Chalk eye

The fragments containing in copper, oxidizing, lead to the deposition of copper salts in the tissues of the eye - chalcosis. In the epithelium and stroma of the cornea, deposits of the smallest grains of blue, golden-blue or green are observed. The posterior surface of the cornea is a dull green color. Closer to the limb, the pigment grains are usually located mainly on the cornea and near the upper and lower limbs in the form of bands leading to the limb (on the top the strips are wide, and from the bottom - narrow).

The iris is colored greenish or greenish-yellow in color; at the pupillary margin its deposition of a pigment of brown color. There is a strengthening of the zone of corneoscleral trabeculae. Pigmentation has a rusty, rust-brown or yellow hue and gets rid of the usual pigmentation of a dark gray color, which is observed after the cyclite. The most pronounced pigmentation occurs near foreign bodies, in the iris-corneal corner or in the deep layers of the peripheral part of the cornea.

The ring on the anterior capsule of the lens, corresponding to the width of the pupil with the rays of turbidity emanating from it, resembling the figure of sunflower, is a constant sign of chalcosis.

In the vitreous body - pronounced destruction, kalkoticheskie changes have the character of rough floating threads and films, dotted with shiny dots, can be a brick-red shade. There is a dilution of the vitreous of various degrees, as well as the formation of schwart and connective tissue strands. These changes are observed at a far-reaching stage of the process.

In later periods of chalcosis a brick-red shade of the vitreous body is noted, more pronounced and to the side where the foreign body is located.

Symptoms of chalk eye

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

Treatment of chalk eye

The introduction of copper fragments into the eye, except for very small ones, causes aseptic (chemical) inflammation with abundant exudation. 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, brown copper oxide hydrate, copper carbonate compounds of green color. Unlike iron, copper in the eye turns into an insoluble state in an insignificant amount. Soluble copper salts circulate with eye fluids and can be eliminated from the eye completely.

When the eye is "smeared," along with the dissolution of the copper foreign body and the deposition of copper salts in the eye tissues, their gradual dissolution and elimination from the eyeball, accompanied in some cases by a reduction in the phenomena of chalcosis and even spontaneous healing of it, occurs again. Proceeding from this, conservative treatment of the disease is indicated.

The introduction of a conjunctive 10% and 15% solution of sodium thiosulfate for the prevention and treatment of chalcosis. Also recommend a 5% solution of sodium thiosulfate in the form of installations, in the form of intravenous infusions, instillation of drops, trays 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 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 applied to the open eye. The eye electrode is connected to the negative pole. An indifferent electrode and a lead plate with a gasket are applied to the back surface of the neck and connected to the positive pole. Galvanic current of 1-2 mA is passed through the eye for 20 minutes. Procedures are performed daily or every other day.

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

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

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

Prevention of chalk eye

Prevention of chalcosis is, first of all, in surgical intervention as early as possible, the entry of chemically active foreign bodies into the tissues of the eye. However, it is difficult to solve the problem of the prevention of siderosis and chalcosis in inoperable cases or when the foreign body has been in the eye tissues for a long time, where changes in the eye tissues have already occurred under the influence of metal-toxicity and after the removal of the fragment, a further development of the pathological process is possible.