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Management of conjunctival cicatrizing diseases and severe ocular surface dysfunction
A G Chiou1, G J Florakis, M Kazim
1Edward S. Harkness Eye Institute, Columbia Presbyterian Medical Center, New York, New York 10032, USA.
Survey of Ophthalmology
|August 26, 1998
Summary
Ocular surface disorders, including conjunctival scarring and trichiasis, can impair vision. Comprehensive management involves addressing underlying causes and employing surgical interventions for visual rehabilitation.
Area of Science:
- Ophthalmology
- Ocular Surface Disease
- Corneal Surgery
Background:
- Conjunctival scarring and ocular surface disturbances arise from various factors including injury, infection, and systemic conditions.
- These conditions can lead to persistent irritation, dry eye, and potentially severe visual impairment.
- The cornea may be affected directly or secondarily, complicating the clinical presentation.
Purpose of the Study:
- To outline the comprehensive evaluation and management strategies for patients with conjunctival scarring and ocular surface disturbances.
- To emphasize the importance of addressing underlying etiologies and integrating medical and surgical treatments.
- To discuss surgical options for restoring ocular surface integrity and visual function.
Main Methods:
- Systematic review of literature on ocular surface disorders and their management.
- Analysis of treatment modalities including medical therapies (anti-inflammatories, immunosuppressants) and surgical interventions.
- Evaluation of surgical techniques such as conjunctival grafting, stem cell transplantation, and keratoplasty.
Main Results:
- Effective management requires thorough patient evaluation and identification of the underlying disease process.
- Multifaceted treatment approaches combining medical control of inflammation and surgical correction are crucial.
- Surgical interventions like limbal stem cell transplantation and penetrating keratoplasty can restore ocular surface physiology.
- Keratoprosthetics offer visual rehabilitation in severe, refractory cases.
Conclusions:
- Optimal management of ocular surface disorders necessitates a comprehensive approach, addressing both the underlying pathology and structural abnormalities.
- Surgical interventions play a vital role in restoring ocular surface integrity and improving visual acuity.
- Prompt attention to corneal complications like ulceration or perforation is essential to preserve ocular health.