Leukoma: Causes, Complications, Diagnosis and Treatment – Investigative Study

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 periphery of the cornea can not affect vision at all.

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, the leucoma can be congenital or obtained.

The congenital leukoma: can occur in the embryo in the uterus, as a result of the impact of viruses and bacteria that infect the cornea of ​​the eye.

The obtained leucoma: occurs after birth under the influence of the factors listed above and occurs many times more frequently than congenital leukoma.

Complications

On the surface, the leucoma, formed as a result of corneal ulcer or its mechanical damage, irregularities are usually observed, the cornea often becomes thin.

However, sometimes the cornea has spikes 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 to see a spot in the details, to determine its depth. An ophthalmoscopy is also performed (background inspection with special instruments), which allows to determine the degree of transparency of the leucoma, to control the fundus reflex.

Treatment

The most effective treatment for the 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 special corneal transplant. The operation is performed on an outpatient basis, using local or general anesthesia.

Keratography represents a treatment method to introduce natural pigments into the cornea with a special tattoo needle. In cases of corneal leukoma, the iris and pupil can be reconstructed cosmetically.

In cases of additional strabismus, the pupil may be adjusted or strabismus surgery may occur. In the past, many attempts have been made to tattoo the cornea, but the results were not satisfactory.

The rehabilitation period, depending on the characteristics of the cornea 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 mild illumination of the walleye and not cure it completely.

Study on the Leucoma

A study from the University Eye Hospital in Munich, which treated 20 patients for 2 years by keratography, where the age ranged from 7 to 75 years. It was observed in blind eyes with corneal leucoma and the intolerance of a contact lens or a prosthesis.

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.

In the results, 6 patients were treated once, 4 twice and 9 three times. 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.

The outpatients were very satisfied with the cosmetic result of the treatment and mainly observed a different reaction of other people to their appearance. The long-term results must be evaluated.