Ceasing of epithelisation and deposit formation of unknown origin on the cornea

The author presents a so far unknown pathological process interrupting permanently the regeneration of the superficially damaged cornea, and its consequences and therapy of the condition as well. The process occurs only in 5.6% of the injured individuals. The occurrence is in no correlation with the quality or extent of the damage. Also it is independent of the form and duration of therapy. The essence of the pathological changes is the slowing of corneal epithelisation within 2-4 days, followed by a complete cessation. After that a thin membrane-like layer develops simultaneously and evenly within 12 days on the area without epithelium, the surface of which is dull, transparent and whitish in colour. Within weeks or months an individually varying thickening of the membrane occurs, but the area does not grow. The surface becomes whitish-grey and is without any epithelium and with no adherence to tear. The deposits are closely and inseparably adherent to their base, their substance is rigid, being brittle only at the margins. The lesion is staining greenish-yellow with Na-fluorescein, and lively blue with toluidine blue. It is staining in small reddish-brown with rose bengal. In vivo the deposits are not measurably influenced by hyaluronidase, trypsin, alpha-chymotrypsin and papain. The microbes play no role in the process. Histological and electron-microscopical examinations suggest the corneal deposit are the product of the necrobiotic process occurring on the corneal surface during regeneration. The specific treatment consists of local application of corticoid-heparin. On the basis of the results of the examinations and literary data the author suggests that the corneal deposition and the similarly rare KCV (keratoconjunctivitis vernalis) plaque formation is the same specific process, i.e. the peculiar manifestation of the atopic state of the organism occurring independently of age.