Walleye - Eye disease in which there is persistent turbidity its cornea. The main reasons for the development of cataracts - a corneal injury, chemical burns, inflammatory or infectious diseases. Clinically shown a sharp decline in visual acuity up to complete blindness, corneal change color. Diagnosis is to conduct the inspection, visometry, tonometry, biomicroscopy with a slit lamp, ultrasound and CT eyeball sockets. Treatment of cataracts cornea surgery alone. Apply various options for keratoplasty or keratoprosthetics.
Ophthalmology up to 60% of total damage to eyes. Pathology of the cornea is ranked fifth in the world among the causes of blindness. Even with small corneal opacity with peripheral or central localization can be observed a significant decrease in vision that leads to disability in the working age population. The severity of the process, a variety of outcomes, the complexity of the treatment, the difficulty of rehabilitation of patients with cataract cornea attach special importance to this problem. leucoma The incidence in men and women equally.
eye burns (thermal or chemical); penetrating wounds of the cornea; inflammatory diseases of various nature (herpesvirus, bacterial); corneal ulceration; recurrent pterygium grade 3-4 (these are the same false pterygium, especially after eye burns with formation simblefarona). Furthermore, any surgery on the eyeball is a risk factor for corneal cataracts. Congenital form occurs as a result of intrauterine infection of the fetus is accompanied by viral agents and malformations of other organs and systems.
Pathogenetic mechanisms of the development of cataracts is as follows: after exposure to traumatic factors or infectious agent in the cornea begins to develop inflammation, appears stromal edema and corneal cells (keratocytes) begin to produce specific enzymatic agents and chemoattractants. As a result, the expansion of blood vessels perikornealnaya limb. The damage zone begins the movement of white blood cells from the bloodstream, additionally activated inflammatory cell infiltration. Thus damaged cells begin to throw angiogenic factors, that stimulate the movement and distribution of vascular endothelial cells, which leads to neovascularization and tissue replacement highly differentiated fibrous connective tissue of the cornea.
glaucoma, cataract, microphthalmia or microcornea, atrophy of the iris). The acquired form of cataracts cornea is the final stage of an injury or infection in the cornea, so the complaints of the patient medical attention depends on the primary disease, destruction of the area and the location of the optical opacity of the cornea area. In case of accident - this pain, foreign body sensation, blepharospasm. A patient with an inflammatory disease of the cornea complained of decreased vision, photophobia, slёzotechenie, severe pain. With the development of cataracts in the optical zone of visual acuity drastically reduced or completely absent. If a cataract is localized in the area paraopticheskoy, visual acuity can be maintained. Rinse the affected cornea becomes milky white.
Depending on the depth of the defeat of the eyeball are the following categories of post-traumatic cataracts:
ophthalmoscopy. To detect changes in the deeply lying media eyeball held ultrasound eyeball, if necessary, appoint an additional CT scan of the orbits. Diagnosis of acquired cataracts form includes a standard list: medical history of the patient, conducting external examinations, visometry (the localization of turbidity in paraopticheskoy zone), tonometry. Biomicroscopy slit lamp is the main method of diagnosis. With the help of an ophthalmologist thoroughly examines the blurred, defines its boundaries, density, degree of transparency and dissemination area. Given the impossibility to examine deeply lying structures of the eye must be mandatory ultrasound eyeball, CT scan or MRI of the orbits.
lamellar keratoplasty (replacement of the affected area of the cornea transplant). In case of impossibility of transplantation must be keratoprosthetics (replacement of the affected area is an artificial corneal implant). The peculiarity of surgery for congenital corneal opacity is a combined nature of the intervention, which significantly increases the trauma. Operations technically complicated because of the narrowness of the optic fissure, a possible collapse of the eyeball. Possibility of keratoplasty in the child depends on the size of walleye, the depth of lesions, surgery is most often performed under the age of 1 year. Forecast visual functions doubtful.
To restore the view in the case of acquired cataracts are using different types of reconstructive surgery (the choice depends on the category of post-traumatic wall-eye). In category 1 perform different versions of partial penetrating keratoplasty. When 2 categories corneal transplant complemented iridoplastika. When cataracts category 3 shows complex surgeries - penetrating keratoplasty with cataract extraction with intraocular lens implantation. When cataracts 4 and 5 categories keratoplasty is ineffective, the only treatment - keratoprosthetics.
Possible complications during keratoplasty include perforation, bleeding or rejection by a transplant. Results & Forecast keratoplasty acquired cataracts is determined by the totality of clinical circumstances, including the etiology of the disease, the IOP value, the presence of newly formed blood vessels, the nature and severity of comorbidities.
Prevention of cataractscornea.
Measures for the prevention of corneal cataracts include compliance with safety at work, the use of means of protection of the body when working with chemical agents. Upon receipt of the eyeball injury is necessary as soon as possible consult an ophthalmologist for first aid and determine the most appropriate treatment. Timely diagnosis and competent medical therapy of inflammatory and infectious diseases of the cornea is an important measure in the prevention of cataracts. To reduce the occurrence of congenital forms require a thorough examination of pregnant women in early pregnancy, and if necessary - carrying out treatment of viral or bacterial infections.