Sideroz Eye

Siderosis of the eye - is nothing like the deposition of iron salts in the tissues of the eye. With siderosis, all the tissues of the eye are impregnated with iron salts - corneal stroma, deposition of brown pigment in the form of dust on the endothelium of the cornea from the anterior chamber, which creates its brown opalescence. With local siderosis, pigmentation is noted only around the fragment.

Symptoms of an eye siderosis

Anterior chamber of normal depth or deep (with ciliary ligament (cilin) and subluxation of the lens in far-reaching stages of the process). The moisture of the anterior chamber is usually opalescent due to the presence of small iron particles (yellowish brown spots) in it.

Iris is darker, often brown in color, which is associated with deposition of a large number of grains of yellow-brown pigment. On the surface (in crypts) and in the stroma of the iris, there can be free iron deposits. In the far-reaching stage of siderosis, the pupil reacts weakly to light or does not react at all.

In the corneal-corneal corner, gonioscopy reveals the deposition in the form of exogenous and endogenous pigmentation of the helmet canal (the scleral vas deferens). Sometimes there is a complete blockage of the iris-cornea brittle by the pigment, because of which the zones of separation are not visible.

In the lens, along with the opacities caused by his trauma, deposits of brown pigment grains are observed in the epithelium of the anterior capsule. In the initial stages of siderosis, deposits on the pupillary margin look like plaques, in later stages - pigment rings formed from multiple plaques. In the center of the pupil, a brown ring is visible, in the cortical layers, the ring is lighter, on the periphery it spreads and is marked as separate points. Sometimes pigment deposits exist along the wounded canal of the lens. In the far-advanced stages of the process, the lens may have a dark brown color.

In connection with the degeneration of the zinn ligament, the wrinkling of the lens and its subluxation may be noted.

In the vitreous body there is a pronounced destruction or clouding, as well as the formation of a mop.

In the mesh shell, clinically determined changes are detected in the far-advanced stage of siderosis. They manifest themselves in the form of peripheral retinitis pigmentosa, which is characterized by the presence of pigment foci on the fundus and in these cases resembles the pattern of changes in retinal pigmentary degeneration. In the late stages of the pathological process, large pigment white atrophic foci are seen in the central parts of the fundus. In severe cases of siderosis, the optic nerve disk is rusty, and in secondary glaucoma glaucomatous excision of the optic nerve is observed.

With a long-term finding of a fragment in the eye, developed siderosis occurs in 22%, far-reaching - in 1% of cases. Clinically pronounced manifestations of siderosis more often (in 50% of cases) occur when exposed to a foreign body on the eye tissue for 6-12 months. When the fragment is found in the eye for more than 3 years, changes are observed that are characteristic of developed siderosis, somewhat less often - typical of a far-reaching process.

If the fragment is in the anterior chamber, the siderosis of the anterior part of the eye develops faster.

When the fragment is inserted into the lens, the initial phenomena of siderosis are more often observed, mainly in the anterior part of the eyeball.

The mesh shell remains intact for a long time. The degree of expression of siderosis does not depend on the size of a foreign body.

Treatment of eye siderosis

For the prevention of siderosis it is recommended to use high-frequency induction currents. Since one of the first violations in siderosis is a decrease in the dark adaptation, as a therapeutic effect in this disease, vitamin A is used, since it has a certain beneficial effect on the eye tissue with siderosis.

For treatment of siderosis, unitol (antidote of heavy metals) is recommended - in courses: the first 2 days - 3 times a day for 7.5 ml of 5% solution of unitol, the next 5 days - 5 ml 3 times a day intramuscularly. On an outpatient basis, a unitol solution of 3 ml is administered once a day. The course of treatment is 30 days. All patients in the conjunctival sac of the affected eye are instilled with a 5% solution of Unitol 4 to 6 times a day. When inflammatory phenomena caused by prolonged stay in the eye of an iron-containing foreign body, symptomatic treatment (installation of atropine, corticosteroids, disinfectants, antibiotics) is performed. It is also possible to use subconjunctival injections of a 5% solution of unitol in 0.2 ml daily, a course of treatment 15 days, a year - four courses.

The positive effect of unitol with siderosis was noted after removal of the fragment - in a number of patients the further development of the process is prevented, therefore, unitol is recommended to be used both for prophylaxis and for treatment of siderosis of the eye.

Prevention of siderosis of the eye

Prevention of siderosis 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.