nurseinfo nursing notes for bsc, p.c. or p.b. bsc, msc, and gnm nursing notes

LEUCOMA - Clinical Manifestations and Management 

LEUCOMA - Clinical Manifestations and Management

LEUCOMA - Clinical Manifestations and Management

Leucoma means opacity of the cornea. The extent of the leucoma may vary. It may affect a small area of the cornea or whole of the cornea may be affected, causing a total leucoma depending upon the amount of damage or corneal tissue. Corneal opacity is formed by healed corneal ulcer, healed keratitis, penetrating or operative injury to the cornea, foreign bodies and corneal dystrophy. Any damage to the substansia propria leaves behind opacity.

Nebular corneal opacity is a faint opacity resulting from superficial scars involving Bowman’s layer and superficial stroma. A nebular opacity covering the pupil produces more discomfort and blurring of vision than a leucoma which completely cuts off the light rays.

Adherent leucoma is a leucomatous opacity in which iris tissue is incarcerated. It results following corneal perforation.

CLINICAL MANIFESTATION

  • No symptoms if the opacity is outside the pupillary area
  • Visual disturbance – if it is in the pupillary area


MANAGEMENT

1. If the leucoma is small and does not hamper vision, it does not require any treatment, except cosmetic treatment known as tattooing. The white opacity in the cornea is made black, by chemicals in the following ways

After local anesthesia with xylocaine 4% drops, the epithelium over the leucoma is scrapped off with a cataract knife.

2% gold chloride or 2% platinum chloride and 2% hydrazine hydrate solutions are applied to the raw are one after another, with swab sticks, when the opacity takes a black color.

Excess of the chemicals is washed away, atropine and antibiotic ointment are applied and the eye is kept bandaged for 48 hours

 

2. If the leucoma is so situated that it hampers vision, then treatment becomes necessary for improvement of vision. This may be done in two ways –

Keratoplasy or corneal graft: Opaque portion of the cornea is removed and a portion of clear cornea from a donor eye is replaced.

Optical iridectomy: by this method the papillary area is extended to the periphery by making a complete iridectomy. The cosmetic treatment can follow optical iridectomy.