Adhesion of the eyeballs
Introduction
Introduction to Ryukyu Adhesion The symblepharon is the adhesion state of the eyelids to the bulbar conjunctiva and the cornea. basic knowledge The proportion of the disease: the incidence rate is about 0.001% -0.005% Susceptible people: no special people Mode of infection: non-infectious Complications: cataracts, uveitis, glaucoma
Cause
Rupture adhesion cause
(1) Causes of the disease
Occurs in chemical (acid, alkali) burns, thermal burns, blast injuries, conjunctival diseases such as Stevens-Johnson syndrome, conjunctival pemphigus, severe trachoma and conjunctival surgery. Severe sacral adhesions can cause eye movements. Limit, double vision, can also form varus, trichiasis and horn deformity, according to the extent of adhesion, divided into parts, extensive, total sacral adhesions and atresia of sacral adhesions.
(two) pathogenesis
Conjunctival chemical injuries are most often acidic and alkaline burns, and their pathological processes are generally divided into four periods:
1 degeneration and necrosis;
2 inflammatory response period;
3 ulcer proliferative phase;
4 Scar stage, acidic substances can cause protein denaturation, forming a barrier after solidification, thus limiting the damage to the shallow layer of tissue, while alkaline chemical burns are relatively serious, alkaline substances can cause lipid saponification in the keratoconjunctival epithelium, Binding to the mucin and collagen of the corneal stroma, thereby destroying the keratoconjunctival barrier and infiltrating into the tissue, the pH in the anterior chamber can be rapidly increased, resulting in damage to the lens and anterior uveal membrane, and severe eyeball atrophy. Alkali burns are often a complex and lengthy pathological process. The Hughes staging method and domestic related materials are divided into three phases.
Acute phase
A few seconds to 24 hours after burn, the alkaline substance can penetrate the cornea into the anterior chamber within a few minutes after the injury, which is manifested as cornea, conjunctival epithelial necrosis, shedding and conjunctival edema, corneal stromal edema, corneal limbus and Extensive thrombosis of the nearby blood vessels, hemorrhage, and even acute iritis, and even a large amount of flocculation exudation in the anterior chamber. The cornea of the severe alkali burn is porcelain white, and it is impossible to see the intraocular tissue, due to iris and ciliary body ischemia. Necrosis, decreased aqueous secretion, and marked reduction in intraocular pressure.
2. Repair period
The corneal epithelium begins to regenerate approximately 5 to 7 days to 2 weeks after injury, and new blood vessels gradually invade the cornea, and iritis tends to be static.
3. Complication period
2 to 3 weeks after burns enter the complication period, often with repeated and persistent aseptic corneal ulcers, each causing corneal perforation, scar tissue healing after the necrotic tissue of the deciduous conjunctiva is detached, shortening or disappearing, sputum adhesion or formation Corneal leukoplakia, thick vasospasm, and even eyelid atresia, develop into dry eye, uveitis, cataract, glaucoma or eyeball atrophy.
Prevention
Ryukyu adhesion prevention
Pay attention to labor protection and work safety.
Complication
Rupture adhesion complications Complications, cataract, uveitis, glaucoma
Can be complicated by cataract, uveitis, secondary glaucoma, corneal leukoplakia and so on.
Symptom
Ryukyu adhesion symptoms common symptoms
The crotch is shortened or even completely disappeared due to conjunctival scar contraction, especially in the lower part of the crotch. When the lower jaw is pulled, vertical contusions are seen in the conjunctiva between the eyelid and the eyeball. In severe cases, the rotation of the eyeball is restricted in all directions. There are varying degrees of corneal resting lesions, such as corneal leukoplakia and even eye atrophy.
Examine
ball adhesion check
Pathological examination: The material is derived from the excised scar tissue. The general pathological manifestations are irregular epithelial hyperplasia, angiogenesis and connective tissue hyperplasia, and scar formation is obvious.
No special auxiliary inspection.
Diagnosis
Diagnosis of symblepharon adhesion
According to the history of ocular trauma, combined with the clinical manifestations of the eye, it is easy to confirm the diagnosis.
