Chalcosis of the eye

Fragments containing copper, when oxidized, lead to the deposition of copper salts in the tissues of the eye - chalcose. In the epithelium and stroma of the cornea, deposits of tiny grains of blue, golden-blue or green color are observed. The back surface of the cornea is a cloudy green color. Closer to the limbus, pigment grains are usually located mainly on the cornea and at the upper and lower limbus in the form of stripes going to the limbus (the stripes are wide at the top, narrow at the bottom).

The iris is greenish or greenish-yellow; at the pupillary margin, there is a deposit of brown pigment. There is an increase in the corneoscleral trabeculae zone. The pigmentation has a reddish, reddish-brown or yellow tint and is separated from the usual dark-gray pigmentation observed after cyclitis. The most pronounced pigmentation is near foreign bodies, in the iridocorneal angle or in the deep layers of the peripheral part of the cornea.

A ring on the anterior capsule of the lens, corresponding in width to the pupil with radial rays of opacification extending from it, resembling the shape of a sunflower, is a constant sign of chalcosis.

In the vitreous body - pronounced destruction, calcotic changes have the character of coarse floating threads and films, dotted with shiny dots, can be brick-red in color. Liquefaction of the vitreous body of varying degrees of severity is observed, as well as the formation of adhesions and connective tissue strands. These changes are observed at an advanced stage of the process.

In later stages of chalcosis, a brick-red tint of the vitreous body is noted, more pronounced on the side where the foreign body is located.

Symptoms of chalcosis of the eye

Clinically expressed chalcosis of the retina is rare. The changes are localized mainly in the area of the macula lutea, where a corolla is determined, consisting of individual foci of various sizes and shapes, the color of which varies from yellowish to copper-red. The foci have a metallic luster. Early manifestations of chalcosis are usually not detected ophthalmoscopically. The clinical picture of chalcosis and the degree of expression of the pathological process vary. The size of the fragment does not have a special effect on the degree of expression of chalcosis. Around the copper fragment located in the eye, an inflammatory process always occurs, a zone of aseptic suppuration is formed. The tissue in this zone melts, an abscess is formed, and conditions are created for the movement of the fragment. Copper foreign bodies often lead to eye atrophy.

Treatment of chalcosis of the eye

The introduction of copper fragments into the eye, with the exception of very small ones, causes aseptic (chemical) inflammation with abundant exudation. The inflammatory process in the eye occurs as a result of the formation of soluble copper compounds. Copper in the eye is found in the form of copper sulfate of a brown color, copper oxide hydrate of a yellow color, copper carbonates of a green color. Unlike iron, copper in the eye becomes insoluble in an insignificant amount. Soluble copper salts circulate with eye fluids and can be completely excreted from the eye.

In case of "coppering" of the eye, along with the dissolution of the copper foreign body and deposition of copper salts in the tissues of the eye, their gradual dissolution and removal from the eyeball occurs again, accompanied in some cases by a decrease in the phenomena of chalcosis and even its spontaneous healing. Based on this, conservative treatment of the disease is indicated.

Subconjunctival administration of 10% and 15% sodium thiosulfate solution is used for the prevention and treatment of chalcosis. A 5% sodium thiosulfate solution is also recommended in the form of instillations, intravenous infusions, drops, baths and ointments.

To treat chalcosis of the eye, ionization with the opposite sign is used. The ionization technique is as follows: a constant electric current is passed through the eye in the direction from the back of the eye to the cornea. A glass bath with a platinum electrode soldered into it, filled with a 0.1% solution of sodium chloride (table salt), is placed on the open eye. The eye electrode is connected to the negative pole. An indifferent electrode in the form of a lead plate with a gasket is placed on the back of the neck and connected to the positive pole. A galvanic current of 1-2 mA is passed through the eye for 20 minutes. The procedures are performed daily or every other day.

For better absorption of turbidity, diathermy (0.2-0.3 A) is sometimes performed beforehand for several minutes. One course consists of 30 procedures. It is advisable to repeat the courses every two months.

Vitamin A gives favorable results in the treatment of chalcosis. It is also recommended to use Unitol in the form of intramuscular injections (7.5 ml of a 5% solution 3 times a day during the first two days, 5 ml 3 times a day during the next 5 days) and eye drops (6 times a day), as well as a 5% or 10% solution of sodium thiosulfate 4 times a day in the form of instillations.

Complex treatment of siderosis and chalcosis of the eye should be carried out under constant control of not only clinical but also electrophysiological studies.

Prevention of chalcosis of the eye

Prevention of chalcosis consists primarily of surgical intervention as early as possible, when chemically active foreign bodies enter the eye tissues. However, it is difficult to resolve the issue of preventing siderosis and chalcosis in inoperable cases or when a foreign body has been in the eye tissues for a long time, where changes have already occurred in the eye tissues under the influence of metal intoxication and after removal of the fragment, further development of the pathological process is possible.