โฃ๐๐ถ๐น๐ฎ๐บ๐ฒ๐ป๐๐ฎ๐ฟ๐ ๐๐ฒ๐ฟ๐ฎ๐๐ถ๐๐ถ๐โฃ
Strands composed of degenerated epithelial cells and mucus develop and adhere to the corneal surface causing foreign body sensation & painโฃ
โฃ
๐๐ต๐ช๐ฐ๐ญ๐ฐ๐จ๐ช๐ฆ๐ดโฃ
โ Aqueous tear deficiency - KCSโฃ
โ Corneal exposure (seventh nerve palsy)โฃ
โ Occlusion abnormalities - blepharoptosisโฃ
โ Ocular surgery (keratoplasty)โฃ
โ Systemic diseases with effects on the ocular surface (Sjogrenโs syndrome)โฃ
โ Extended use of anticholinergic medicationsโฃ
โ Other ocular surface abnormalities.โฃ
โฃ
๐๐ข๐ต๐ฉ๐ฐ๐ญ๐ฐ๐จ๐บโฃ
โ Increase in tear film mucus to aqueous ratio (decrease in aqueous tear production/ increased production or accumulation of the mucinous component) -> formation of mucoid filamentsโฃ
โ They adhere to small defects on corneal epitheliumโฃ
โ Mucin attaches to epithelial defect and loose epithelial strands are incooperatedโฃ
into mucin strand attached to the surfaceโฃ
โ Initial step - damage to basal epithelialโฃ
cells, epithelial basement membrane, or Bowmanโs layer -> focalโฃ
detachments of epithelial basement membraneโฃ
โ Blinking - areas of detachment to become elevated -> to irritation,โฃ
inflammation, and increased mucus productionโฃ
โ Sites of epithelial damage provide the scaffold for filaments to developโฃ
โฃ
๐๐บ๐ฎ๐ฑ๐ต๐ฐ๐ฎ๐ดโฃ
โ Mild to severe foreign body sensation exacerbated by blinkingโฃ
โ Photophobia, blepharospasm, epiphoraโฃ
โฃ
๐๐ช๐จ๐ฏ๐ดโฃ
โ Multiple filamentary attachments firmly adherent to the corneal surface 0.5-10mmโฃ
โ Decreased aqueous tearsโฃ
โ Increased mucin in the precorneal tear filmโฃ
โ Subepithelial opacities at the base of filamentsโฃ
โ Blinking causes traction on the filaments and detach them leaving behind anโฃ
epithelial defectโฃ
โ Filaments stain with Rose Bengal and Fluorescein.โฃ
โฃ
๐๐ณ๐ฆ๐ข๐ต๐ฎ๐ฆ๐ฏ๐ตโฃ
Management of underlying conditions like dry eye syndromes, medication toxicity, contact lens overuse, blepharoptosis.โฃ
โ Topical lubricants and ointmentโฃ
โ Bandage contact lensโฃ
โ Mucolytic agent โ N- Acetylcysteineโฃ
โ Topical Nacl drops.โฃ Removed at slit lamp using jewelerโs forceps - avoid disrupting the epithelium at base of filament.โฃ
โฃ
๐๐ฐ๐ฎ๐ฑ๐ญ๐ช๐ค๐ข๐ต๐ช๐ฐ๐ฏ๐ด: Infectious Keratitisโฃ
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