EYE DISEASES : DYSTROPHIC KERATITIS (KERATITIS NEUROPARALYTICA S. DYSTROPHICA) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Etiology. The trigeminal nerve is damaged, mostly inflammatory in nature (often on the grounds of malaria, flu, or focal infection).
The pathogenesis. Dysesthesia and trophic cornea, leading to degeneration and breakdown of the corneal cells.
Symptoms. Severe pain in the eye in the absence of tactile sensitivity of the cornea (anesthesia dolorosa corneae). Not sharply pronounced inflammation in the eye (not related to the severity of subjective sensations), lacrimation, sometimes rhinorrhea. The surface of the cornea loses its luster, becomes dull, rough. Sometimes visible disintegration of the epithelium, associated infection, which leads to the formation of ulcers of the cornea (see). Usually there is a reaction of the iris in the form of narrowing of the pupil with sluggish reaction to light.
For a very long period. The disease lasts for many weeks, and sometimes months, until the total elimination of the inflammatory process, capturing the V nerve.
Detection is often difficult. The most important reference point is the absence of corneal reflex, often mono-anaesthesia back of the nose and cheeks in the presence of pain points in this area. Acute pain when pressure at the point of exit n. supraorbitalis. The presence of pain when pressure on the area of the fossa canina shows involvement in the process and the third root of the V nerve (Gesserit).
Vigorous treatment of common diseases before the development of severe phenomena in the eye.
Treatment common cause. Intravenous infusion of 40% solution of hexamine with 25% glucose solution. Intramuscular penicillin. When malarial lesions energetic antimalarial therapy, novocaine blockade by Vishnevsky; sinoagent the origin of the process adrenaline tamponade of the nose, opening the sinuses. Local application of disinfectants: 30% albutsida, sulfiding emulsion fish oil; systematic puscarie drops quinine morphine (in the form of heat), on the night of vaseline oil; for pain - morphine or gray mercury ointment belladonna, leeches to the temples.