How should chronic keratitis be treated

Abstract: the basic principle of treating corneal ulcer is to take all effective measures to quickly control infection, strive for early cure and reduce the sequelae of keratitis to a minimum.

chronic keratitis is divided into ulcerative keratitis and non ulcerative keratitis. Ulcerative keratitis, also known as corneal ulcer, non ulcerative keratitis, namely deep keratitis. Inflammation caused by corneal trauma, bacteria and viruses invading the cornea. The affected eye has foreign body sensation, tingling and even burning sensation. Mixed hyperemia on the surface of bulbar conjunctiva, accompanied by fear of light, tears, visual impairment and increased secretion. Corneal surface infiltration and ulcer formation. The basic principle of

and

in the treatment of corneal ulcer is to take all effective measures to quickly control infection, strive for early cure and reduce the sequelae of keratitis to a minimum. Because most ulcerative keratitis is caused by external causes, it is very important to remove the external causes and eliminate pathogenic microorganisms. In order to contribute to the etiological diagnosis, smears should be taken from the edge of corneal ulcer, Conduct bacterial culture and drug sensitivity test (mold culture if necessary). However, do not delay the treatment in order to wait for the test results, and take necessary measures immediately.

1. Hot compress: dilate the blood vessels of the eyes, remove the obstruction, promote blood flow, enhance resistance and nutrition, and quickly recover the ulcer.

2. Flushing: if there are many secretions, normal saline or 3% boric acid solution can be used to flush the conjunctival sac three or more times a day, so as to flush out the secretions, necrotic tissues, bacteria and toxins produced by bacteria. In this way, it can not only reduce the factors of infection expansion, but also ensure that the local drug concentration will not be reduced.

3. Mydriasis:

A. atropine is the main and commonly used drug, with a concentration of 0.25 ~ 2% solution or ointment, dropping every day Apply it 1 ~ 2 times (after dropping, pay attention to press the lacrimal sac to avoid excessive absorption of the solution by the mucosa and poisoning).

B. It can not be used for simple corneal ulcer or non significant irritation symptoms. It must be used for ulcer with significant irritation symptoms and potential perforation. This medicine has a dual effect on the treatment of corneal ulcer; On the one hand, it can rest the pupil sphincter and ciliary muscle, on the other hand, it can prevent iridocyclitis and its consequences. Moreover, because the spasm of intraocular muscles is relieved, it also has the effect of relieving pain and pain.

4. Bacterial preparation:

A. sulfonamide chemicals such as 10 ~ 30% sodium sulfacetamide and 4% sulfaisoxazole eye drops.

B. for the infection of gram-positive cocci, local drip of 0.1% rifampicin eye drops or 0.5% erythromycin or 0.5% bacitracin eye drops 4 to 6 times a day is sufficient to control. Some broad-spectrum antibiotics, such as 0.5% aureomycin 0.25% chloramphenicol and 0.5% tetracycline (0.5%) have more effective antibacterial effects.

C. for gram-negative bacilli infection, 1 ~ 5% streptomycin, 0.3 ~ 0.5% gentamicin, polymyxin B (20000 units / ml), 0.25 ~ 0.5% neomycin, 0.5% kanamycin, etc.

D. for serious ulcers whose bacterial culture and drug sensitivity test results are unknown, a variety of broad-spectrum antibiotics can be used at the beginning, dropping once every few minutes or quarter of an hour in turn, and then decreasing as appropriate. In addition, subconjunctival injection can also be used, once a day, and continuous injection for several days until the ulcer symptoms subside. Conjunctival necrosis sometimes occurs after subconjunctival injection of some drugs, which should be paid attention to.

E. antiviral drugs include 0.1% herpesin, etc. Antifungal agents include nystatin (25000 units / ml), 0.1% amphotericin B, 0.5% trichomycin and 0.5% equimycin, etc.

5. Binding and wrapping:

A. in order to stop the rotation of the eyeball and promote the early recovery of the ulcer, it must be wrapped… This treatment is especially suitable for winter. Because it not only prevents the eyeball from catching cold, but also has the effect of hot compress and protection.

B. if there is secretion in the conjunctival sac, it should not be wrapped, It can be replaced by Buller’s eye mask or black glasses. In addition, if the ulcer is likely to wear out or bulge during the scarring period, it should be wrapped with compression bandage every day. If it is impossible during the day, it should be used during sleep at night in order to save the adverse consequences.

6. Etiological treatment:

A. when treating corneal ulcer, we must pay attention to the causes of ulcer and treat it.

B. conjunctival disease and malnutrition should be paid attention to most. For example, trachoma pannus ulcer, if not treated at the same time, the ulcer is difficult to recover. Another example is corneal softening. If you do not pay attention to systemic nutrition and supplement vitamin A, corneal softening will not only be difficult to recover, but also worsen.

7. Stimulation therapy: when the ulcer has completely healed and begins to scar, try to make the scar thinner and better.

and

for small, dense and central corneal leukoplakia, in order to improve visual acuity, hyperopia iridectomy can be performed. For larger leukoplakia, corneal transplantation can be performed. Sometimes corneal leukoplakia hinders beauty. Soot and Chinese ink can be used as corneal ink acupuncture.

8. Treatment of corneal ulcer complicated with disease:

A. emergency measures should be taken for corneal ulcer about to perforation. Make the patient stay in bed, give laxatives, acetazolamide and other drugs to reduce intraocular pressure, and instruct the patient to avoid sudden increase of intraocular pressure such as sneezing or coughing.

B. If corneal ulcer is perforated, it not only tends to heal, but also increases corneal nutrition. In order to achieve this goal, artificial anterior chamber puncture can also be performed. This will not only make the aqueous humor flow out slowly, but also avoid the adverse consequences of ulcer perforation, such as rainbow membrane prolapse or lens prolapse. Moreover, anterior chamber puncture can also stop severe eye pain. If anterior chamber puncture is performed at the base of the ulcer, it can be covered with conjunctival flap. Iris prolapse can be treated with iridectomy.

C. for patients with corneal fistula, cauterization should be performed, and anti-inflammatory therapy should be performed at the same timeGlaucoma surgery and conjunctival flap covering corneal fistula.

  d、 β X-ray can inhibit the growth of corneal blood vessels. In addition, both heterosexual protein therapy and traditional Chinese medicine therapy can enhance systemic resistance and promote the healing of keratitis.

corneal ulcer is difficult to use a strict classification to adapt to its different clinical processes. This paper only classifies according to the viewpoint of etiology combined with clinical manifestations, and summarizes its symptoms and treatment, in order to enable readers to get a clear concept.

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antifungal drugs. It is suitable for the treatment of fungal keratitis caused by Candida albicans, Aspergillus fumigatus, Cryptococcus and coccidium.

price: ¥ 6

this product is suitable for the treatment of acute and chronic bacterial conjunctivitis, blepharitis, wheat granuloma, meibomian adenitis, dacryocystitis, keratitis, corneal ulcer and other external eye infections.

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all kinds of acute and chronic conjunctivitis, peripheral keratitis, dacryocystitis and chemical burns; Prevention and treatment of infection and inflammatory reaction before and after various eye operations.

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this product is suitable for the treatment of bacterial conjunctivitis, keratitis, corneal ulcer, dacryocystitis, postoperative infection and other external eye infections.

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It is used to treat eye infections caused by Escherichia coli, Haemophilus influenzae, Klebsiella, Staphylococcus aureus, hemolytic streptococcus and other sensitive bacteria, such as trachoma, conjunctivitis, keratitis, eyelid marginal inflammation, etc.

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is mainly used for treatment of acute and chronic conjunctivitis, keratitis, scleritis, uveitis, acute scleritis, cataract, glaucoma, corneal transplantation and ocular mechanical or chemical burns. This product can also be used for the treatment of external ear inflammation.

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this product is suitable for the treatment of bacterial conjunctivitis, keratitis, corneal ulcer, dacryocystitis, postoperative infection and other external eye infections.

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this product is suitable for the treatment of bacterial conjunctivitis, keratitis, corneal ulcer, dacryocystitis, postoperative infection and other external eye infections.

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this product is suitable for the treatment of bacterial conjunctivitis, keratitis, corneal ulcer, dacryocystitis, postoperative infection and other external eye infections.

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broad-spectrum anti herpesvirus drugs. For the treatment of herpes simplex keratitis.

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this product is suitable for the treatment of bacterial conjunctivitis, keratitis, corneal ulcer, dacryocystitis, postoperative infection and other external eye infections.

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this product is suitable for the treatment of bacterial conjunctivitis, keratitis, dacryocystitis and other external eye infections.

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this product is a non steroidal anti-inflammatory drug, which can only be used when at least one other non steroidal anti-inflammatory drug fails to treat. It can be used for the treatment of pain such as chronic arthritis (such as osteoarthritis), operation and acute post-traumatic pain, and treatment of primary dysmenorrhea. The price of

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, Abstract: the basic principle of treating corneal ulcer is to take all effective measures to quickly control infection, strive for early cure and reduce the sequelae of keratitis to a minimum., Chronic keratitis is divided into ulcerative keratitis and non ulcerative keratitis. Ulcerative keratitis, also known as corneal ulcer, non ulcerative keratitis, namely deep keratitis。 Inflammation caused by corneal trauma, bacteria and viruses invading the cornea. The affected eye has foreign body sensation, tingling and even burning sensation. Mixed hyperemia on the surface of bulbar conjunctiva, accompanied by fear of light, tears, visual impairment and increased secretion. Corneal surface infiltration and ulcer formation., The basic principle of treating corneal ulcer is to take all effective measures to quickly control infection, strive for early cure and minimize the sequelae of keratitis. Because most ulcerative keratitis is caused by external causes, it is very important to remove the external causes and eliminate pathogenic microorganisms. In order to contribute to the etiological diagnosis, smears should be taken from the edge of corneal ulcer, Conduct bacterial culture and drug sensitivity test (mold culture if necessary). However, do not delay treatment in order to wait for the test results, and take necessary measures immediately.

Chronic keratitis is divided into ulcerative keratitis and non ulcerative keratitis. Ulcerative keratitis, also known as corneal ulcer, non ulcerative keratitis, namely deep keratitis. Inflammation caused by corneal trauma, bacteria and viruses invading the cornea. The affected eye has foreign body sensation, tingling and even burning sensation. Mixed hyperemia on the surface of bulbar conjunctiva, accompanied by fear of light, tears, visual impairment and increased secretion. Corneal surface infiltration and ulcer formation. The basic principle of

and

in the treatment of corneal ulcer is to take all effective measures to quickly control infection, strive for early cure and reduce the sequelae of keratitis to a minimum. Because most ulcerative keratitis is caused by external causes, it is very important to remove the external causes and eliminate pathogenic microorganisms. In order to contribute to the etiological diagnosis, smears should be taken from the edge of corneal ulcer, Conduct bacterial culture and drug sensitivity test (mold culture if necessary). However, do not delay the treatment in order to wait for the test results, and take necessary measures immediately.

1. Hot compress: dilate the blood vessels of the eyes, remove the obstruction, promote blood flow, enhance resistance and nutrition, and quickly recover the ulcer.

2. Flushing: if there are many secretions, normal saline or 3% boric acid solution can be used to flush the conjunctival sac three or more times a day, so as to flush out the secretions, necrotic tissues, bacteria and toxins produced by bacteria. In this way, it can not only reduce the factors of infection expansion, but also ensure that the local drug concentration will not be reduced.

3. Mydriasis:

A. atropine is the main and commonly used drug, with a concentration of 0.25 ~ 2% solution or ointment, dropping every day Apply it 1 ~ 2 times (after dropping, pay attention to press the lacrimal sac to avoid excessive absorption of the solution by the mucosa and poisoning).

B. It can not be used for simple corneal ulcer or non significant irritation symptoms. It must be used for ulcer with significant irritation symptoms and potential perforation. This medicine has a dual effect on the treatment of corneal ulcer; On the one hand, it can rest the pupil sphincter and ciliary muscle, on the other hand, it can prevent iridocyclitis and its consequences. Moreover, because the spasm of intraocular muscles is relieved, it also has the effect of relieving pain and pain.

4. Bacterial preparation:

A. sulfonamide chemicals such as 10 ~ 30% sodium sulfacetamide and 4% sulfaisoxazole eye drops.

B. for the infection of gram-positive cocci, local drip of 0.1% rifampicin eye drops or 0.5% erythromycin or 0.5% bacitracin eye drops 4 to 6 times a day is sufficient to control. Some broad-spectrum antibiotics, such as 0.5% aureomycin 0.25% chloramphenicol and 0.5% tetracycline (0.5%) have more effective antibacterial effects.

C. for gram-negative bacilli infection, 1 ~ 5% streptomycin, 0.3 ~ 0.5% gentamicin, polymyxin B (20000 units / ml), 0.25 ~ 0.5% neomycin, 0.5% kanamycin, etc.

D. for serious ulcers whose bacterial culture and drug sensitivity test results are unknown, a variety of broad-spectrum antibiotics can be used at the beginning, dropping once every few minutes or quarter of an hour in turn, and then decreasing as appropriate. In addition, subconjunctival injection can also be used, once a day, and continuous injection for several days until the ulcer symptoms subside. Conjunctival necrosis sometimes occurs after subconjunctival injection of some drugs, which should be paid attention to.

E. antiviral drugs include 0.1% herpesin, etc. Antifungal agents include nystatin (25000 units / ml), 0.1% amphotericin B, 0.5% trichomycin and 0.5% equimycin, etc.

5. Binding and wrapping:

A. in order to stop the rotation of the eyeball and promote the early recovery of the ulcer, it must be wrapped… This treatment is especially suitable for winter. Because it not only prevents the eyeball from catching cold, but also has the effect of hot compress and protection.

B. if there is secretion in the conjunctival sac, it should not be wrapped, It can be replaced by Buller’s eye mask or black glasses. In addition, if the ulcer is likely to wear out or bulge during the scarring period, it should be wrapped with compression bandage every day. If it is impossible during the day, it should be used during sleep at night in order to save the adverse consequences.

6. Etiological treatment:

A. when treating corneal ulcer, we must pay attention to the causes of ulcer and treat it.

B. conjunctival disease and malnutrition should be paid attention to most. For example, trachoma pannus ulcer, if not treated at the same time, the ulcer is difficult to recover. Another example is corneal softening. If you do not pay attention to systemic nutrition and supplement vitamin A, corneal softening will not only be difficult to recover, but also worsen.

7. Stimulation therapy: when the ulcer has completely healed and begins to scar, try to make the scar thinner and better.

and

for small, dense and central corneal leukoplakia, in order to improve visual acuity, hyperopia iridectomy can be performed. For larger leukoplakia, corneal transplantation can be performed. Sometimes corneal leukoplakia hinders beauty. Soot and Chinese ink can be used as corneal ink acupuncture.

8. Treatment of corneal ulcer complicated with disease:

A. emergency measures should be taken for corneal ulcer about to perforation. Make the patient stay in bed, give laxatives, acetazolamide and other drugs to reduce intraocular pressure, and instruct the patient to avoid sudden increase of intraocular pressure such as sneezing or coughingMake.

B. If corneal ulcer is perforated, it not only tends to heal, but also increases corneal nutrition. In order to achieve this goal, artificial anterior chamber puncture can also be performed. This will not only make the aqueous humor flow out slowly, but also avoid the adverse consequences of ulcer perforation, such as rainbow membrane prolapse or lens prolapse. Moreover, anterior chamber puncture can also stop severe eye pain. If anterior chamber puncture is performed at the base of the ulcer, it can be covered with conjunctival flap. Iris prolapse can be treated with iridectomy.

C. for patients with corneal fistula, cauterization, anti glaucoma surgery and conjunctival flap covering corneal fistula should be performed.

  d、 β X-ray can inhibit the growth of corneal blood vessels. In addition, both heterosexual protein therapy and traditional Chinese medicine therapy can enhance systemic resistance and promote the healing of keratitis.

corneal ulcer is difficult to use a strict classification to adapt to its different clinical processes. This paper only classifies according to the viewpoint of etiology combined with clinical manifestations, and summarizes its symptoms and treatment, in order to enable readers to get a clear concept.

, 1. Hot compress: dilate the blood vessels in the eyes, relieve the obstruction, promote blood flow, enhance resistance and nutrition, and quickly recover the ulcer., 2. Flushing: if there are many secretions, normal saline or 3% boric acid solution can be used to flush the conjunctival sac three or more times a day, so as to flush out the secretions, necrotic tissues, bacteria and toxins produced by bacteria. In this way, it can not only reduce the factors of infection expansion, but also ensure that the local drug concentration will not be reduced., 3. Mydriasis: A. atropine is the main and commonly used drug, with a concentration of 0.25 ~ 2% solution or ointment, dropping every day Apply 1 ~ 2 times (after dropping the medicine, pay attention to press the lacrimal sac to prevent the solution from being excessively absorbed by the mucosa and causing poisoning). B. It can not be used for simple corneal ulcer or those with insignificant irritation symptoms. It must be used for ulcer with significant irritation symptoms and potential perforation. This medicine has a dual effect on the treatment of corneal ulcer; on the one hand, it can rest the pupil sphincter and ciliary muscle, and on the other hand, it can prevent and treat corneal ulcer Iridocyclitis and its consequences. Moreover, because the spasm of intraocular muscles is relieved, it also has the effect of relieving pain and pain., 4. Bacterial preparation: A. sulfonamides, such as 10 ~ 30% sulfacetamide sodium and 4% sulfaisoxazole eye drops., B. for the infection of gram-positive cocci, local drip of 0.1% rifampicin eye drops or 0.5% erythromycin or 0.5% bacitracin eye drops 4 to 6 times a day is sufficient to control. Some broad-spectrum antibiotics, such as 0.5% aureomycin 0.25% chloramphenicol and 0.5% tetracycline (0.5%) have more effective antibacterial effect. C. for gram-negative bacilli infection, 1 ~ 5% streptomycin, 0.3 ~ 0.5% gentamicin and polymyxin B can be selected (20000 units / ml), 0.25 ~ 0.5% neomycin, 0.5% kanamycin, etc. D. for ulcers with severe conditions whose bacterial culture and drug sensitivity test results are unknown, a variety of broad-spectrum antibiotics can be used at the beginning, dropping once every few minutes or a quarter of an hour in turn, and then decreasing as appropriate. In addition, subconjunctival injection can also be used, once a day And continuous injection for several days until the ulcer symptoms subside. Conjunctival necrosis sometimes occurs after subconjunctival injection of some drugs, which should be paid attention to., E. antiviral drugs include 0.1% herpesin, etc. Antimycotic agents include nystatin (25000 units / ml), 0.1% amphotericin B, 0.5% trichomycin and 0.5% equimycin, etc. 5. Binding and wrapping: A. in order to stop the rotation of the eyeball and promote the early recovery of the ulcer… This treatment is especially suitable for winter. It not only prevents the eyeball from getting cold, but also has the effect of hot compress and protection. B. if the conjunctiva If there is secretion in the capsule, it should not be bandaged, but can be replaced by Buller’s eye mask or black glasses. In addition, if the ulcer is likely to wear out or swell during the scarring period, it should be bandaged with compression bandage every day. If it is impossible during the day, it should be used during sleep at night in order to save the adverse consequences