bubble_chart Overview

When the epithelial part of the corneal membrane peels off and forms a curled filament, with one end attached to the surface of the corneal membrane and the other end free, it is called filamentary keratopathy.

bubble_chart Etiology

It may be related to the following factors:

1. abnormal proliferation of epithelial cells;
2. abnormal junction between the basement membrane and the anterior elastic membrane;
3. excessive formation of mucoid-like substances.

It is commonly seen in dry eye disease and viral infections (adenovirus, HSV, etc.), and can also occur in neurotrophic keratitis, cicatricial keratitis (prickly-ash-like sore (trachoma), pemphigus, etc.). Additionally, corneal abrasions, wearing corneal contact lenses, and intraocular surgery can also cause this lesion.

bubble_chart Diagnosis

1. Has a long history of eye disease, or suffers from corneal xerosis, absolute glaucoma, etc.
2. Mild cases only have a foreign body sensation in the eye, while severe cases show obvious corneal irritation symptoms.
3. The corneal surface epithelium appears in a rolled filamentous shape, which can be as fine as a needle tip or as thick as sesame, with one end attached to the epithelium and the other end free, mostly seen near the upper corneal margin.

bubble_chart Treatment Measures

In addition to addressing the underlying cause, topical application of corneal lubricants, mucolytic agents (acetylcysteine), and 5% saline solution is sufficient. If ineffective, under slit-lamp examination and after surface anesthesia, a cotton swab dipped in saline can be used to remove filamentous debris. Alternatively, the filaments can be wiped with ether, 1–2% silver nitrate, or 10% zinc sulfate, followed immediately by saline irrigation and covering the affected eye with an eye patch for one day. Wearing soft corneal contact lenses can also be beneficial.