Keratitis in hypo- and beriberi
Last reviewed: 23.04.2024
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Keratitis in hypo- and avitaminosis is caused by a violation of the general metabolic processes in the body. They arise due to the receipt of insufficient amounts of vitamins or poor assimilation of individual groups of vitamins. Corneal lesions often marked with a deficiency of vitamins A, B "B 2, C, PP, E. Corneal diseases develop against severe general pathology organism which is a consequence of vitamin deficiency, or conversely, difficult absorption of vitamins. Usually both eyes fall ill. The severity of changes in the cornea depends on the degree of vitamin deficiency in the body in hypovitaminosis, and in extremely severe cases (beriberi) - on the duration of the disease and the content of other vitamins.
[Symptoms and treatment of keratitis in hypo- and beriberi
The most effective method of primary diagnosis is the definition of the symptoms of the disease.
Keratitis in beriberi A
Avitaminosis A causes changes in the epithelial layer of the conjunctiva and the cornea. Avitaminosis symptoms have the following - in the initial stage, the sensitivity of the cornea decreases and the dystrophic changes slowly build up, the normal gloss and humidity of the surface disappear. It becomes dull, cloudy opacities develop. This is a stage of precursorosis, which is followed by epithelial xerosis, that is, cornification of the epithelium. In the beginning, on the conjunctiva of the eyeball and the cornea, xerotic dry plaques appear, within the open eye gap, like small droplets of frozen fat. Superficial dry cells sluschivayutsya, and there are unpleasant sensations. In this stage, with rational nutrition and treatment, recovery with a slight loss of eye function is still possible. The third stage of avitaminosis A is keratomalacia. The entire cornea becomes cloudy. Changes quickly shift from surface layers to deep ones. Simultaneously with the spread of turbidity begins the process of disintegration of the cornea. In the corners of the eyes abundantly detachable. Treatment, begun in this stage, ends with a rough scarring of defects. Without treatment, corneal perforation occurs. In connection with the lack of sensitivity of the cornea, tissue disintegration is painless.
Treatment: full nutrition with the inclusion of products of animal and vegetable origin rich in vitamins A and carotene, retinol acetate oil solution inside or intramuscularly at a daily dose of 100,000 ME and a multivitamin complex.
Locally: instillations of sulfanilamide preparations 3-4 times a day to prevent infection of the erosion surface; vitamin drops (citral and riboflavin in alternation), drugs that promote the regeneration of the epithelium (retinol, actovegin, balarpan, fish oil), in addition, ointments containing vitamins are required.
Keratitis with avitaminosis B
Avitaminosis B, in the cornea symptoms of avitaminosis are manifested against the background of general changes in the body: polyneuritis, loss of muscle tone, dysfunction of the gastrointestinal tract. There are opacities in the central part of the cornea, swelling of the epithelium, then discoid keratitis develops with persistent prolonged course and severe outcome. The superficial layers of the cornea become infected, necrotic, and possibly perforated. Already in the stage of development of discoid keratitis, the iris and ciliary body are involved in the pathological process, and then the choroid.
Treatment: rational nutrition with the inclusion of dishes from legumes, cereals, liver, kidneys. Thiamine bromide and multivitamins are prescribed in therapeutic doses.
Local treatment depends on the stage of the disease. The general approach is the same as with avitaminosis A.
Keratitis in beriberi B 2
Avitaminosis B 2 can cause superficial keratitis with ulceration, but a stromal form of inflammation is also possible. Keratitis with avitaminosis B 2 is characterized by the ingrowth of a large number of surface vessels. Rational treatment in the stage of early manifestations leads to recovery. Disease of the cornea, this avitaminosis symptoms occur against the background of seborrheic dermatitis, angular stomatitis, glossitis and other manifestations of avitaminosis В 2.
Treatment: full nutrition with a mandatory daily inclusion in the diet of milk, meat, legumes; prescribe drugs riboflavin and multivitamins in therapeutic doses according to age.
Local treatment is symptomatic. Apply a 0.02% riboflavin solution in the drops. The general principle of local treatment is the same as with avitaminosis A. To suppress the growth of newly formed vessels, subconjunctival injections of steroid preparations (dexazone 0.5 ml once a day) are conducted with courses of 7-10 days.
Keratitis with avitaminosis B 6, B 12, PP, E
Avitaminoses B 6, B 12, PP, E are always reflected on the corneal state, manifested by a violation of epithelialization, mainly in the central part, after which the cornea becomes impregnated with tear fluid, its transparency changes, infiltrates appear, then erosion and ulceration. At different times, newly formed vessels germinate. Keratitis occurs against the background of general changes in the body, characteristic for a given hypo- or avitaminosis. It is the identification of a link with a specific general pathology that allows us to establish the correct diagnosis and prescribe a general etiologic treatment, without which local therapy is ineffective.
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