symptoms of microRNA virus keratitis, early symptoms and signs of microRNA virus keratitis
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Symptoms of microribonucleic acid virus keratitis
Typical symptoms: continuous blinking, eyeball beating consistent with pulse, edema, visual impairment, tear overflow, red eye, corneal opacity, sticky tears, and poor bead pain
Related symptoms: Sui tears are sticky, red, tears overflow, visual impairment, corneal opacity
1. The incubation period is short, generally about 24 hours, and the longest is no more than 3 days.
2. Conscious symptoms: The onset is urgent, which can be monocular at the beginning, but quickly involves both eyes. After the onset, severe foreign body sensation, eye pain, fear of light and tears and other symptoms appear. The secretion is serous at first, and then becomes mucous cellulose. Generally, the disease developed to its peak in 1 ~ 2 days, gradually eased after 3 ~ 4 days, and returned to normal after 7 ~ 10 days. Some patients have symptoms such as general discomfort, headache, fever, stuffy nose and sore throat.
3. Eye manifestations:
1) Eyelid swelling: Different in severity, all patients can occur. Its swelling is edematous, without red pain, and can subside in a few days.
2) Bulbar subconjunctival hemorrhage: The incidence rate is as high as 70%, and the most common site is above the temporal. The hemorrhage is mostly spotted or flaky, and the color is bright red. In severe cases, it can spread to the whole subconjunctival hemorrhage, which is similar to traumatic subconjunctival hemorrhage. Bleeding occurs within 1 ~ 2 days, and it is absorbed by itself in about 1 week for mild cases, and can only be absorbed after 1 month for severe cases. Clinically, according to whether subconjunctival hemorrhage is divided into two types:
① Hemorrhagic type, more common in young patients.
② Edema type is seen in elderly patients.
3) Follicular formation: It was not obvious in the early stage because of high congestion of eyelid conjunctiva. After 3 ~ 4 days, when the congestion subsided, it was found that there were more fine follicles in the lower fornix, which were less and lighter than EKC.
① Multiple corneal epithelial erosion: the incidence is high. Three hours after the onset of the disease, multiple epithelial erosion of needle tip size appeared in corneal epithelium, which was scattered or arranged in strips and flakes, which was the main cause of eye pain and foreign body sensation. After 3 ~ 4 days, it can disappear by itself, and a few last for more than 2 weeks.
② Surface punctate corneal epithelial lesion (SPK): SPK appeared after conjunctivitis subsided in about 30% of patients. Usually there are only a few infiltration points, mostly in the center of cornea, which can only be found through slit lamp microscope. Most of them disappeared by themselves after 1 ~ 4 weeks, rarely caused subepithelial infiltration caused by EKC, and generally did not cause visual impairment. Glucocorticoid can disappear within a few days.
5) Other symptoms: Most cases in the onset, may have ear or submandibular lymph node enlargement, and tenderness. This symptom disappears with the subsiding of conjunctivitis. Very few cases can still have changes in iritis.
4. This disease can be caused by EV70 and CA24 viruses, and its clinical manifestations are difficult to distinguish. According to literature statistics, CA24 caused less subconjunctival hemorrhage (84%) than EV70 (98%) (P=0. 01), and the degree of hemorrhage in the former was lower than that in the latter, but the former was more likely to have systemic symptoms than the latter.
It is not difficult to diagnose this disease in epidemic period. However, in the early stage of epidemic or sporadic cases, if you don't pay attention, it can be confused with conjunctivitis caused by other viruses (such as epidemic conjunctival keratitis caused by adenovirus types 3, 4 and 11), so it needs to be identified.
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