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我院自1989年以来共收治长期漏诊外眼部异物的病人15例。处理效果较满意,外眼部异物的机械性刺激,是引起角膜炎的原因之一,但是,长期按角结膜炎治疗而将异物漏诊,临床上并不多见。现将15例治疗体会综合报告如下。 1 临床资料 15例患者中男7例,女8例。年龄15～47岁。农民13例,职员2例。右眼10例,左眼5例。病程1～6个月。异物种类:谷壳5例,脱落睫毛8例,头发断楂2例。异物位置:角膜5例,泪小点6例(上1例,下5例),睑板腺开口4例。 2 典型病例 例1,陈昌荣,男41岁,农民。因左眼异物感畏光、流泪3个月。在当地治疗无效,于1989年6月末来诊。详细询问病史,发病于春季在田间创茬子时“迷眼”后。眼部检查:左眼视力0.3,睫状充血(+),角膜9时位近瞳孔区处约3mm×2mm灰白色病灶,中央表面略隆起,有光泽,周边浅层溃疡,新生血管自角膜缘长入。怀疑为“角膜谷壳异物”,经裂隙灯检查证实为谷壳。于表麻下剔除一约1.0mm×1.5mm不规则异物。经局部抗炎及营养支持疗法,2周后临床治愈。遗留角膜斑翳,视力为0.5。
Our hospital since 1989, a total of 15 cases of long-term missed diagnosis of foreign body outside the eye of patients. Treatment effect is more satisfactory, mechanical stimulation of foreign eye foreign bodies, is one of the causes of keratitis, but the long-term treatment of keratoconjunctivitis foreign body missed diagnosis, clinically rare. Now 15 cases of treatment experience comprehensive report is as follows. 1 clinical data of 15 patients, 7 males and 8 females. Aged 15 to 47 years old. 13 farmers, 2 staff. Right eye in 10 cases, left eye in 5 cases. Duration of 1 to 6 months. Foreign body types: chaff in 5 cases, off the eyelashes in 8 cases, 2 cases of hair cut hawthorn. Location of foreign body: cornea in 5 cases, 6 cases of punctum (1 case, 5 cases), meibomian gland opening in 4 cases. 2 typical case cases 1, Chen Changrong, male, 41, farmer. Because of the left eye feeling photophobia, tears 3 months. In the local treatment invalid, came to the clinic in late June 1989. Asked in detail about the history, the incidence of spring in the field of stubble when the “glimpse” after. Eye examination: 0.3 left visual acuity, ciliary hyperemia (+), corneal 9:00 near the pupil area about 3mm × 2mm gray white lesions, the central surface slightly uplift, shiny, peripheral superficial ulcers, neovascular margin from the cornea Into. Suspected to be “corneal chaff foreign body,” confirmed by slit lamp chaff. Remove about 1.0mm × 1.5mm irregular foreign matter from the table. After local anti-inflammatory and nutritional support therapy, 2 weeks after clinical cure. Left corneal sclera, visual acuity of 0.5.