Keratomalacia

Description:

Keratomalacia (keratomalacia, Greek keras, keratos por, horn substance + malakia softness) — the defeat of a cornea which is characterized by its necrosis and fusion, caused by insufficiency of vitamin A in an organism, as a rule, both eyes are surprised.

Keratomalacia symptoms:

Defeat of a cornea is usually preceded by a conjunctiva xerosis — formation of the separate dry spots which are not moistened by the lacrimal liquid on an eyeglobe conjunctiva ("sandy shallows at an outflow"). In some cases To. develops at once, passing a conjunctiva xerosis stage. The earliest changes of a cornea are gloss losses, emergence on its surface opacification ("pebble-leather"), decrease in sensitivity. When progressing process the cornea gets grayish-white or milk color, inflammatory reaction insignificant or is absent, formation of an erosion, infiltration and a keratohelcosis is observed (the last tends to distribution). Bystry, sometimes fulminant (during 24 — 48 h) process distribution, a necrosis and fusion of a cornea (fig.) can lead to its perforation, loss of an iris and crystalline lens; often observed accession of consecutive infection — to an entophthalmia and a panophthalmia.

At patients dysfunctions of a pigmental epithelium and disturbance of formation of rhodopsin are noted that is the reason of a hemeralopia. Along with damage of eyes dryness and the increased keratinization of skin, gloss loss, fragility and a hair loss, dryness of mucous membranes are observed, and result of what patients often have a hoarseness of a voice, bronchitis.

The diagnosis is established on the basis of a clinical picture, and also results of determination of content of vitamin A and its metabolites in a blood plasma by method of liquid chromatography.

Keratomalacia reasons:

Develops mainly at children of younger age as a result of insufficient intake of vitamin A with food, disturbances of a resorption of nutrients from intestines at coloenterites of various etiology, hard proceeding general infectious diseases, damages of a liver. It is most widespread in the developing countries of Asia and Africa.

Treatment of the Keratomalacia:

Treatment is directed to elimination of a vitamin deficiency and the prevention of consecutive infection. The diet is of great importance, products, vitamin-rich And yes carotene, the vitamins C, RR, groups B containing enough protein and fats are recommended (a liver, eggs, butter, carrots, salad, green peas, apricots, berries, etc.). Vitamin A is applied also inside and intramusculary. For the purpose of prevention of consecutive infection appoint antibiotics and streptocides (30% solution of a sulfacetamide of sodium, 20% solution of Sulfapyridazinum of sodium, 1% Unguentum Tetracyclini, 0,5% levomitsetinovy ointment, etc.). In cases of progressing of process resort to a keratoplasty (keratoplasty).

Forecast, as a rule, adverse: process usually comes to an end with formation of a resistant cataract, in case of a purulent complication — an eyeglobe atrophy.