Allergic keratitis is an inflammatory process affecting cornea after contact of the visual analyzer with the allergen. In ophthalmology this disease is an acute process that requires immediate treatment.
The cornea is the outer protective layer of the eyeball. The shell protects other structures of the eye are from mechanical, chemical, bacteriological and thermal damage. In the normal state properties of this layer is transparency, surface curvature, sphericity, structural and optical homogeneity, form quality svetogorets.
Keratitis allergic Genesis in most cases accompanied by inflammatory processes in the conjunctiva. Patients with this diagnosis mostly teenagers aged 10 to 15 years. Keratitis different nature without quality treatment end loss of vision.
Varieties of the disease
Classification of keratitis allergic Genesis touches on the causes and impacts on the visual analyzer. Distinguish:
- Bacterial eye disease pathogenic flora of tuberculous keratitis, syphilitic, brucellosis.
- The virus – defeat the smallpox virus, herpes simplex, adenovirus.
- Toxic origin.
- Post-traumatic – reaction of the cornea on its own damaged tissue and fluid of the eyeball.
By type of exposure secrete exogenous and endogenous form of the disease. The degree of involvement in the inflammatory process there are superficial and deep keratitis.
Causes of keratitis
The main cause of hypersensitivity reaction is contact with the allergen. It can be pollen, smoke, sprayed in the air of substances that contact with drugs in the treatment of other ophthalmic diseases.
Exogenous pathogens – parasites, TB infection – not only provoke an allergic reaction in the system of the eye, but the asthma attacks, the development of rinorei, eosinophilic dermatitis.
For allergic keratitis there is the appearance of subepithelial edema and infiltration of the cornea. Capsule infiltration may occur at different depths of the corneal layer. In this case the eyeball loses its inherent brilliance. The surface areas of infiltration with proper treatment resolves without any sequelae. With the defeat of the deep layers of the cornea and other structures of the eye scarring and possible clouding of the membranes of the eyeball.
Symptoms of the disease
Allergic form of keratitis are similar to many diseases of inflammatory Genesis in the system of the visual analyzer.
The patient has the following complaints:
- photophobia and lacrimation;
- stinging, burning in the eyes;
- the feeling of a foreign object;
- pain syndrome;
- inability to open eyes;
- the decrease in visual acuity.
- hyperemia of the eyeball.
It is important
A particular danger is a clouding of the transparent membranes of the eye, as after suffering an allergic keratitis visual acuity can not be restored.
Keratitis endogenous origin caused by parasitic infestation, tuberculosis, other diseases accompanied by fever, General weakness. Without proper treatment, these conditions cause perforation of the cornea, glaucoma, cataract, inflammation of the optic nerve.
Diagnosis and treatment of allergic keratitis do ophthalmologist in conjunction with an allergist. If you suspect a lesion tubercle bacilli required to consult a tuberculosis specialist. During the examination, to exclude keratitis bacterial, viral or fungal nature.
Methods of examination of the patient consists of the following steps:
- Physically inspection and survey, testing of visual acuity.
- Biomicroscopy examination of the fundus, other organs of the eyeball using special equipment to exclude other diseases.
- Analgezirutaya – study of the sensitivity of the cornea.
- Run scratch tests for cutaneous Allergy tests to identify the allergen.
- The cultures detachable eyeball – to exclude bacterial or viral nature of the disease.
- Feces on eggs of worms – if you suspect worm infestation.
- A blood test to determine the level of eosinophils.
At suspicion on tuberculosis shows the assignment of the x-ray light or of x-rays, Mantoux tests or Perca.
Treatment allergic keratitis
Methods of patient management depends on the severity of the allergic reaction. You should avoid contact with the substance that triggered the hypersensitivity reaction. If you cannot identify the allergen, remove all suspicious substances, medicines.
Treatment is complex. Shown to use as a local anti-inflammatory and antihistamines, and drugs for system-wide action.
- dexamethasone – drops topically in the form of ointments;
- dexamethasone injection in conjunctival SAC in severe hypersensitivity reactions;
- prednisone, hydrocortisone is topically in the form of ointments.
In severe form of the disease prescribe steroid drugs system-wide actions in an injection form. The reception is a long and calculated individually.
In addition, shows the assignment of antihistamines non-steroidal nature, b vitamins, ascorbic acid. For relief of symptoms bacterial infections prescribed antibiotics and antibiotics topically in the conjunctival SAC.
If tuberculin tests have confirmed infection with the tubercle Bacillus, in addition to antihistamines, the patient is administered a specialized therapy for the suppression of the causative agent.
After the relief of acute process shown physiotherapy. When impairment of vision is prescribed electrophoresis, or ultrasonic injection of hyaluronidase. If during allergic keratitis in the corneal tissue formed cicatricial bands, shown keratoplasty.
To prevent the development of allergic reactions should avoid contact with possible pathogenic substances. To undergo periodic examinations to avoid worm infestation, and infection with the tubercle Bacillus.
Prognosis depends on the severity of the process. At a superficial form of keratitis after eliminating contact with the allergen comes full recovery. If the affected deep layers of the cornea, it is possible to reduced visual acuity up to complete loss.
Roman Gudkov, doctor, medical commentator