Xerophthalmia
| Classification according to ICD-10 | |
|---|---|
| E50.1 | Vitamin A deficiency with Bitot spots and xerosis conjunctivae |
| E50.6 | Vitamin A deficiency with xerophthalmic scars of the cornea |
| E50.7 | Other manifestations of vitamin A deficiency in the eye xerophthalmia without further information |
| ICD-10 online (WHO version 2019) | |
The xerophthalmia (from Greek ξηρός xeros "dry" and ὄφθαλμος ophthalmos "eye") is a vitamin A deficiency Conditional Marketing form of the dry eye , which occurs particularly in developing and emerging countries. Since it mainly affects young children, it is also known as "child blindness". It has to be differentiated from the dry eye syndrome that often occurs in western industrialized nations . However, the terms are not uniform in the literature. Often the term xerophthalmia is also used for the dry eye in a very general way (not only due to vitamin A deficiency).
Symptoms
- Bitot spots with vitamin A deficiency: spots on the conjunctiva that appear dried out
- Callus appears dull and dry
- Severe itching of the eye
Differential diagnoses
- Rheumatic diseases (e.g. sicca syndrome , Sjogren's syndrome , chronic polyarthritis , scleroderma )
- Vitamin A deficiency
- Trachoma
- Lagophthalmos
Diagnosis
- Schirmer test : In the Schirmer test, tear secretion is measured by hanging strips of blotting paper in the conjunctival sac.
- Diagnosis of the underlying disease
consequences
Xerotic keratitis
Inflammation of the cornea due to the settlement of xerosis - bacteria with formation of thick mucus.
Keratomalacia
The Keratomalacia is a softening and opacity of the cornea. In severe cases, keratomalacia can lead to a complete loss of function.
therapy
The dry eye therapy depends on the underlying disease. The missing tear fluid can be treated symptomatically with replacement fluid.
One study showed that eye drops with anakinra (human interleukin antagonist for the treatment of rheumatoid arthritis) can relieve xerophthalmia in malfunctioning meibomian glands. However, approval is still pending.
Antibiotic eye drops with azithromycin are often used as off-label use today . The antibiotic acts directly on the epithelia of the meibomian glands and promotes the formation of fatty secretions that keep the eyes moist.
Individual evidence
- ^ V. Klauß, UC Schaller: Tropical ophthalmology — prevention and therapy . In: The ophthalmologist . tape 101 , no. 7 , June 16, 2004, ISSN 0941-293X , p. 741-765 , doi : 10.1007 / s00347-004-1039-8 ( springer.com [accessed January 10, 2016]).
- ↑ Francisco Amparo, Mohammad H. Dastjerdi, Andre Okanobo, Giulio Ferrari, Leila Smaga, Pedram Hamrah, Ula Jurkunas, Debra A. Schaumberg, Reza Dana: Topical Interleukin 1 Receptor Antagonist for Treatment of Dry Eye Disease: A Randomized Clinical Trial. In: JAMA ophthalmology. Volume 131, No. 6, 2013, ISSN 2168-6173 , pp. 715-723, doi: 10.1001 / jamaophthalmol.2013.195 , PMID 23599118 .
- ↑ Yang Liu, Wendy R. Kam, Juan Ding, David A. Sullivan: Effect of Azithromycin on Lipid Accumulation in Immortalized Human Meibomian Gland Epithelial Cells. In: JAMA Ophthalmology. 2014; 132 (2), pp. 226–228. doi: 10.1001 / jamaophthalmol.2013.6030 .
