Index
Definition:
The leucoma is the clouding of the cornea, which emerges due to an injury due to a traumatic, inflammatory, or ulcerative process. When a scar occurs, the cornea loses its transparency and the ability to transmit light.
Depending on the location of the leucoma on the cornea and its size, it affects the quality of vision. The leukoma, located in front of the pupil, can reduce vision (sometimes even blindness). A spot formed on the cornea’s periphery can not affect the eye.
Causes
- Corneal injury (wounds, burns)
- Ophthalmologic surgeries
- Keratitis
- Congenital corneal opacity
- Conjunctival disease
Types of leukoma
The division of leucoma species depends on their form and nature of origin. Due to the shape, it is customary to distinguish the following types of leucoma: cloud, scar, spot, etc.
By nature, leucoma can be congenital or obtained.
Congenital leukoma: can occur in the embryo in the uterus due to the impact of viruses and bacteria that infect the eye’s cornea.
The obtained leucoma occurs after birth under the influence of the factors above and appears more frequently than congenital leukoma.
Complications
On the surface, the leucoma formed due to a corneal ulcer or its mechanical damage; irregularities are usually observed, and the cornea often becomes thin.
However, sometimes the cornea has spiked with an iris that causes pupil deformation and secondary glaucoma.
The reduction of visual acuity due to leukoma can involve a series of serious complications: accommodation spasm, severe myopia, accommodative or muscular asthenopia, strabismus, etc.
Diagnostico
The leucoma is diagnosed with a slit lamp, which allows seeing a spot in the details to determine its depth. Ophthalmoscopy is also performed (background inspection with special instruments), which helps determine the degree of transparency of the leucoma to control the fundus reflex.
Treatment
The most effective treatment for leukoma is a surgery called keratoplasty. This surgery is quite complicated, during which the damaged part of the cornea is replaced.
You can use donor material or a particular corneal transplant. The operation is performed outpatient, using local or general anesthesia.
Keratography represents a treatment method to introduce natural pigments with a unique tattoo needle into the cornea. In cases of corneal leukoma, the iris and pupil can be reconstructed cosmetically.
In cases of other strabismus, the pupil may be adjusted, or strabismus surgery may occur. Many attempts have been made to tattoo the cornea, but the results were not satisfactory.
Depending on the characteristics of the cornea, the rehabilitation period can last up to a year. During this period, the patient must be seen by an ophthalmologist.
As a general rule, keratoplasty has a favorable prognosis, and pharmacological treatment is carried out to treat residual inflammation in the cornea. At the same time, the choice of drugs depends on the cause of the disease.
Antiviral and antituberculous medications can cause soft illumination of the walleye and not cure it completely.
Study on the Leucoma
A study from the University Eye Hospital in Munich treated 20 patients for two years by keratography, where the age ranged from 7 to 75 years. It was observed in blind eyes with corneal leucoma and a contact lens or prosthesis intolerance.
Penetrating injuries, contusions, chemical burns, infections, and previous surgery were the causes of the leucoma. Patients were treated on an outpatient basis, all adults under topical anesthesia.
Six patients were treated once, four twice, and 9 three times in the results. In 1 patient, the treatment was not completed. Two patients were treated with strabismus surgery after keratography.
Post-treatment patients receive a contact lens, non-steroidal drops, and antibiotic eye drops for a week.
One-third of patients complained of photophobia and pain during the first days after treatment for up to 2 weeks.
