornea, it can cause different degrees of visual impairment. The disease occurs mostly in children and adolescents, especially those with malnutrition and allergies. Poor hygiene habits, dark and humid living environment are also related to the induction of this disease. Patients often have eyelids, cheeks, ears, nose and other parts of the body. Eczema, lymphatic tuberculosis, bone tuberculosis, etc. basic knowledge Sickness ratio: 0.1% Susceptible people: mostly occur in children and adolescents Mode of infection: non-infectious Complications: keratitis Conjunctival congestion
Cause
Causes of blistering keratoconjunctivitis
The occurrence of vesicular keratoconjunctivitis, a new view is considered to be an infection immune mechanism, caused by a variety of microbial proteins, such as tuberculin in bacteria, Staphylococcus aureus protein and fungi, Chlamydia or parasite proteins Hair allergy, when antigens such as microbial proteins enter the body, produce antibodies that sensitize and proliferate T cells, cause the body to be allergic, and sensitized lymphocytes are stimulated by the same antigen again, sensitized lymphocytes Direct killing of cells with antigens, while releasing various lymphokines causes local reactions, forming a rash composed of monocytes, macrophages and lymphocytes.
The disease occurs mostly in children and adolescents, especially those with malnutrition and allergies. Poor hygiene habits, dark and humid living environment are also related to the induction of this disease. Patients often have eyelids, cheeks, ears, nose and other parts of the body. Eczema, lymphatic tuberculosis, bone tuberculosis, etc.
Prevention
Follicular keratoconjunctivitis prevention
Should strengthen nutrition, regulate diet, more exposure to sunlight and fresh air, pay attention to exercise, enhance physical fitness, for stubborn and easy to relapse cases, try tuberculin desensitization therapy.
Complication
Follicular keratoconjunctivitis complications Complications keratitis conjunctival hyperemia
More common in women, adolescents and children, with a slight foreign body sensation, if the cornea is involved, the symptoms worsen.
1The initial stage of bubial conjunctivitis is solid. There is a hyperemia area around the red small lesion (1-3mm) of the conjunctival bulge. At the limbus, there is a triangular lesion with the tip pointing to the cornea and the tip being easily ulcerated to form an ulcer. Healed within 10-12d without leaving scars.
2 lesions occur in the limbus, there are single or multiple grayish white nodules, nodules are smaller than those of vesicular conjunctivitis, localized congestion of the lesions, leaving a slight scar after the lesions heal, making the limbal dentate staggered Not uniform.
3 After the initial vesicular conjunctivitis symptoms, in the presence of active blepharitis, acute bacterial conjunctivitis and malnutrition and other predisposing factors may recur. After repeated episodes, the rash can be invaded to the center, and the new blood vessel bundle also grows. Into, called bundle keratitis.
Symptom
Follicular keratoconjunctivitis symptoms Common symptoms Keratitis, tearing, photophobia, conjunctival edema and corneal ulcer
Follicular keratoconjunctivitis has only a foreign body sensation or a burning sensation. For example, invading the cornea, there are severe photophobia, tearing, tingling and phlegm.
According to the site of the lesion invasion, the disease can be divided into clinically: the lesion only occurs in the conjunctiva, which is called vesicular conjunctivitis, which occurs in the cornea, which is called vesicular keratitis, and the lesion invades the cornea, which is called blistering keratoconjunctivitis.
1. Follicular conjunctivitis occurs in the nodule of the bulbar conjunctiva, which is grayish red, with a diameter of about 1 to 4 mm. The conjunctival hyperemia around the nodule is congested (figure). The nodule is easily ruptured, and the tip forms an ulcer. The epithelial cells are then edged. Internal growth, ulcer healing in about 1 week, generally no scars, in more serious cases, sometimes a large ulcer, lesions can be deep and shallow sclera, scars left after healing, a few in the palpebral conjunctiva or rim Sexual ulcers, common in vitamin A deficiency.
2, bubble keratoconjunctivitis nodules located in the limbus, showing a gray-white round infiltration, clear boundaries, easy to form ulcers, opaque scars left behind after healing, so that the limbus is not neat, sometimes on the limbus and its adjacent conjunctiva Most of the miliary-like fine nodules appear along the limbus, called miliary vesicular keratoconjunctivitis. These nodules can disappear without rupture, and they can also fuse with each other to form ulcers.
3, keratitis and bundle keratitis see corneal disease.
Examine
Examination of blistering keratoconjunctivitis
1. Physical examination pay attention to check the conjunctiva and cornea.
2. Auxiliary inspection is generally not required.
3. Corneal lesions are an effective method for screening pathogens in simple, rapid, and outpatient clinics. Corneal lesions are examined for all infectious keratitis such as corneal ulcers.
Diagnosis
Diagnosis and differentiation of vesicular keratoconjunctivitis
The bulbar conjunctiva is the conjunctiva between the conjunctiva and the limbus, which is the thinnest part of the conjunctiva and the most transparent part. Therefore, the sclera is partially visible through the bulbar conjunctiva and the white sclera and the clear blood vessels. The conjunctiva is loosely connected to the tissue beneath it, which is beneficial to the movement of the eyeball and also provides space for the accumulation of fluid during inflammatory edema.
