Symptoms of diseases and damage to the conjunctiva of the eye. Yellow spot on the eyeball near the pupil: reasons for its appearance and photo Why the eyelids form an accordion

The human body is a complex mechanism where even the smallest gears play an important role. If a failure occurs, the entire system suffers. Parts of the body such as the sclera, vitreous body or conjunctiva are firmly connected to the entire visual system and perform a barrier (protective) function against microorganisms and bacteria entering the eyeball.

The work of mucous membranes, protein and gelatinous membranes nourish the human eye and are connective tissue for the circulatory system and lymphatic tissues. This article talks about what the conjunctiva is and what functions it performs.

The conjunctiva is one of the layers of the eye

The conjunctiva is the outer mucous membrane that is found in the upper and lower pouch. The fornix, or blind recesses, carry out the movement of the eye. The main structure of the conjunctiva is epithelial cells that have formed multilayered cylindrical tissue.

The mucous membrane starts from the inner corner of the eye and is distributed along the inside of the lower and upper eyelids, while being tightly adjacent to the skin. Due to its anatomical shape, more epithelial tissue is concentrated in the superior blind pouch.

Features of the structure:

The conjunctiva itself is a thin tissue, the epithelial cells of which are colorless (completely transparent).
In the depths of the upper and lower eyelids, the mucous membrane is connected to the sclera. Its borders reach the ciliary girdle. It was this thin fabric that got its name.
The mucous membrane is divided into two parts, forming a small conjunctival sac.
Near the inner corner of the eye there is a small fold, which in medicine is called the semilunar fold (third eyelid).

The main feature of the conjunctiva is its presence in all mammals, but unlike animals, in humans the sweet semilunate, like the entire mucous membrane, is very small. Also, in humans, the mucous membrane fits tightly to the lower and upper eyelids, while in animals, such a film covers the entire eyeball like protective glasses. This phenomenon can be found in birds, reptiles and sharks.

The conjunctiva is nourished by the blood supply. The vessels located in the mucous membrane also nourish the cornea.

The conjunctiva contains lacrimal glands, which start from the inner corner of the eye and thicken as they approach the outer corner. It also contains thin lacrimal canaliculi (upper and lower), or lymph flows, which are responsible for transporting fluid into the nasal cavity.

The membrane consists of Henle cells, which produce mucin. Mucin is an enzyme that is part of all secretions and glands. The mucous membrane consists of two layers: subepithelial and epithelial. The first layer is loose tissue, which consists of lymphoid tissue and glands.

The epithelial layer consists of multilayered cells, which include the lacrimal glands of Wolfirng, Krause, as well as glands that produce mucin and secretion, serving as moisturizers and disinfectants.

Function of the conjunctiva

Eye examination

The main function of the mucous membrane is to protect the eyeball from dust and dirt, as well as to provide a feeling of comfort. The conjunctiva plays an important role in the visual system and performs a number of necessary functions:

Like the entire mucous membrane, the conjunctival sac produces a secretion that protects the eyeball. The lacrimal and sebaceous glands are also produced, which moisturize the eye. Without this function, a person would not be able to keep his eyes open for a long time, and any small particles (dust and dirt) would cause terrible pain and irritation.
The conjunctiva supplies the eyeball with nutrition. Through the circulatory system and lymphatic currents, all the necessary nutrients enter and then into the optic nerves.
Blinking is the final process of constant hydration and protection of the eye due to the mucous membrane. During blinking, the cornea is lubricated with tears, thereby killing harmful microorganisms and bacteria, removing small dust particles from the eye shell.
Pathogenic bacteria and microorganisms die when they enter the mucous membrane due to immunoglobulin and lysozyme, which are produced by the secretory function. This allows you to avoid the development of infectious and inflammatory processes.
Thanks to the secreted antibacterial enzymes, the healing process of microscopic wounds occurs, which are caused by dry eyes, prolonged wearing of lenses and irritation due to small dust particles. The conjunctiva also secretes other protective elements, such as lactoferrin, lymphocytes, plasma and mast cells, and neutrophils.
The mucous membrane contains 2 thin lacrimal canaliculi, which are responsible for transporting tear fluid into the nasal cavity.
Due to constant hydration, the transparency of the cornea is maintained.

Inflammatory processes and diseases of the conjunctiva

Conjunctivitis is the most common disease of the conjunctiva

Diseases of the conjunctiva:

The most common inflammatory process of the mucous membrane is conjunctivitis. The conjunctival disease affects the inside of the eyelid and the sclera. As a rule, during inflammation the color of the mucous membrane can change and the vessels become more distinct.
Hyperemia of the mucous membrane. Redness of the conjunctiva. This is a common symptom of both ordinary inflammation associated with a cold, and such diseases as scleritis and uveitis.
Infectious, bacterial and viral conjunctivitis. These are inflammatory processes caused by pathogenic bacteria and microorganisms. As a rule, the mucous membrane is affected by adenoviruses or fungi. Three forms of the disease can be transmitted contagiously.
Chlamydial conjunctivitis is a lesion of the mucous membrane by chlamydia bacteria. Infection occurs through contact of the genitals with the hands, and then the hands with the eyeball. The most common carriers are scarves and towels. The disease is progressive and causes ptosis of the eye.
Trachoma is a granular conjunctivitis caused by intracellular organisms. This disease is progressive, accompanied by pus, hyperemia, and irritation. The chronic stage leads to blindness.
Allergic conjunctivitis appears against the background of irritants. This seasonal disease is accompanied by lacrimation, itching, hyperemia, and photophobia.
Melanosis is a disease that causes pigmentation of the mucous membrane and sclera.
Pinguecula is a common benign pathology. It looks like a small yellow or white growth. Not a viral disease, it appears due to an excess of proteins and fats.
Pemphigus is a pathology that affects not only the mucous membrane of the eye, but also the nose, mouth, larynx and esophagus. Accompanied by the appearance of small blisters, it carries an unfavorable prognosis. Scars, inflammation and wrinkling of the mucous membrane appear.
Pterygium of the eye, or pterygoid hymen, is the process of growth of mucous membrane on the cornea. It is removed surgically. The pathology progresses, can reach the pupil area and lead to a decrease in visual acuity.
A conjunctival cyst is a small hollow formation. Appears against the background of conjunctivitis and injuries. Typically, this is a benign growth that does not require surgery, but can significantly reduce visual acuity. The cyst is painless, appears suddenly and can disappear just as quickly.

Drops must be instilled correctly!

If alarming signs or unclear symptoms appear, you should contact an ophthalmologist (ophthalmologist), who will prepare directions for the necessary tests. Often, in case of some inflammatory processes, the ophthalmologist refers you to a gynecologist, urologist and allergist for consultation.

First, specialists will examine and draw up a general clinical picture. During the consultation, it is recommended to answer all questions in detail (is there a reaction to sunlight, contact with allergens, malaise, itching, burning sensation). In some cases, ultrasound diagnostics of the eye, CT or MRI of blood vessels and the condition of the eye are prescribed.

For hygienic purposes, it is worth bringing your own towel and pillowcase. Try to prevent your personal hygiene products from being used by both friends and relatives. Any contact with the pathogen can lead to inflammatory processes.

After visiting the toilet, public places and the street, it is important to wash your hands with antibacterial soap. 90% of all infectious diseases are transmitted tactilely.

An allergic reaction may occur due to chlorinated water. Frequent washing, visiting the pool and saunas also leads to irritation of the mucous membrane. It is also recommended to carry out wet cleaning at least 2-4 times a week and wash bed linen frequently (at least 2 times a month).

If you use contact lenses, then for preventive purposes you should use moisturizing drops. As a rule, long-term wearing of lenses disrupts the production of mucous and sebaceous secretions, which leads to dry eye syndrome.

In case of redness, itching and photophobia, it is recommended to wear dark glasses and immediately consult a specialist.
If you use eye drops, you must bring your own dropper for hygiene purposes. The blindfold is applied strictly as prescribed by the doctor.

Even though the conjunctiva is a small, transparent tissue, it performs large functions in our body. Eyes are our senses and perceptions, thanks to which we can not only see, but also distinguish colors, identify shapes, and enjoy bright colors.

Any violation and inattention to oneself can lead to complete loss of vision. You should not ignore symptoms and warning signs, especially since even the slightest redness can be a symptom of a serious illness.

The following video will introduce you to the methods of treating conjunctivitis:

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anonymous, Male, 23 years old

Hello! My name is Dmitry, I am a 5th year student at Medical University. My problem is the following - for the last couple of weeks my eyes have been itching sometimes - as if I were tired. I wipe it (through my eyelids, naturally) and it will turn a little red, it will last and it will go away. Today, after another wiping, a sensation of a foreign body appeared on the surface of the eye. I thought I got an eyelash when I was wiping it. It turned out that the outer shell of the sclera has moved away from the eye over a large area and when the eyeball moves, it forms folds that sometimes appear on the cornea, sometimes to the side. There is no pain, I know about conjunctivitis, I also heard about corneal peeling. And this is the first time I’ve encountered something like this, where rubbing the eye causes the sclera to peel off. How serious is the problem? Is it possible to fix it at home, or should I rush to see a specialist?

Let's look at this issue from a biological point of view. There is no such disease as “swelling of the eye mucosa”. They call it that only to simplify perception. From a biological point of view, the mucosa is a multilayered squamous non-keratinizing epithelium (as in the oral cavity, pharynx). Of course, there is no epithelium in the eye. In this case, we are talking about formations in the outer shell of the eye (sclera), in its anterior part - the cornea, the inner part of the upper eyelid, the inner part of the lower eyelid, or the conjunctiva.

Symptoms and causes

Swelling of the mucous membrane of the eye - the causes of this condition?

Swelling can be caused by many things, and many of them have different symptoms. Below we present the most common causes of edema. We will also look at their symptoms.

Allergy

Often, swelling can be caused by various types of allergies. In case of allergies, swelling has the following symptoms:

Burning;
Redness and swelling of the eyelids;
Photophobia and lacrimation;
Sensation of a foreign body in the eye.

In most cases, there are no symptoms such as pain and pus.

Acute allergic swelling of the eye mucosa is distinguished by the fact that it occurs in both eyes and develops at a high speed, and the swelling and itching are felt more strongly, which does not allow the eyes to open normally; the person can only “squint”.

Infections of various kinds

Both external and internal infections can cause swelling. In this case, edema is only part of the general condition of the body, and it is necessary to treat not only it, but also the cause that caused it. You can tell that this is an infection by the following symptoms:

Pain;
Redness of the eyes;
Cut;
Discharge of pus (or mucus);
In rare cases, removable films may appear on the conjunctiva (the thin transparent tissue covering the outside of the eye).

Infections (viral or bacterial) rarely affect both eyes.

The most contagious and common forms that are transmitted by contact or airborne droplets are:

Acute epidemic conjunctivitis;
Meningococcal conjunctivitis;
Pneumococcal conjunctivitis.

Adenoviral conjunctivitis can often be observed, the symptoms of which are similar to a common cold or fever. Sore throat at first, and the manifestation of conjunctivitis later.

Physical injuries

The eye is one of the most easily damaged organs. It is located outside and sometimes minor injuries are not paid attention to, although they should not be neglected. After all, these injuries can lead to complete blindness. You should consult a doctor if you have the following symptoms:

Profuse lacrimation;
Decreased visual acuity;
Hemorrhage leading to protrusion of the eyeball.

Often the causes of edema can be: foreign bodies (sand, dust), mites, wind irritation or photophobia (as a cause, not a consequence).

Postoperative injuries

Sometimes operations to improve vision or remove cataracts can have negative side effects. And one of them can be swelling. Decreased vision and a feeling of fogginess are also possible. Often such swelling goes away in the first week after surgery.

Possible consequences

Like any change, neoplasm or disease, swelling of the eye mucosa without the necessary treatment can cause complications and undesirable consequences. Such as blepharitis, keratitis, iritis, corneal ulcer, barley, erysipelas, eyelid abscess, boil.

Some of the complications are contagious to others and, in addition to immediate treatment, require isolation until complete recovery.

Due to a frivolous attitude towards the fact that the mucous membrane of the eye is swollen, often (in 20% of the population) there is at least one case of blepharitis.

More severe cases are also possible - a creeping corneal ulcer. This pathology lasts quite a long time and has a lot of symptoms (pain in the eyes, severe photophobia, lacrimation, and others). It is caused by chronic diseases of the cornea, which, in turn, develop due to the influence of streptococci. This disease should be treated only in a hospital setting and under the constant supervision of a doctor.

Principles of treatment of ocular edema

If you notice swelling in the eyeball area in the morning, then try to figure out the reason for its appearance.

Make sure it's not an allergic reaction (the tips above will help). If the cause of swelling of the eye mucosa is an allergy, immediately eliminate the allergen. Rinse your eyes with chamomile infusion or boiled (cooled) water (this will help relieve discomfort). And also take a drug like Suprastin (antihistamines - reduce allergic reactions).

If this is not an allergy, or you have not detected an allergen, you should immediately consult an ophthalmologist. He will examine you and send you for biological tests for bacteriological examination and isolation of a pure culture. Antibiotic susceptibility testing may be necessary in the future.

First aid for edema of various etiologies

Emergency treatment when the mucous membrane of the eye is swollen may most often include the following drugs:

Disinfectants and antiseptics: furatsilin (solution), potassium permanganate and hydrogen peroxide, for bacterial infections;
Some of the main drugs for the treatment of allergic edema are: Claratin, Erius, Tavegil and the like. Their main properties are desensitizing and antihistamine.
Antiviral drugs, including for local ophthalmic use (Zovirax, Famciclovir and others) for the treatment of ophthalmoherpes.

This is not the entire list of drugs used. Other medications can be used as injections or tablets. Such as antibiotics or immune stimulants are used only as prescribed by a doctor.

In some cases, treatment may be difficult, in light of which hormonal corticosteroid drugs can be used, but for a short period and taking into account contraindications and concomitant diseases.

Eye drops occupy a significant place in the treatment of inflammation. They help relieve swelling, reduce tearing, and anesthetize the eye, but many have a fairly large list of side effects, so using them on your own is strictly prohibited. They are prescribed only by a doctor.

Traditional medicine in the fight against edema

And also in the process of treating swelling of the eye mucosa, traditional medicine can be used, such as:

Treating the eyelids with an infusion of cold black tea, or washing the eyes with a warm infusion (it has antiseptic properties and helps relieve eye puffiness);
Compresses made from raw grated potatoes, which will also reduce swelling and have an analgesic effect;
Rinsing the eyes with a warm aqueous solution of propolis or honey will help with defects, injuries or ulcers of the cornea.
Infusions of chamomile, linden, sage, dill, arnica or cornflower have an anti-inflammatory effect on the mucous membrane of the eye. They need to be used several times a day.

It is important to understand that you should not limit yourself to these remedies and think that everything will heal on its own. First of all, you need to contact an ophthalmologist for an examination and prescription of proper treatment.

Postoperative period

After surgery, swelling may be uncomfortable for some time. For a speedy recovery and improved well-being, you can use the following tips:

During sleep, the head should be at a level higher than the feet. This will ensure significant blood flow and reduce swelling.
Reduce eye strain. Read less, use a computer or TV, and be in bright places less often.
Avoid dusty and sunny places (use sunglasses if possible).
Until complete recovery, limit yourself to sports and any other types of physical activity.
Visiting saunas and similar places is not recommended.

These simple tips will help you quickly get rid of swelling of the eye mucosa resulting from an allergic reaction, infectious disease, complicated treatment or surgery. And if you have any additional questions, you should consult an ophthalmologist.

Tear film of the eyes

We talk about the tear film rather than the tear layer because it has a complex structure and consists of three different, immiscible layers of liquid. It contains a layer of fat, water and mucus. The layer of mucous membrane that lies directly on the corneal epithelium significantly reduces the surface tension of the tear film and allows the aqueous layer to evenly and quickly cover the surface of the epithelium. Disruption of this layer causes damage to the corneal epithelium, even when the amount of tears produced is sufficient.

Causes of dry eye syndrome

Dry eyes can occur in people prone to chronic rheumatic diseases of unknown cause - idiopathic dry eye syndrome. Most often, xerophthalmia occurs with Sjögren's syndrome. Associated symptoms include a feeling of dry mouth, trouble chewing and swallowing food, difficulty speaking, dental caries, enlarged salivary glands, changes in lymph nodes in the lungs, kidneys or liver, as well as arthritis and white finger syndrome. Useful in diagnosis is the determination of autoantibodies ANA, anti-Ro, anti-La and a biopsy of the salivary gland.

Xerophthalmia can also occur during autoimmune bullous syndromes. During the development of these diseases, pathological scarring of the conjunctiva, formation of adhesions in the conjunctiva, as well as drying of the surface of the cornea and desquamation of the corneal epithelium occur. This occurs as a result of the development of an inflammatory process that enhances the activity of the lacrimal glands. Cells of the body's own appear, aimed at destroying properly constructed and functioning cells that secrete tears. All the mechanisms that cause autoimmune reactions in the human body have not been studied exactly, but experimental studies are being conducted to look for the causes. With the current state of knowledge, treatment of such conditions, as well as other autoimmune diseases, only symptomatic

Another disease that can lead to the development of dry eye syndrome is trachoma, that is, chronic bacterial conjunctivitis caused by Chlamydia trachomatis. Once called Egyptian eye inflammation, it is now virtually eliminated in Europe and North America, but is common in underdeveloped countries in Africa, Asia and South America, in environments with poor hygiene. The development of tourism and large migration of people have led to the fact that this disease is increasingly affecting countries with a high level of development. The initial stages of trachoma are characterized by the appearance of so-called needles or yellowish outgrowths on the conjunctiva, especially the upper eyelids. As the disease progresses, the number of lumps systematically increases, changes color to intense yellow, and their consistency resembles jelly.

Speaking about the causes of dry eye syndrome, we must not forget about the neurogenic causes of disorders of the endocrine and tear-forming systems. This is affected by damage to the facial nerve (VII) and trigeminal nerve. The development of dry eye syndrome causes paralysis of the facial nerve, which occurs with damage to the muscle responsible for closing the palpebral fissure. A constantly raised upper eyelid causes the surface of the eyeball to dry out, which, even despite the increased secretion of tears, gives an unpleasant feeling of dryness in the eye, irritation of the conjunctiva or sand under the eyelid.

pregnancy;
stress;
conjunctival scars;
vitamin A deficiency;
old age;
wearing contact lenses;

Symptoms of xerophthalmia

Treatments for dry eye syndrome

Biomicroscopy involves viewing the patient's eyes through an ophthalmic lamp. In this simple way, it is possible to evaluate the stability characteristics of the tear film. The cornea is then assessed. To do this, one drop of fluorescein is instilled into the conjunctival sac, and then the patient is asked to blink, and the corneal epithelium is assessed using a slit lamp cobalt filter. A pathological result is considered to be the presence of more than 10 fluorescein spots or diffuse staining of the cornea. A Schirmer test is also performed, which involves studying, using two small pieces of paper placed under the eyelids, the number of tears produced in one minute. A result less than 5 mm indicates a tear secretion disorder. There is also the Schrimer II test, which evaluates reflex tear production. First, the conjunctiva is anesthetized, and then the nasal mucosa is irritated.

Dry eye syndrome

A feature of dry eye syndrome is the abundance of subjective symptoms, expressed in various complaints of patients, against the background of relatively meager objective manifestations. This circumstance often results in untimely diagnosis of the disease in question.

The most common complaints of patients with dry eye syndrome are the sensation of a “foreign body” in the eye, a burning sensation in the eyes, less often - dryness, photophobia. Typically, the severity of these symptoms increases when the patient is in a smoky, smoky room, or when using fan heaters or air conditioners.

A specific subjective sign of dry eye syndrome is the patient’s inadequate pain reaction to the instillation of completely indifferent eye drops (chloramphenicol, dexamethasone, etc.).

Objective manifestations of dry eye syndrome include a reduction or absence of tear menisci (better visible along the edge of the lower eyelid, in the projection of the cornea), the appearance of scanty mucous discharge in the form of stretching threads and various inclusions in the tear film (clumps of mucus, epithelial cells), visible in the light slit lamp. In most patients with dry eye syndrome, the missing tear meniscus is replaced by swollen bulbar conjunctiva, creeping onto the free edge of the lower eyelid. In rare cases, when the lower eyelid is retracted, the bulbar conjunctiva slowly unsticks from the tarsal conjunctiva, and when the eyeball moves, folds form on the bulbar conjunctiva, which smooth out on their own only after a few seconds. An important diagnostic criterion is persistent staining with sodium fluorescein and rose bengal of the epithelium of the conjunctiva and cornea within the open palpebral fissure.

In severe (and more rare) cases, dry eye syndrome manifests itself in the form of “dry” keratoconjunctivitis, filamentous keratitis, recurrent corneal erosion, as well as corneal-conjunctival xerosis due to vitamin A deficiency.

The functional signs of dry eye syndrome are a decrease in tear production (less than 15 mm according to Schirmer) and impaired stability of the tear film (its breakup time is less than 10 s according to Norn).

The causes of dry eye syndrome are varied and are often associated with manifestations of female and male menopause, autoimmune diseases of the exocrine glands and collagenoses (Sjögren, Stevens-Johnson syndromes, etc.), hereditary complex dysfunction of the autonomic nervous system (Riley-Day syndrome), and some diencephalic disorders and other similar conditions.

There are also cases of symptomatic dry eye syndrome - due to damage to the surface of the eyeball due to burns, conjunctival pemphigus, trachoma, etc., with blepharitis (usually meibomian), lagophthalmos and other diseases of the anterior part of the eyeball.

In the pathogenesis of dry eye syndrome, two factors are important: a decrease in the secretion of tear film components (tears, mucus, etc.) and an increase in its evaporation. There are also cases of their combination. As a result, the stability of the tear film and, consequently, the wettability of the corneal epithelium is disrupted and the clinical symptom complex under consideration develops.

Dry eye syndrome currently occurs in every third patient who first consults an ophthalmologist.

In recent years, the relevance of dry eye syndrome has increased due to its development in young people working at a computer, as well as exposure to air-conditioned air (so-called ocular office syndrome).

The first to most fully describe the clinical picture of “dry” keratoconjunctivitis in 1933 was the Swedish ophthalmologist Henrick Conrad Sjogren (b. 1899). However, this disease was previously known in connection with trachoma and vitamin A deficiency.

Xerophthalmia - causes and treatment of dry eye syndrome

Dry eye syndrome (xerophthalmia) is one of the most common eye diseases and accounts for a significant percentage of the reasons for visits to the ophthalmology office. Dryness of the eyeball is based on a violation of the secretion of tears, which results in drying of the conjunctiva and cornea. The lack of natural eye protection from harmful factors creates favorable conditions for the development of bacterial, viral and fungal infections.

Changes in the composition of tears, as well as abnormalities in their physiological distribution over the surface of the eye, can lead to disease and clouding of the cornea.

Tear film of the eyes

The tear film of the eyes is a multicomponent substance located on the surface of the eyeball and performs an important function in receiving visual stimuli, and also protects the cornea from atmospheric oxygen, protects it from damage due to drying and has antibacterial properties.

When you blink, the individual components of tears, created by the lacrimal glands, are distributed on the cornea of the eye, while the aqueous component of tears helps cleanse the eyes of impurities that have entered there.

We talk about the tear film rather than the tear layer because it has a complex structure and consists of three different, immiscible layers of liquid. It contains a layer of fat, water and mucus.

The layer of mucous membrane that lies directly on the corneal epithelium significantly reduces the surface tension of the tear film and allows the aqueous layer to evenly and quickly cover the surface of the epithelium. Disruption of this layer causes damage to the corneal epithelium, even when the amount of tears produced is sufficient.

The aqueous layer is responsible for creating the proper environment for epithelial cells, providing them with essential nutrients, and also cleanses the surface of the eye from metabolic products and foreign matter.

The outermost tear-fat layer protects the aqueous layer from evaporation and also ensures the stability and optical smoothness of the surface of the tear film.

The thickness of the tear film changes between blinks, but physiologically its structure remains constant.

Causes of dry eye syndrome

Dry eyes can occur in people prone to chronic rheumatic diseases of unknown cause - idiopathic dry eye syndrome. Most often, xerophthalmia occurs with Sjögren's syndrome.

Associated symptoms include a feeling of dry mouth, trouble chewing and swallowing food, difficulty speaking, dental caries, enlarged salivary glands, changes in lymph nodes in the lungs, kidneys or liver, as well as arthritis and white finger syndrome. Useful in diagnosis is the determination of autoantibodies ANA, anti-Ro, anti-La and a biopsy of the salivary gland.

All the mechanisms that cause autoimmune reactions in the human body have not been studied exactly, but experimental studies are being conducted to look for the causes. With the current state of knowledge, treatment of such conditions, as well as other autoimmune diseases, only symptomatic and is aimed at inhibiting the destruction of lacrimal gland cells.

Another culprit of dry eye syndrome can be extensive burns of the conjunctiva. As a result of this condition, scarring of the conjunctival tissue occurs, disruption of the functions and structure of goblet cells, and their number in the mucous membrane decreases. This entails consequences in the form of a reduced amount of mucus. The unstable composition of the tear film makes it difficult to retain it on the surface of the eye. As a result, the eyeball dries out, despite sometimes increased secretion of tears.

The development of tourism and large migration of people have led to the fact that this disease is increasingly affecting countries with a high level of development. The initial stages of trachoma are characterized by the appearance of so-called needles or yellowish outgrowths on the conjunctiva, especially the upper eyelids. As the disease progresses, the number of lumps systematically increases, changes color to intense yellow, and their consistency resembles jelly.

A constantly raised upper eyelid causes the surface of the eyeball to dry out, which, even despite the increased secretion of tears, gives an unpleasant feeling of dryness in the eye, irritation of the conjunctiva or sand under the eyelid.

Other causes of tear secretion disorders include:

too low blink rate (for example, when working on a computer, reading, driving a car, watching TV);
being in smoky rooms, with central heating, air conditioning, in the wind;
environmental pollution with industrial gases and dust;
poorly treated conjunctival diseases;
pregnancy;
stress;
conjunctival scars;
abuse of eye drops containing preservatives;
vitamin A deficiency;
old age;
wearing contact lenses;
menopause (in particular, a decrease in estrogen levels, which can be corrected with hormone replacement therapy);
taking birth control pills;
taking certain antiallergic and psychotropic drugs;
some diseases (diabetes mellitus, seborrhea, acne, thyroid diseases).

Symptoms of xerophthalmia

Xerophthalmia is a disorder of tear secretion that causes dryness of the conjunctiva and cornea, and as a result of peeling, the eye epithelium is deprived of its natural protection. Dry eye can also occur when the structure of the tear film is abnormal and the surface of the eye dries too quickly. In this condition, the eye becomes very sensitive to the effects of pathogens such as fungi, bacteria and viruses.

The patient feels dryness of the conjunctiva, sometimes the mucous membrane of the nose and throat, itching, burning, and when the cornea dries out, burning pain. The frequency of blinking increases, itching of the eyelids appears, there may be a feeling that there is a foreign body in the eye, most often patients describe it as sand under the eyelids, and subjective swelling of the eyelids. Increased sensitivity to light and eye fatigue. Thick mucus may accumulate in the corners of the eyes.

Patients in the advanced stage of the disease may experience visual disturbances, pain and photophobia. Paradoxically, in the initial stages of dry eye syndrome, patients complain of increased lacrimation, which is called crocodile tears. All unpleasant symptoms are aggravated in a room with dry air, full of cigarette smoke or dust, as well as with air conditioning.

Dry eye syndrome is a complex disease that affects the general condition of the patient, professional activity and interaction with the environment. Uncharacteristic initial symptoms of dry eye syndrome often cause late diagnosis. A well-conducted interview from the patient is essential, as physical examination does not reveal symptoms unique to dry eye.

Treatments for dry eye syndrome

To begin treatment, it is necessary to conduct an accurate diagnosis. Tests from two groups are widely used: studying the stability of the entire tear film and tests for assessing individual parts of the tear film. The most commonly used are biomicroscopy, Schirmer test and tear film interruption time test.

A pathological result is considered to be the presence of more than 10 fluorescein spots or diffuse staining of the cornea. A Schirmer test is also performed, which involves studying, using two small pieces of paper placed under the eyelids, the number of tears produced in one minute. A result less than 5 mm indicates a tear secretion disorder. There is also the Schrimer II test, which evaluates reflex tear production. First, the conjunctiva is anesthetized, and then the nasal mucosa is irritated.

Another test, tear film interruption time, is one of the most common and widely used tests to evaluate the tear film. It involves determining how long the tear film remains on the surface of the eye. Pathological result below 10 seconds.

Treatment of dry eye syndrome is symptomatic, since there are no medications that act on the cause of the disease. Dry eye syndrome is treated by an ophthalmologist, temporarily using artificial tears to moisturize the eyes and prevent them from drying out. The drugs used are derivatives of methyl cellulose, hyaluronic acid, polyvinyl alcohol and other compounds. These substances are characterized by varying degrees of viscosity. Their disadvantage is their short duration and the need to use them every hour. Eye gels that are used every 6 hours are slightly more effective.

Consistency of therapy, regular use and a good selection of drops are important. Artificial tears containing preservatives can irritate the eyes, so it is best to choose artificial tears that do not contain these agents. Useful for dry eye syndrome are sodium hyaluronate and calendula extract. You need to remember to close the package tightly.

In case of non-closure of the eyelids, when the use of artificial tears does not provide improvement, soft contact lenses are used. They cause the formation of a smooth and moist layer on the surface of the eye, which helps to moisturize the dry corneal epithelium and conjunctiva.

If it can be improved, laser surgery can be used to close the tear ducts, which may help in the long term. It is important to remember to maintain eye hygiene: do not touch your eyes with anything that may be even slightly dirty, and do not touch your eyes with the drop applicator.

Treatment for dry eye is long-term and often ineffective. Factors facilitating therapy are air humidification and the use of protective glasses. Dry eye syndrome is a disease that requires long-term treatment, but with good patient cooperation and care about the factors influencing the course of this disease, changes causing visual disturbances are rarely observed.

You can often see such a request in search engines.

From the point of view of the anatomy of the eye, this is somewhat incorrect, since there is no mucous membrane in the usual sense (stratified squamous non-keratinizing epithelium, as in the oral cavity, pharynx, rectum) in the human eye. So what is meant when they say that “the mucous membrane of the eye is swollen”?

In this case, we can talk about three formations that touch the outer shell of the eyeball - the sclera in its front, transparent part, which is called the cornea:

About the causes of edema

Acute allergic edema occurs symmetrically, develops very quickly, sometimes in a matter of hours, and there is no pus. The swelling and itching are so pronounced that it is simply impossible to open the eyes - they turn into small “slits”.

Bacterial and viral infections often affect one eye. The most common and contagious forms that are transmitted by contact and airborne droplets are acute epidemic, meningococcal, pneumococcal conjunctivitis.

The greatest danger is herpetic viral conjunctivitis. It can cause ulceration of the cornea, and also spread the virus through the perineural spaces into the brain, with the development of herpetic encephalitis. This complication is characterized by high rates of mortality and disability.

Also common is adenoviral conjunctivitis, which is similar to the common “cold” with fever, sore throat at the beginning and conjunctivitis appearing later.

Thus, swelling of the mucous membrane of the eye, the causes mentioned above, has a polyetiological nature.

Principles of treatment of edema

It is very important to examine the patient by an ophthalmologist, as well as to take the discharge for bacteriological examination, isolate a pure culture, and then determine sensitivity to antibiotics. The principles of emergency treatment include the administration of the following drugs:

antihistamines and desensitizers (they are the main ones for the treatment of allergic edema): Claritin, Suprastin, Cetrin, Tavegil, Erius;
antiseptic and disinfectants: solution of furacillin, potassium permarganate, hydrogen peroxide;
antibiotics: sulfacyl - sodium (albucid), chloramphenicol ophthalmic ointment;
antiviral drugs, including forms for topical ophthalmic use (acyclovir, Zovirax, famciclovir) for the treatment of ophthalmoherpes.

Other drugs are used either in the form of tablets or injections. These include antibiotics, agents that enhance immunity (interferon, ridostin, various interferon inducers).

Swelling of the eye mucosa, the treatment of which is difficult, can be tried (with caution) to be treated with hormonal corticosteroid drugs, but for a short time and taking into account concomitant diseases and contraindications.

Traditional medicines that are used to treat eye swelling are as follows:

treatment of the sclera and eyelids with cold infusion of tea;
compresses with raw grated potatoes, which relieves signs of swelling and reduces pain;
washing the eyes with a warm aqueous solution of honey, propolis and mumiyo. Helps with defects, injuries and ulcers of the cornea, as well as during the recovery stage of keratitis and ophthalmic herpes;
An aqueous infusion of chamomile has a gentle effect on the mucous membrane of the eye. You need to wash your eyes several times a day.

Postoperative swelling

Swelling of the mucous membrane of the eye after blepharoplasty is the most common type of iatrogenic (that is, caused by medical intervention) edema. Blepharoplasty is a cosmetic surgery that removes bags under the eyes.

After surgery, swelling may bother you for some time, so to reduce its severity and quickly eliminate it, you can use the following methods:

During sleep, the head should be significantly higher than the legs, this ensures the outflow of blood;
cold lotions should be placed on the eyes;
no need to strain your eyes by reading, blinking, being in bright places, or working on a computer;
wear sunglasses and avoid dusty places until you recover;
Bend over work, gymnastics, swimming, visiting the bathhouse and other types of physical activity are prohibited.

These simple tips will help you quickly get rid of swelling after surgery, and if it occurs while you are fully healthy, you will know which specialists you should contact.

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Feature dry eye syndrome is the abundance of subjective symptoms, expressed in various complaints of patients, against the background of relatively meager objective manifestations. This circumstance often results in untimely diagnosis of the disease in question.

The most common complaints of patients dry eye syndrome- a feeling of a “foreign body” in the eye, a burning sensation in the eyes, less often - dryness, photophobia. Typically, the severity of these symptoms increases when the patient is in a smoky, smoky room, or when using fan heaters or air conditioners.

A specific subjective sign dry eye syndrome is the patient’s inadequate pain reaction to the instillation of completely indifferent eye drops (chloramphenicol, dexamethasone, etc.).

Objective manifestations dry eye syndrome consist in the reduction or absence of the tear menisci (better visible along the edge of the lower eyelid, in the projection of the cornea), the appearance of scanty mucous discharge in the form of stretching threads and various inclusions in the tear film (clumps of mucus, epithelial cells), visible in the light of a slit lamp. In most patients with dry eye syndrome, the missing tear meniscus is replaced by swollen bulbar conjunctiva, creeping onto the free edge of the lower eyelid. In rare cases, when the lower eyelid is retracted, the bulbar conjunctiva slowly unsticks from the tarsal conjunctiva, and when the eyeball moves, folds form on the bulbar conjunctiva, which smooth out on their own only after a few seconds. An important diagnostic criterion is persistent staining with sodium fluorescein and rose bengal of the epithelium of the conjunctiva and cornea within the open palpebral fissure.

In severe (and rarer) cases dry eye syndrome manifests itself in the form of “dry” keratoconjunctivitis, filamentous keratitis, recurrent corneal erosion, as well as corneal-conjunctival xerosis due to vitamin A deficiency.

Functional signs dry eye syndrome serve as a decrease in tear production (less than 15 mm according to Schirmer) and a violation of the stability of the tear film (its rupture time is less than 10 s according to Norn).

Causes dry eye syndrome varied and more often associated with manifestations of female and male menopause, autoimmune diseases of the exocrine glands and collagenoses (Sjögren, Stevens-Johnson syndromes, etc.), hereditary complex dysfunction of the autonomic nervous system (Riley-Day syndrome), some diencephalic disorders and other similar conditions .

There are also cases of symptomatic dry eye syndrome- due to damage to the surface of the eyeball due to burns, conjunctival pemphigus, trachoma, etc., with blepharitis (usually meibomian), lagophthalmos and other diseases of the anterior part of the eyeball.

In pathogenesis dry eye syndrome Two factors are important: a decrease in the secretion of tear film components (tears, mucus, etc.) and an increase in its evaporation. There are also cases of their combination. As a result, the stability of the tear film and, consequently, the wettability of the corneal epithelium is disrupted and the clinical symptom complex under consideration develops.

Dry eye syndrome currently occurs in every third patient who first visited an ophthalmologist.

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anonymous, Male, 23 years old

Symptoms and causes

Swelling of the mucous membrane of the eye - the causes of this condition?

Swelling can be caused by many things, and many of them have different symptoms. Below we present the most common causes of edema. We will also look at their symptoms.

Often, swelling can be caused by various types of allergies. In case of allergies, swelling has the following symptoms:

Burning;
Redness and swelling of the eyelids;
Photophobia and lacrimation;
Sensation of a foreign body in the eye.

In most cases, there are no symptoms such as pain and pus.

Infections of various kinds

Pain;
Redness of the eyes;
Cut;
Discharge of pus (or mucus);
In rare cases, removable films may appear on the conjunctiva (the thin transparent tissue covering the outside of the eye).

Infections (viral or bacterial) rarely affect both eyes.

The most contagious and common forms that are transmitted by contact or airborne droplets are:

Acute epidemic conjunctivitis;
Meningococcal conjunctivitis;
Pneumococcal conjunctivitis.

Adenoviral conjunctivitis can often be observed, the symptoms of which are similar to a common cold or fever. Sore throat at first, and the manifestation of conjunctivitis later.

Physical injuries

Profuse lacrimation;
Decreased visual acuity;
Hemorrhage leading to protrusion of the eyeball.

Often the causes of edema can be: foreign bodies (sand, dust), mites, wind irritation or photophobia (as a cause, not a consequence).

Postoperative injuries

Possible consequences

Some of the complications are contagious to others and, in addition to immediate treatment, require isolation until complete recovery.

Due to a frivolous attitude towards the fact that the mucous membrane of the eye is swollen, often (in 20% of the population) there is at least one case of blepharitis.

Principles of treatment of ocular edema

If you notice swelling in the eyeball area in the morning, then try to figure out the reason for its appearance.

First aid for edema of various etiologies

Emergency treatment when the mucous membrane of the eye is swollen may most often include the following drugs:

Disinfectants and antiseptics: furatsilin (solution), potassium permanganate and hydrogen peroxide, for bacterial infections;
Some of the main drugs for the treatment of allergic edema are: Claratin, Erius, Tavegil and the like. Their main properties are desensitizing and antihistamine.
Antiviral drugs, including for local ophthalmic use (Zovirax, Famciclovir and others) for the treatment of ophthalmoherpes.

This is not the entire list of drugs used. Other medications can be used as injections or tablets. Such as antibiotics or immune stimulants are used only as prescribed by a doctor.

In some cases, treatment may be difficult, in light of which hormonal corticosteroid drugs can be used, but for a short period and taking into account contraindications and concomitant diseases.

Traditional medicine in the fight against edema

And also in the process of treating swelling of the eye mucosa, traditional medicine can be used, such as:

Treating the eyelids with an infusion of cold black tea, or washing the eyes with a warm infusion (it has antiseptic properties and helps relieve eye puffiness);
Compresses made from raw grated potatoes, which will also reduce swelling and have an analgesic effect;
Rinsing the eyes with a warm aqueous solution of propolis or honey will help with defects, injuries or ulcers of the cornea.
Infusions of chamomile, linden, sage, dill, arnica or cornflower have an anti-inflammatory effect on the mucous membrane of the eye. They need to be used several times a day.

Postoperative period

After surgery, swelling may be uncomfortable for some time. For a speedy recovery and improved well-being, you can use the following tips:

During sleep, the head should be at a level higher than the feet. This will ensure significant blood flow and reduce swelling.
Reduce eye strain. Read less, use a computer or TV, and be in bright places less often.
Avoid dusty and sunny places (use sunglasses if possible).
Until complete recovery, limit yourself to sports and any other types of physical activity.
Visiting saunas and similar places is not recommended.

Dry eye syndrome (xerophthalmia) is one of the most common eye diseases and accounts for a significant percentage of the reasons for visits to the ophthalmology office. Dryness of the eyeball is based on a violation of the secretion of tears, which results in drying of the conjunctiva and cornea. The lack of natural eye protection from harmful factors creates favorable conditions for the development of bacterial, viral and fungal infections.

Changes in the composition of tears, as well as abnormalities in their physiological distribution over the surface of the eye, can lead to disease and clouding of the cornea.

Tear film of the eyes

The outermost tear-fat layer protects the aqueous layer from evaporation and also ensures the stability and optical smoothness of the surface of the tear film.

The thickness of the tear film changes between blinks, but physiologically its structure remains constant.

Causes of dry eye syndrome

Dry eyes may occur in people prone to chronic rheumatic diseases of unknown cause - idiopathic dry eye syndrome. Most often, xerophthalmia occurs with Sjögren's syndrome. Associated symptoms include a feeling of dry mouth, trouble chewing and swallowing food, difficulty speaking, dental caries, enlarged salivary glands, changes in lymph nodes in the lungs, kidneys or liver, as well as arthritis and white finger syndrome. Useful in diagnosis is the determination of autoantibodies ANA, anti-Ro, anti-La and a biopsy of the salivary gland.

Another culprit of dry eye syndrome can be extensive burns of the conjunctiva. As a result of this condition, scarring of the conjunctival tissue occurs, disruption of the functions and structure of goblet cells, and their number in the mucous membrane decreases. This entails consequences in the form of a reduced amount of mucus. The unstable composition of the tear film makes it difficult to retain it on the surface of the eye. As a result, it happens dry eyeball despite sometimes increased secretion of tears.

Speaking about the causes of dry eye syndrome, we must not forget about the neurogenic causes of disorders of the endocrine and tear-forming systems. This is affected by damage to the facial nerve (VII) and trigeminal nerve. The development of dry eye syndrome causes paralysis of the facial nerve, which occurs with damage to the muscle responsible for closing the palpebral fissure. A constantly raised upper eyelid causes the surface of the eyeball to dry out, which, even despite the increased secretion of tears, produces unpleasant feeling of dryness in the eye, irritation of the conjunctiva or sand under the eyelid.

Among other reasons tear secretion disorders should be highlighted:

too low blink rate (for example, when working on a computer, reading, driving a car, watching TV);
being in smoky rooms, with central heating, air conditioning, in the wind;
environmental pollution with industrial gases and dust;
poorly treated conjunctival diseases;
pregnancy;
stress;
conjunctival scars;
abuse of eye drops containing preservatives;
vitamin A deficiency;
old age;
wearing contact lenses;
menopause (in particular, a decrease in estrogen levels, which can be corrected with hormone replacement therapy);
taking birth control pills;
taking certain antiallergic and psychotropic drugs;
some diseases (diabetes mellitus, seborrhea, acne, thyroid diseases).

Symptoms of xerophthalmia

Xerophthalmia is impaired tear secretion, which causes dryness of the conjunctiva and cornea, and as a result of peeling of the eye epithelium, it is deprived of natural protection. Dry eye can also occur when the structure of the tear film is abnormal and the surface of the eye dries too quickly. In this condition, the eye becomes very sensitive to the effects of pathogens such as fungi, bacteria and viruses.

Treatments for dry eye syndrome

Treatment of dry eye syndrome is symptomatic, since there are no medications that act on the cause of the disease. Dry eye syndrome treated by an ophthalmologist - temporarily with the help of artificial tears to moisturize the eyes and prevent them from drying out. The drugs used are derivatives of methyl cellulose, hyaluronic acid, polyvinyl alcohol and other compounds. These substances are characterized by varying degrees of viscosity. Their disadvantage is their short duration and the need to use them every hour. Eye gels that are used every 6 hours are slightly more effective.

Dry eye treatment– long-term and often ineffective. Factors facilitating therapy are air humidification and the use of protective glasses. Dry eye syndrome is a disease that requires long-term treatment, but with good patient cooperation and care about the factors influencing the course of this disease, changes causing visual disturbances are rarely observed.

Krasutsky Viktor Iosifovich

Hello! In absentia, even from your descriptions, we will not be able to establish a diagnosis. Seek advice and possible treatment from a specialized ophthalmology center (CMOC).

Kubrak Natalia Viktorovna

Hello. Unfortunately, the photo cannot be opened. Judging by your description, you have very dry mucous membranes of the eyes - what could cause such problems (hormonal changes usually aggravate the symptoms of dryness). You need a Schirmer test to evaluate tear production in the eye. After this, it is necessary to use artificial tear preparations on an ongoing basis. From uv Kubrak NV.

Eye- one of the most complex organs of the human body in its structure. It includes a range of anatomical and physiological entities, each of which can be susceptible to many different diseases. Accordingly, in medical science it is customary to divide pathologies characteristic of our visual analyzer.

Skin diseases around the eyes and eyelids

Typically, lesions are localized on the face, especially around the eyes, on the eyelids, and also near the mouth and nose.

Characteristic symptoms

redness;
peeling;
rashes of an inflammatory or blistering nature;
blepharitis.

Demodicosis is chronic, characterized by periodic exacerbations in the spring and autumn. Its therapy is quite long and effective only with strict adherence to all personal hygiene measures to prevent re-infection. Treatment is carried out by a dermatologist, usually on an outpatient basis. It includes the use of specific external agents in combination with the ingestion of quinoline drugs and antihistamines.

Coloboma of the eyelid is a segmental defect of the eyelid, involving all its layers. In most cases, it is a congenital disorder, but can also develop as a result of injury or complications. It occurs more often on the upper eyelids, although sometimes it affects the lower eyelids as well. Usually the defect has the shape of a triangle, the base of which is located at the ciliary edge of the eyelid. Since the defect covers all layers of the eyelid, there are no glands and eyelashes in the area of the coloboma.
This disease poses a very serious danger to the eye, as it often leads to secondary diseases of the visual organs, such as keratitis or corneal dystrophy.

The most effective method of treatment is surgery, which consists of excision of the coloboma and moving a musculocutaneous flap to the site of the defect. With the help of such plastic surgery, a physiological edge of the eyelid is formed, which prevents the development of complications, as well as ptosis or entropion.

Ankyloblepharon

This pathology is characterized by partial or complete fusion of the edges of the eyelids. This disease can be either congenital or acquired, resulting from scarring on the edges of the eyelids due to injury or burns. Treatment of the pathology is surgical.

Ptosis is an abnormally low position of the upper eyelids in relation to the eyeballs. This pathology can be congenital or acquired.

Causes of ptosis

damage to the oculomotor nerve ( in such cases, ptosis accompanies paralysis of the muscles of the eyeball, which is manifested by double vision in the eyes and dilation of the pupil);
Horner's syndrome, which is accompanied by a lack of sweating on the affected side and constriction of the pupil;
severe muscle pathologies, which manifest themselves as weakness and increased fatigue;
isolated lesion of the levator palpebrae superioris muscle;
many neurological diseases ( strokes, encephalitis, etc.).

Treatment of this disease is predominantly surgical with mandatory treatment of the underlying pathology.

Turn of the century

When the eyelid turns in, its free edge turns towards the eyeball. The cause of the development of pathology is spastic or convulsive contractions of any part of the orbicularis oculi muscle. In addition, this may be a consequence of scar tightening of the conjunctiva and cartilage of the eyelid, which occurs in some chronic eye diseases, for example, trachoma.

With entropion or entropion, the eyelashes rub against the surface of the conjunctiva and cornea, which quickly leads to irritation, redness of the eye and profuse lacrimation. The most effective method of treating entropion is surgery.

Eversion of the century

Causes of ectropion

age-related changes in which the lower eyelid droops due to weakening of the eye muscles;
paralysis of the orbicularis oculi muscle ( paralytic and spastic ectropion);
tightening of the skin of the eyelids after burns, injuries, systemic lupus erythematosus, etc. ( cicatricial eversion).

For spastic inversion, therapy is used to treat its cause. For other types of ectropion, surgical intervention is indicated.

Blepharitis is a marginal inflammation of the eyelids.

Causes of blepharitis

chronic allergic and infectious diseases;
viral infections;
anemia;
lack of vitamins;
diseases of the digestive tract, teeth and nasopharynx;
untreated vision pathologies.

The main causative agent of the infectious nature of the disease is Staphylococcus aureus. Also, the development of blepharitis contributes to constant irritation of the eye by dust, smoke and wind. The pathological condition, as a rule, occurs with persistent decreases in immunity. In addition, allergic blepharitis may develop as a result of contact of cosmetics that irritate the skin on the eyelids or eyes, or as a result of taking certain medications.

Symptoms of blepharitis
In mild cases, the edges of the eyelids become red, slightly swollen and covered at the roots of the eyelashes with small gray-white scales that are easily separated. Patients complain of a feeling of heaviness in the eyelids, itching under the eyelashes and their loss. The eyes water, get tired very quickly, are sensitive to bright light, wind, dust, etc. In more severe cases, purulent crusts form along the edges of the eyelids, and when separated, small bleeding ulcers are exposed. Their scarring can lead to deformation of the eyelids and abnormal growth of eyelashes, which can even grow towards the eye. Eyelashes become thin, sparse, and fall out easily. Sometimes the disease may not cause the formation of ulcers and scales. In this case, the reddened edges of the eyelids will be thickened and moisturized, and when pressure is applied to the cartilage, an oily secretion will be released.

Treatment of blepharitis
With ulcerative blepharitis, it is necessary to carefully observe eyelid hygiene. Discharge and crusts are removed with a damp cotton swab. If the crusts are rough, they must first be softened with wet lotions or ointments containing corticosteroids and antibiotics.

With seborrheic blepharitis, it is also necessary to monitor eyelid hygiene. In addition, hydrocortisone ointment and eye drops are used ( ophtagel).

For demodectic blepharitis, the main goal of therapy is to reduce the level of mite damage. The eyelids should be wiped twice a day with a swab containing saline solution. The edges of the eyelids are lubricated with hydrocortisone and dexagentamicin ointment. It is important that the edges of the eyelids are covered with ointment before going to bed - this will disrupt the life cycle of the mites.

In the treatment of allergic blepharitis, the first place is to eliminate the allergen. In addition, therapy includes long-term use of antiallergic eye drops and lubrication of the edges of the eyelids with corticosteroid ointment. For infectious-allergic blepharitis, use dexagentamicin ointment or maxitrol.

Abscess of the century

An eyelid abscess is a limited inflammation of the eyelid tissue with the formation of a cavity in it that is filled with pus.
Most often, an abscess develops as a consequence of an infected eyelid wound.
Causes of eyelid abscess

barley;
boils;
ulcerative blepharitis;
purulent processes in the orbit of the eye and paranasal sinuses.

With an abscess, the eyelid is swollen, painful, the skin is red, hot to the touch and tense. Gradually, the affected area begins to acquire a yellowish tint, and a softening area appears. The abscess can open spontaneously with the release of pus - in this case, the inflammatory phenomena subside, but often a fistula remains, which indicates that the source of inflammation has not yet been eliminated. For treatment, sulfonamides and antibiotics are prescribed, as well as sulfadimethoxine orally. In addition, when the abscess begins to soften, it is better to surgically open it under sterile conditions.

Trichiasis is the name given to abnormal growth and placement of eyelashes, which occurs as a result of ulcerative blepharitis, trachoma and other pathologies. The eyelashes are directed towards the eye, irritating the cornea and conjunctiva, which causes inflammation. The main method of treatment is surgical.

Swelling of the eyelid is caused by an abnormal increase in fluid content in its subcutaneous tissue.

Edema is caused by:

heart, kidney and thyroid diseases;
injuries;
insect bites;
lymphatic drainage disorders;
leaks of cranial fluid.

The development of eyelid edema is facilitated by the high extensibility of the skin in this area, the rich blood supply to the eyelids, the very loose structure of the subcutaneous tissue, as well as its ability to accumulate fluid.

Clinically, inflammatory edema is manifested by a local increase in temperature, pronounced redness of the skin and pain when palpated. Most often such swelling is one-sided. Pain and enlargement of the lymph nodes are sometimes noted. With non-inflammatory edema, the skin of the eyelids is “cold”, pale, and palpation of the eyelid is painless. In these cases, the swelling is usually bilateral, more pronounced in the morning and often combined with swelling of the legs or abdomen.

Allergic edema is usually significantly pronounced, develops suddenly, is not accompanied by pain and quickly disappears. Its occurrence is often preceded by a feeling of weakness, headache and increased fatigue. The reason for the development of such edema is an allergic reaction of the body to any irritants.

Barley is an acute purulent inflammation of the sebaceous gland located near the ciliary bulb or hair follicle of the eyelash. Internal barley is also distinguished, caused by inflammation of the meibomian gland lobule ( meibomite).

Most often, stye on the eye is caused by a bacterial infection ( in 90% of cases it is Staphylococcus aureus) with weakened immunity in patients with reduced resistance to various infections. Barley often occurs against the background of a cold, inflammation of the paranasal sinuses, tonsillitis, dental diseases, disorders in the gastrointestinal tract, helminthic infestations, furunculosis, and diabetes mellitus.

Symptoms of both forms of stye are swelling and inflammation of the eyelid margin, redness and soreness. In the initial stages, a painful point appears on the edge of the eyelid or on the eyelid itself from the side of the conjunctiva due to inflammation of the sebaceous gland. Then, swelling and redness of the skin and conjunctiva appear around this point. After two to three days, a yellow “head” of barley appears in this area, and when opened, pus and sometimes pieces of tissue are released. The disease can be recurrent.

Treatment of stye at the beginning of the process involves wetting the area of the painful point on the eyelid with 70% ethyl alcohol 3 to 5 times a day. In many cases, this makes it possible to stop the further development of the pathology. For already formed barley, antibiotics and sulfa drugs in the form of ointments and drops, dry heat and UHF therapy are used. If body temperature and symptoms of general malaise begin to increase, then antibiotics are also prescribed orally. For barley, it is not recommended to use compresses or wet lotions, as they contribute to the spread of infection.

With meibomitis, inflammation does not develop so acutely, and the internal barley is opened more often into the conjunctival sac. But in some cases, after it a pathology called chalazion develops.

A chalazion is a cyst of the sebaceous gland of the eyelid, resulting from a blockage of its duct caused by chronic inflammation of the surrounding tissues. In such cases, the contents of the gland turn into a jelly-like mass, and on the eyelid you can feel a dense formation the size of a small pea. The skin in this place is mobile and raised, and on the side of the conjunctiva there is an area of redness with a grayish zone in the very center.

Causes of chalazion

effects of barley;
decreased protective functions of the body;
colds;
hypothermia;
violations of personal hygiene rules;
prolonged wearing of uncomfortable contact lenses;
very oily skin;
increased production of the sebaceous gland.

For treatment in the early stages, bactericidal drops and ointments with antibiotics are used. The radical method is the surgical method. On an outpatient basis, under local anesthesia, a special clamp is applied to the eyelid, and the contents of the chalazion are removed through an incision in the skin or conjunctiva along with the capsule. The entire operation takes only a few minutes.

Lagophthalmos

Lagophthalmos is a condition of incomplete closure of the palpebral fissure. It develops against the background of neuritis, after eyelid injuries, and can also be a consequence of congenital shortening of the eyelids. Due to excessive lighting, this pathology can lead to damage to the cornea.
In addition, lagophthalmos causes drying of the cornea and conjunctiva, which is complicated by erosion or keratitis. In addition to treating the underlying disease, disinfecting drops and “artificial tears” are instilled into the eye. To prevent drying out and to prevent infectious lesions, antibiotic ointment, sterile petroleum jelly or sea buckthorn oil are placed in the eye at night. In severe forms of lagophthalmos, surgical intervention with partial suturing of the palpebral fissure is possible.

Blepharospasm

Blepharospasm is an involuntary contraction of the muscles of the eyelid. Most often it is associated with other eye diseases.

There are 3 types of blepharospasm:
1. protective , which occurs when irritation and inflammation of the anterior part of the eye, mucous membrane or skin of the eyelids;
2. essential , which is of a neurotic obsessive nature ( teak), but can also have an organic basis, for example in tetany, chorea or epilepsy;
3. senile , occurring in older people as an isolated syndrome.
Treatment of this pathology is based on eliminating the underlying disease.

Blepharochalasis

Diseases of the lacrimal organs

Dacryocystitis

Dacryocystitis is an inflammation of the lacrimal sac, which is often chronic. One of the most common eye diseases in children. The cause of dacryocystitis is narrowing or blockage of the nasolacrimal duct due to inflammation in the nasal cavity, in the paranasal sinuses or in the bones that surround the lacrimal sac. When a blockage occurs, the outflow of tear fluid is delayed, which leads to the proliferation of microorganisms that cause inflammation of the mucous membranes of the lacrimal sac.

Main symptoms of dacryocystitis

lacrimation;
swelling of the lacrimal sac;
purulent discharge from the affected eye.

Treatment of dacryocystitis consists of prescribing antibacterial therapy, washing the lacrimal ducts and pushing the lacrimal sac, which allows you to break through the obstruction in the nasolacrimal duct.

Tearing

Lacrimation or lacrimation is the excessive secretion of tear fluid. It may be associated with increased production of tear fluid or disturbances in its outflow ( see Dacryocystitis). Excess tear fluid is caused by chemical, mechanical or light irritants, as well as inflammation of the cornea or conjunctiva.
Lacrimation can also be of a reflex nature, appearing in the cold, when the mucous membranes of the nose are irritated, during strong emotional experiences, etc. In most cases, to stop lacrimation, it is enough to remove the irritating factor.

Diseases of the conjunctiva

Conjunctivitis

Conjunctivitis is an inflammatory eye disease that affects the mucous membrane and is caused in most cases by a viral or, less commonly, bacterial infection.
Acute conjunctivitis is characterized by:

pain in the eyes;
purulent or mucopurulent discharge;
swelling of the eyelids;
swelling and redness of the conjunctiva;
photophobia.

Chronic conjunctivitis manifests itself:

itching and burning in the eyes;
feeling of “sand behind the eyelids”;
lacrimation;
eye fatigue;
redness of the whites of the eyes.

Viral conjunctivitis often associated with herpes infection or adenoviral infection of the upper respiratory tract. It can occur with a common cold or sore throat. It manifests itself as lacrimation, intermittent itching, moderate blepharospasm, and scanty non-purulent discharge. In children, this disease may be accompanied by the appearance of films or follicles. Artificial tear drops and warm compresses are used to treat a viral eye disease. If the symptoms are severe, drops with corticosteroids are used. A specific antiviral drug for the treatment of viral conjunctivitis is eye drops containing interferon. If conjunctivitis is caused by the herpes virus, acyclovir and ophthalmoferon drops are prescribed.

Bacterial conjunctivitis caused by bacteria that produce pus. One of the first symptoms is an opaque, sticky, yellowish or gray discharge from the eye, which causes the eyelids to stick together, especially after a night's sleep. However, bacteria such as chlamydia may not cause discharge or significant redness of the conjunctiva. In some patients, bacterial conjunctivitis may only be manifested by the sensation of a foreign body in the eye. Bacterial conjunctivitis is also characterized by dryness of the infected eye and surrounding skin. Like viral conjunctivitis, bacterial conjunctivitis most often first affects only one eye, and then can easily spread to the second. Mild forms of bacterial conjunctivitis do not always require drug treatment and can go away on their own with strict hygiene. However, tetracycline eye ointment or antibiotic eye drops will greatly speed up the healing process.

Trachoma– a type of conjunctivitis caused by chlamydia.
Symptoms of trachoma: redness and thickening of the conjunctiva, the formation of grayish grains on it ( follicles), which consistently disintegrate and scar. In the absence of adequate treatment, this disease leads to purulent inflammation and ulceration of the cornea, entropion of the eyelids, the formation of cataracts and even blindness.
Trachoma can be transmitted through hands and objects ( scarves, towels, etc.), contaminated with secretions ( pus, mucus or tears). Usually both eyes are affected. Antibiotics and sulfonamides are used in the treatment of trachoma. With the development of trichiasis and some other complications, surgical methods are sometimes used.

Blennorea is an acute purulent conjunctivitis caused by gonococcus. One of the common eye diseases in newborns who become infected from a mother with gonorrhea during childbirth. Blenorrheal conjunctivitis is characterized by serous-bloody discharge, and after 3 - 4 days - profuse purulent discharge. If left untreated, corneal ulcers occur, which can result in blindness.

For any infectious conjunctivitis, you should not touch your eyes with your hands, and it is also important for patients to strictly observe the rules of personal hygiene, use only their own towel and wash their hands thoroughly to prevent infection of other family members.

Conjunctivitis caused by toxic substances, develop when chemically aggressive compounds get into the eye.
Main symptom – pain and irritation in the eye, especially when looking up or down. This is the only type of conjunctivitis that can be accompanied by severe pain.

Allergic conjunctivitis occurs upon contact with an allergen in people with hypersensitivity. With this pathology, patients experience severe itching in the eyes and watery eyes. Minor swelling of the eyelids is also common. The main method of treatment is to stop contact with the allergen. In addition, antihistamines are used in the treatment of allergic conjunctivitis ( suprastin) in the form of eye drops or tablets. Drops of artificial tears also help reduce discomfort. In more complex cases, non-steroidal and steroidal anti-inflammatory drugs are used.

Dry eye syndrome

Computer syndrome or “dry eye” syndrome is caused by a lack of hydration of the conjunctiva and a tense state of the visual system, which is caused by static long-term work at a computer at a fixed close distance. In this case, the frequency of blinking decreases several times, and the surface of the cornea dries out, since the tear film is renewed much less frequently.

As a result, the following symptoms occur:

burning, dryness, discomfort and pain in the eyes;
slowdown or stagnation of necessary metabolic processes in the eye structures;
fatigue and redness of the eyes;
decreased visual acuity;
sensation of a foreign body in the eyes;
headache.

The time after which the patient notices characteristic complaints is purely individual and often depends on concomitant eye diseases ( for example, myopia) or vegetative-vascular dystonia.

Prevention of computer vision syndrome includes:

mandatory breaks from work;
correct selection of glasses or contact lenses;
correct body position ( anatomical chair, distance to the monitor at least 30 cm);
special filters in the monitor and correctly selected technical characteristics;
using drops to relieve dry and tired eyes.

Diseases of the outer shell of the eye (Scleritis)

Scleritis is a group of pathologies characterized by inflammation of the sclera ( outer shell of the eye). The main reasons for the development of this disease: rheumatism, tuberculosis, brucellosis, viral infections. It often manifests itself as severe eye irritation, pain, limited swelling and redness, sometimes with a bluish tint.
When palpated, a sharp pain in the eye is noted. The occurrence of complications leads to a decrease in visual acuity.

In cases of inflammation of the superficial layer of the sclera ( episcleritis) irritation is usually less pronounced, and visual acuity does not suffer. Sometimes the process can spread to the cornea with the development of sclerokeratitis and be complicated by iridocyclitis ( inflammation of the iris), which leads to vitreous opacification, pupillary fusion and secondary glaucoma.

As the disease progresses, the inflammatory processes gradually subside, leaving behind areas of black sclera that can bulge and stretch under the influence of intraocular pressure, causing secondary complications. The process takes a very long time - over many months and sometimes years. Treatment of scleritis includes the use of antibiotics, hormonal drugs, corticosteroids and physical therapy.

anonymous, Male, 23 years old

Dry eye syndrome(dry eyes syndrome) - is a complex of signs of pronounced or latent corneal or corneal-conjunctival xerosis that occurs due to a long-term disruption of the stability of the tear film, which covers the cornea with a thin layer.

A specific subjective sign dry eye syndrome is the patient’s inadequate pain reaction to the instillation of completely indifferent eye drops (chloramphenicol, dexamethasone, etc.).

Dry eye syndrome currently occurs in every third patient who first visited an ophthalmologist.

According to statistics, of all patients coming for an outpatient appointment, every fourth has a corneal disease. The social significance of corneal diseases is explained not only by the high frequency of development, but also by the duration of treatment, frequent relapses, and a decrease in visual acuity. Corneal diseases are one of the main causes of blindness and low vision.

Pathogenesis

The structural features, anastomosis and innervation of the marginal looped network of vessels around the cornea explain its rapid response to the development of the pathological process in the sclera, conjunctiva, iris and ciliary body. The conjunctival cavity, which communicates through the lacrimal ducts with the nasal cavity, always contains microflora. The slightest injury to the corneal epithelium is enough to open the entrance gate for infection.

The cornea is easily involved in the pathological process and slowly emerges from it, since it does not have blood vessels. All metabolic processes in the cornea are slowed down.

Symptoms of corneal diseases

Punctate epithelial erosions are small, somewhat concave defects of the epithelium that stain with fluorescein, but they are not visible when stained with rose bengal. Point epithelial erosions are a nonspecific sign of corneal diseases and can develop with various keratopathies. The localization of erosions can often indicate the etiology of the disease.

at the upper limbus: with spring catarrh, upper limbal keratoconjuictivitis, atony of the eyelids and poorly fitted contact lenses;
the area of the cornea between the edges of the eyelids (with open eyes); with dry eye syndrome, decreased sensitivity of the cornea and exposure to ultraviolet rays;
at the lower limbus: for diseases of the edge of the lower eyelid, lagophthalmos, rosacea keratitis, toxic effects of drops.

Punctate epithelial keratitis is a typical sign of viral infections. Characteristic is the detection of granular, opalescent, swollen epithelial cells visible without staining. These epithelial defects stain well with rose bengal but poorly with fluorescein.

Edema of the corneal epithelium- a sign of endothelial decompensation or a significant and rapid increase in intraocular pressure. The cornea loses its characteristic shine; in severe cases, small (vesicles) and small (bullas) bubbles may appear.

Signs of threads:

Thin, comma-shaped mucous filaments lying on the epithelium are connected at one end to the surface of the cornea, the other end moves freely when blinking. At the site of attachment of the thread, a subepithelial translucent gray area can be found.
The threads stain well with rose bengal, but not with fluorescein, because fluorescein accumulates between cells, and pink bengal stains dead and degenerative cells and mucus.

Reasons for the development of threads:

Keratoconjunctivitis with dry eye syndrome, superior limbal keratoconjunctivitis, recurrent erosion syndrome, eye surgery, lagophthalmos, decreased corneal sensitivity, herpes zoster ophthalmicus, acute cerebrovascular accident in the midbrain and essential blepharospasm.

Pannus is a subepithelial ingrowth of fibrovascular tissue of the limbus of inflammatory or degenerative origin. Progressive pannus is characterized by the presence of infiltration along the growing vessels. With regressive pannus, the vessels extend beyond the infiltrate.

Infiltrates- areas of active inflammation of the corneal stroma, consisting of an accumulation of leukocytes and cellular detritus.

Signs of corneal stroma infiltrates

Focal, granular opacification of light gray color, most often in the anterior layers of the stroma, usually combined with hyperemia of the limbus or conjunctiva.
Around the main focus is a rim of less dense infiltration, where in some cases single inflammatory cells are visible.

Reasons for the development of corneal stroma infiltrates

Non-infectious (eg, sensitivity to antigens), occur with contact lens wear and marginal keratitis.
Infectious keratitis caused by bacteria. viruses, fungi and protozoa.

Signs of corneal stromal edema: optical voids between the stroma plates associated with an increase in the thickness of the cornea, and a decrease in transparency due to a violation of the architectonics of the stroma;

Causes of corneal stromal edema: disciform keratitis, keratoconus, Fuchs dystrophy and damage to the corneal endothelium as a result of surgical interventions.

Vascularization occurs in various diseases of the cornea. With biomicroscopy, the venous vessels of the cornea are always visible, but the arterial vessels are difficult to see without fluorescein angiography. The deep vessels arise from the anterior ciliary vessels and run straight in a radial direction, disappearing at the limbus, in contrast to the tortuous superficial vessels that can be found outside the limbus. Deserted deep vessels of the cornea are visible in reflected light in the form of “shadows” of vessels.

Tears are the result of corneal stretching, congenital trauma, and keratoconus, which leads to a rapid influx of fluid into the corneal stroma.
The folds (streak keratopathy) can be caused by surgical trauma, hypotony of the eye, inflammation and edema of the stroma.

Forms

Among the various types of corneal pathology, the main place is occupied by inflammatory diseases (keratitis) and dystrophies. In addition, the cornea is subject to injury and burns. Corneal tumors rarely develop.

The following forms of corneal diseases are distinguished:

keratitis and their consequences;
dystrophy;
tumors;
anomalies in size and shape.

Keratitis and their consequences account for 20-25% of outpatients.

Diagnosis of corneal diseases

The frontal view and details in the corneal section are documented as follows.

Corneal opacities (scar or other degenerative changes) are depicted in black.

Epithelial edema - blue thin circles, stromal edema - blue shading, folds of Descemet's membrane - wavy blue lines.

The hypopyon is represented in yellow.

Blood vessels are in red. The superficial vessel is a wavy lily, starting outside the limbus, and the deep vessel is in the form of a straight line, the beginning of which is indicated at the limbus.

Pigmentation in the form of rings (iron deposits and Krukenbcrg spindle) is depicted in brown.

To diagnose corneal diseases, the method of external examination and lateral illumination is used. Maximum information about the localization of the source of inflammation, the depth of its occurrence, the nature of infiltration and the reaction of external tissues can be obtained by examining a light section of the cornea during biomicroscopy with sufficient magnification. Studying the sensitivity of the cornea is important. The cause of corneal damage may be internal to the body. It needs to be established, and then treatment aimed at eliminating the cause of the disease, in combination with local therapy, will be most effective.

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Systemic immunosuppressive drugs are used for some forms of severe peripheral corneal ulceration and thinning associated with systemic connective tissue damage.

Drugs that accelerate the regeneration of the corneal epithelium:

In eyes with thin stroma, it is important to accelerate the process of epithelial regeneration, since stromal thinning progresses more slowly when the epithelium is intact.

Artificial tears and ointments should not contain potentially toxic (eg benzalkonium) or corneal sensitizing preservatives (eg thiomersal).
Eyelid closure is an emergency measure in neuroparalytic and neurotrophic keratopathies, as well as in eyes with persistent epithelial defects.
- Temporary bonding of eyelids using Blenderm or Transpore tapes.
- CI toxin injection. botulinurn in m. levator palpebrae to create temporary ptosis.
- Lateral tarsorrhaphy or plastic surgery of the medial corner of the eye.
Bandage soft contact lenses improve healing by mechanically protecting the regenerating corneal epithelium in conditions of constant eyelid trauma.
Amniotic membrane transplantation may be appropriate to close a persistent, refractory epithelial defect.

Other treatments for corneal diseases

Adhesive tissue glue (cyanoacrylate) is used to limit stromal ulceration and close small perforations. The glue is applied to a synthetic plate, which is then applied to the area of thinning or perforation and covered with a bandage contact lens.
Closure of a progressive and treatment-resistant ulcer with a conjunctival flap according to Gundersen is used for a unilateral chronic process with a low probability of vision restoration.
Limbal stem cell transplantation is used in cases of limbal stem cell deficiency, such as chemical burns or scarring conjunctivitis. The source of donor tissue can be the fellow eye (autograft) in case of unilateral pathology, the eye of another person, or a cadaveric one (allograft) if both eyes are involved in the process.
Keratoplasty is performed to restore the transparency of the cornea.