Pigmentation of the sclera and conjunctiva - Medical reference book. Neoplasms of the conjunctiva

Syndrome "blue (blue) eyes" is a congenital hereditary-family disease.

Syndrome "blue (blue) eyes"

In this case, the sclera is so thin that the pigment of the choroid shines through it. The lesion is bilateral, accompanied by deafness due to otosclerosis, weakness of the articular capsules and ligamentous apparatus, fragility of tubular bones with frequent fractures and dislocations in the joints. The syndrome is often combined with other anomalies in the development of the eye (embryotoxon, keratoconus, cataract) and the body (congenital heart disease, cleft palate).

Melanosis of the sclera manifested by pigmented dark spots in the surface layers of its anterior section.

Melanosis of the sclera

Sometimes combined with melanosis of the iris, it can move to the cornea. There is a danger of malignancy, and therefore requires dynamic monitoring of these patients.

Congenital anomalies of the shape and structure of the sclera occur in the form of cysts, staphylomas, dermoids and are usually observed simultaneously with other congenital pathologies.

Chapter 10 Diseases of the Choroid

Inflammatory diseases of the choroid of the eye ( uvea) develop quite frequently. This is explained, first of all, by the presence of a large number of vessels in its various departments. The vessels branch into capillaries, which repeatedly anastomose with each other and form a dense network. As a result, the blood flow rate is sharply reduced. A drop in the speed and intensity of blood flow creates conditions for the settling and fixation of various bacterial and toxic agents in it.

Another feature of the choroid is the separate blood supply to the anterior (iris and ciliary body) and posterior (the choroid proper, or choroid) sections. The anterior section is fed by the posterior long and anterior ciliary arteries, and the posterior section is fed by the posterior short ciliary arteries.

The third feature is different innervation. The iris and ciliary body receive abundant innervation from the first branch of the trigeminal nerve via the ciliary nerves. The choroid has no sensory innervation.

The anatomical features of the choroid are clearly manifested in pathological conditions of a particular department.

Distinguish inflammation of the anterior choroid - anterior uveitis, or iridocyclitis; inflammation of the flat part of the ciliary body and the extreme periphery of the choroid itself - peripheral uveitis; rear end - posterior uveitis, or choroiditis, and inflammation of the entire choroid - panuveitis.

Panuveitis and peripheral uveitis are relatively rare, with anterior uveitis or iridocyclitis much more common. The ratio of the frequency of various forms of uveitis - anterior, posterior, peripheral and panuveitis - is defined as 5:2:1:0.5, i.e. panuveitis is 10 times less common than iridocyclitis.

There are primary and secondary, exogenous and endogenous forms of inflammation of the choroid. Primary uveitis is understood to occur on the basis of general diseases of the body, and secondary - uveitis that develops with eye diseases (keratitis, scleritis, retinitis, etc.). Exogenous uveitis develops with penetrating wounds of the eyeball, after surgery, perforated corneal ulcer. Endogenous uveitis is, in most cases, metastatic.

According to the clinical course, uveitis is divided into acute and chronic. However, this distinction is, to a certain extent, conditional. Acute uveitis can become chronic or chronically recurrent. It is also necessary to distinguish between focal and diffuse uveitis, and according to the morphological picture of inflammation - granulomatous and non-granulomatous. Granulomatous include exclusively metastatic hematogenous uveitis, and non-granulomatous - uveitis caused by toxic or toxic-allergic influences. Granulomatous uveitis is characterized by the development of an inflammatory granuloma composed of lymphocytes, epithelioid and giant cells. In a non-granulomatous process, inflammation is diffuse hyperergic in nature.

Anterior uveitis, or iridocyclitis, is usually classified according to the nature of inflammation: serous, exudative, fibrinous-plastic, purulent, hemorrhagic. Posterior uveitis, or choroiditis, is usually classified according to the localization of the process: central, paracentral, equatorial and peripheral. In addition, it is customary to distinguish between limited and disseminated choroiditis.

For practice, the classical division of uveitis into acute and chronic remains important. Acute inflammation corresponds to an exudative-infiltrative process, while chronic inflammation corresponds to an infiltrative-productive process.

The human eye is a truly unique natural creation, which is an organ of vision. According to its structure, the eye is quite complex and consists of a huge number of structural elements.

Of course, there is no need for an ordinary layman to know about each of them, but every person should definitely get acquainted with the main parts of the eye. One of these is the sclera of the eye, which performs a considerable number of the most important functions for the body.

We will talk in more detail about its structure, purpose and possible pathologies in the material presented below.

Sclera of the eye - its outer part

The sclera is the layered tissue on the outside of the eye. Anatomically, the scleral formation is a fibrous tissue of a fairly dense structure. The sclera surrounds the pupil and eyes with a dense ring and forms a kind of white matter.

At the structural level, this part of the organ is organized in a very complex way. Simply put, the sclera is made up of tufted and irregularly arranged collagen. Thanks to the latter substance, the scleral tissue is opaque and has a different density over its entire area.

As noted earlier, the sclera of the eye consists of several layers, of which the following are fundamentally distinguished:

1. outer layer. It is represented by a loose tissue with a clearly organized and branched system of vessels that organize two vascular networks of the eye: superficial and deep.
2. scleral layer. It mainly consists of collagen, or rather its fibers and more complex elastic tissues.
3. Deep layer. It is located in the area between the outer layer and the choroid of the eye. Structurally, it is represented by connective tissues and pigment cells - chromatophores.

The anatomical organization of the sclera presented above is valid both for its anterior part, which is accessible to the gaze of the person himself, and for the posterior part of the eye, located in the eye cavity. It is worth noting that the posterior scleral tissue looks like a thin plate with a lattice structure.

Functions of the sclera

The color of a healthy sclera is white with a slight blue tint.

Based on the previously considered anatomical structure of the sclera of the eye, we can draw some conclusions regarding its functional purpose, which, by the way, is quite large. At its core, the functions of scleral tissue are extremely diverse.

The most significant of these is performed by collagen, which has a chaotic arrangement and complex structure. These features of fibrous tissue protect the eye from the adverse effects of sunlight due to the intense refraction of rays.

For the person himself, this function of the sclera helps to stably and clearly organize the visual function, which, in principle, is the main purpose of the scleral tissue.

In addition to protection from sunlight, the sclera organizes the protection of the sensitive elements of the eye from external factors that can damage them. At the same time, the spectrum of potential damage includes both physical disorders and chronic pathologies.

An additional, but no less important function of the sclera of the eye is that it is this tissue that organizes a kind of framework for fastening the ligamentous, muscular, vascular and other apparatuses of the eye.

The sclera also provides:

1. the path of the ethmoid arteries to the posterior part of the eye;
2. the approach of the optic nerve to the eye muscles and the eye itself;
3. protection of most vessels and nerve fibers of the eye;
4. the exit of venous branches from the eye, providing an outflow of blood.

The sclera is both a protective shell and a strong framework for organizing the structure of the eye.

Possible pathologies

The sclera of the eye as an indicator of human health

It is important to understand that the health and stability of the functioning of this organ largely depends on the state of the scleral tissue of the eye. Normally, the sclera is white with a slight blue tint.

In an adult, just such a tissue is normally observed, but in children, due to the small thickness of this tissue, the blue pigment may have a more pronounced structure, so some babies have a sclera color with a noticeable blue tint.

The first thing that indicates a malfunction of the body is a change in the color of the scleral tissue of the eye. As a rule, the sclera either fades or acquires a shade of yellowness. In both cases, a change in its color is a sure sign of the development of pathology.

So, for example, the yellowness of the scleral tissue indicates the presence of an eye infection or problems with the liver. The only person who is allowed to have a slight yellowing and looseness of the sclera is the elderly. This phenomenon is due to the deposition of fat in the tissues and thickening of the pigment layer, which is the norm.

There are frequent cases in medical practice when, after growing up, the sclera of the eyes also remain with a pronounced blue tint in a person. This phenomenon indicates a congenital disorder in the structure of the organ. Often it indicates a violation of the formation of the eyeball in the womb. In any case, if you notice a change in the color of the sclera in yourself or your loved ones, you should immediately visit the clinic.

In medicine, two types of pathologies of the scleral tissue of the eye are distinguished - congenital diseases and acquired ones. Among the first type, the most common are the following:

• Melanosis or melanopathy is a congenital ailment that manifests itself in excessive pigmentation of the scleral tissue with melanin, as a result of which it acquires a yellowish tint. This pathology manifests itself from childhood and indicates problems with carbohydrate metabolism in the human body.
• Blue sclera syndrome is a similar ailment to the previous one, but only differs by a pronounced blue tint of scleral tissue. As a rule, this pathology is accompanied by other visual or hearing impairments. Often, blue sclera syndrome is associated with iron deficiency in the body.

Acquired pathologies of the sclera of the eye include:

1. Staphyloma, expressed in the depletion of the shell and its protrusion. Such an ailment manifests itself due to the development of destructive processes in the eyes of a person.
2. Episcleritis, which is an inflammatory process of the outer fibrous cover of the eye, which is complemented by nodular seals around the cornea. Often does not require treatment and goes away on its own, but it can recur.
3. Scleritis, which is also inflammation, but already of the internal sclera. This pathology is always accompanied by pain, immunodeficiency of the patient and tissue edema.

The ailments presented above, like most acquired pathologies of the scleral tissue, are an inflammatory process of the eye membrane, which is caused by its depletion due to the action of adverse external factors. Inflammation, as a rule, is provoked by infections and is accompanied by malfunctions in the work of other organs of the body.

Checking the condition of the sclera

Sclera of the eye: schematic

Having determined the unhealthy state of the sclera, it is necessary to immediately visit a specialist. As a rule, pathologies of the scleral tissue are accompanied by the following symptoms:

1. pain in the eyes, intensifying when moving them;
2. constant feeling that something is present in the eyeball;
3. involuntary lacrimation;
4. change in the color of the sclera;
5. manifestation of pronounced disturbances in the structure of the eyeball: its protrusion, dilation of blood vessels, and the like.

It is important to note that it is extremely dangerous to ignore even non-serious pathologies of the sclera, since they can cause some complications. The most unpleasant of the latter is clouding and deformation, as a result of which a person either completely or partially loses his sight.

By contacting a specialist in a timely manner, after talking with him and conducting basic ones, you can reduce the risk of developing complications of scleral tissue pathologies to almost zero, of course, on the condition that appropriate treatment is organized.

It should be understood that the treatment of diseases of the sclera of the eye is a long process that cannot be neglected. Having decided to treat such pathologies, you need to be prepared for a long and persistent course of treatment, otherwise the disease will most likely not be defeated.

As you can see, it is not so difficult to figure out what the sclera of the eye is, what functions it performs and what it can suffer from. The main thing is to delve into the topic and familiarize yourself with the material presented above. We hope you found today's article helpful. Health to you!

Scleroplasty - an operation to strengthen the sclera - in a real video:

Melanosis is a congenital or acquired anomaly in the development of the frontal surface of the sclera, which is characterized by the appearance of pigmentation resembling spots. Their appearance on the protein of the eyeball is due to the deposition of a special coloring matter called melanin. The color of the spot may be pale purple or gray.

The most common type of congenital melanosis is unilateral. At the same time, in the first year of a baby's life, an increase in scleral pigmentation occurs.

Most often, melanosis of the eye is caused by metabolic disorders, namely the digestibility of carbohydrates. The child's sclera may be slightly yellowish in color, and sometimes there is a layered cataract.

Sometimes the color of the sclera can change in an abnormal direction due to some disease, such as hepatitis A (Botkin's disease), cholangitis, mechanical or hemolytic jaundice, cholecystitis, chlorosis, cholera, sarcoidosis, Addison-Birmer anemia.

If eye melanosis is a consequence of an inflammatory process, then it is quite treatable. To do this, you can use some recipes of traditional medicine. Let's consider several options:

Prepare a couple of tablespoons of cornflower inflorescences (baskets must be removed) and pour them with a glass of boiling water.

Leave to infuse for two hours, then strain and use to prepare lotions. Repeat the procedure daily for five days.

Take two tablespoons of finely chopped oak bark and, filling them with half a liter of boiling water, boil over low heat for half an hour. Strain the resulting broth and use to wash the eyes.

A good option is a decoction of cumin. A tablespoon of the fruits of this plant should be poured with a glass of boiling water and boiled over low heat for five to ten minutes.

At the end, add a teaspoon of cornflower blue inflorescences to the broth. The finished product must be filtered using cotton wool for this. Apply by instilling a couple of drops twice a day.

Take a tablespoon of medicinal chamomile and brew it with a glass of boiling water. Leave for a quarter of an hour to insist, then strain.

Soak pre-prepared cotton swabs in the infusion and place in front of your eyes. This is the best time to lie down. The duration of the procedure is twenty minutes.

A very effective remedy for combating melanosis is celandine. Take a tablespoon of raw materials and fill it with a glass of boiling water. Boil over low heat for five minutes, then strain and stir in a teaspoon of honey.

Use the medicine to make lotions. Leave them in front of your eyes for no longer than a quarter of an hour.

Mix equal parts of baking soda, freshly chopped cucumber and boiling water. Use as a bedtime lotion. The course of treatment is three weeks.

Prepare a collection of three parts of birch leaves, two parts of wild rose and red clover heads, one part of strawberry leaves and half of St. John's wort.

Prepare an infusion at the rate of 50 ml of boiling water per teaspoon of the mixture. Insist hour well wrapped. Strained infusion is used for compresses, leaving them for twenty minutes.

Eye treatment will be much more successful if certain dietary standards are observed. Limit the amount of sweets, starchy foods, tomatoes, white bread, puddings, refined cereals.

Fatty and salty foods should be avoided, this also applies to meat. Avoid salt and spices altogether. Eliminate the consumption of strong coffee and tea.

Your diet should include fish and seafood, as well as leafy vegetables.

Include cabbage, parsley, carrots, sweet peppers, citrus fruits, onions, nuts, apples, eggs and honey in the menu. Be sure to cook a variety of whole grain cereals, use corn, rye, wheat.

There is a recipe for a special vitamin salad that will help you get rid of eye diseases. Chop white cabbage, carrots, beets, radishes, fennel and parsley.

Stir and season with vegetable oil (olive or corn). This salad should be eaten about twice a week for the prevention and treatment of eye diseases.

Do not forget about daily eye massage. For a couple of minutes a day, gently and lightly tap with tufts or fingernails on and around covered gases.

This procedure does not take much time and effort, while having an amazing effect. It allows you to regulate blood circulation and helps get rid of puffiness and fatigue.

Remember that if you decide to use traditional medicine to treat eye melanosis, treat eye melanosis only after consulting your doctor. He will confirm the diagnosis and correct the selected treatment regimen.

Diseases of the sclera, unlike diseases of other membranes of the eye, are poor in clinical symptoms and are rare. As in other tissues of the eye, inflammatory and dystrophic processes occur in the sclera, and anomalies of its development occur. Almost all changes in it are secondary.

They are probably due to intimate proximity to the outer (conjunctiva, vagina of the eyeball) and inner (vascular) membranes, common vascularization and innervation with other parts of the eye.

Among the anomalies of the sclera, color anomalies can be distinguished - congenital (blue sclera syndrome, melanosis, etc.) and acquired (drug-induced, infectious), as well as anomalies in the shape and size of the sclera.

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blue sclera syndrome

This is the most striking congenital anomaly in the color of the sclera. The disease is manifested by damage to the ligamentous-articular apparatus, skeleton, eyes, teeth, internal organs and otological disorders. Depending on the clinical manifestations, different forms of the disease are distinguished: a combination of blue sclera with increased bone fragility - Eddow syndrome; with deafness - Van der Hove syndrome, etc.

The disease in most cases is inherited in an autosomal dominant manner, but autosomal recessive inheritance is also possible. The blue color of the sclera depends mainly on its possible thinning, increased transparency and translucence of the bluish choroid.

Sometimes there are associated changes such as keratoconus, embryotoxon, corneal dystrophy, layered cataract, glaucoma, iris hypoplasia, as well as hemorrhages in various parts of the eyeball and its auxiliary apparatus.

All medical workers, including pediatricians, should remember that the blue color of the sclera is primarily a formidable pathological sign if it is detected later than the first year of a child's life. At the same time, one should not overestimate the fact of the natural bluish tint of the sclera in a newborn, due to its tenderness and comparative thinness. In the process of development and growth of the child, but no later than by the age of three, the sclera in children has a white or slightly pinkish tint. In adults, it’s taking on a yellowish tone over time.

Treatment is symptomatic and ineffective. Anabolic steroids, large doses of vitamin C, fluorine preparations, magnesium oxides are used.

Melanosis of the sclera.

With congenital genesis, the disease has a characteristic picture, including three symptoms: pigmentation of the sclera in the form of grayish or slightly violet spots against the background of the rest of its normal whitish color; a darker iris, as well as a dark gray color of the fundus. Possible pigmentation of the skin of the eyelids and conjunctivitis. Congenital melanosis is more often unilateral. Increased pigmentation corresponds to the first years of life of children and puberty. Melanosis of the sclera must be differentiated from melanoblastoma of the ciliary body and the choroid itself.

A congenital hereditary change in the color of the sclera such as melanosis can also be the result of a violation of carbohydrate metabolism - galactosemia, when the sclera of a newborn appears yellowish and often at the same time a layered cataract is detected.

Yellowish staining of the sclera in combination with exophthalmos, strabismus, retinitis pigmentosa and blindness is a sign of a congenital lipid metabolism disorder (malignant histiocytosis, Niemann-Pick disease). Darkening of the sclera is accompanied by a pathology of protein metabolism, alkaptonuria.

Treatment is symptomatic, ineffective.

Acquired anomalies in the color of the sclera.

Diseases such as infectious hepatitis (Botkin's disease), obstructive (mechanical) jaundice, cholecystitis, cholangitis, cholera, yellow fever, hemolytic jaundice, chlorosis, pernicious anemia (Addison-Birmer anemia) and sarcoidosis can lead to them. The color of the sclera changes with the use of quinacrine (malaria, giardiasis) and an increase in the amount of carotene in food, etc. As a rule, all these diseases or toxic conditions are accompanied by icterus or yellowish coloration of the sclera. Icteric sclera is in many cases the earliest sign of pathology.

Treatment is general etiological. Ictericity and other shades of color of the sclera disappear during recovery.

Congenital changes in the shape and size of the sclera.

They are mainly a consequence of the inflammatory process in the antenatal period or an increase in intraocular pressure and manifest themselves in the form of staphylomas and buphthalmos.

Staphylomas are characterized by local limited stretching of the sclera. There are intermediate, ciliary, anterior equatorial and true (posterior) staphylomas of the sclera. The outer part of the staphyloma is the thinned sclera, and the inner part is the choroid, as a result of which the protrusion (ectasia) almost always has a bluish color. Intermediate staphylomas are located near the edge of the cornea and are the result of trauma (injury, surgery). Ciliary staphyloma is localized in the zone of the ciliary body, more often according to the place of attachment of the lateral rectus muscles, but in front of them.

The anterior equatorial staphylomas correspond to the exit area of ​​the vorticose veins under the lateral rectus muscles of the eye, posterior to their insertion. True posterior staphyloma corresponds to the cribriform plate, i.e., the place of entry (exit) of the optic nerve. It is usually accompanied by high myopia due to lengthening of the axis of the eye (axial myopia). However, both equatorial and posterior staphylomas of the sclera are detected late and only by an ophthalmologist.

Treatment for extensive staphylomas is only surgical.

Information about buphthalmos is given in the section on congenital glaucoma.

Kovalevsky E.I.

Dark spots on the sclera merged in the form of a dark strip

The first thought that arises when looking at a photograph where there is a dark strip on the white of the child's eye is scleral melanosis. Such a diagnosis can be made on the basis of several signs, however, it is not necessary to “run ahead of the locomotive”, but it is better to sort everything out in order.

Melanosis of the sclera is a deposition of pigment cells, melanocytes, in the anterior layers of the white of the eye, the sclera, or as it is also called, in the white of the eye. In these cases, the spots on the sclera can be from light gray to dark gray in various shapes in the form of a spot or spots that have merged with each other, which can form a strip of various widths, most often flat, not protruding above the surface of the sclera. In children, melanosis is usually congenital and most often unilateral.

I must say that melanosis occurs not only on the sclera, on the iris and retina, but also in other organs where there are melanocytes, that is, cells containing the pigment melanin

When scleral melanosis is detected in a newborn child, parents often note that in the first months to a year, pigmentation, that is, staining of the sclera, increases. However, quite often, scleral melanosis remains at the same level, without leading to visual impairment and without harming general health. Parents of a child with melanosis of the sclera of the eye should know that their child should be exposed to direct sunlight as little as possible throughout his life.

Nevertheless, I know of cases when parents did not pay attention to the advice of doctors not to stay under the sun's rays and melanosis was not complicated by anything. In such cases, the entire responsibility for the health of the child falls entirely on the shoulders of his parents, if they were promptly warned by a doctor.

But it should be noted that dark spots on the sclera of the eye can be a sign of a rare hereditary disease called ochronosis. In such people, pigmentation also appears on the skin, joints, auricle, heart valves, the nails become characteristic blue with brown stripes. The first sign of this disease is dark brown urine.

It is clear that the appearance of a dark spot on the sclera of a child's eye should alert parents, who should definitely consult an ophthalmologist and, if necessary, other specialists and follow their recommendations.

CONGENITAL SCLERAL MELANOSIS

Congenital melanosis of the sclera is characterized by its focal or diffuse pigmentation due to pigment hyperplasia of the uveal tissue. Most of the pigment accumulates in the superficial layers of the sclera and episclera, the deep layers of the sclera are relatively poorly pigmented. Pigment cells are typical chromatophores, the long processes of which penetrate between the scleral fibers. Pigmentation of the sclera is usually a manifestation of melanosis of the eye.

Congenital melanosis of the sclera is a hereditary disease with a dominant type of inheritance. The process is more often one-sided, only in 10% of patients both eyes are affected.

With melanosis, the sclera has spots of a grayish-bluish, slate, slightly purple or dark brown color against the background of the usual color.

Pigmentation can be in the form of:
- individual small spots in the perivascular and perineural zones;
- large isolated islands;
- color changes in the type of marble sclera.

In addition to melanosis of the sclera, as a rule, pronounced pigmentation of the iris is observed, usually in combination with a violation of its architectonics, dark color of the fundus, and pigmentation of the optic disc. A pericorneal pigmented ring is often seen. Possible pigmentation of the conjunctiva or skin of the eyelids.

Melanosis is usually detected from birth; pigmentation increases in the first years of life and in puberty. The diagnosis is established on the basis of a characteristic clinical picture. Melanosis must be differentiated from melanoblastoma of the ciliary body and choroid.

Melanosis of the sclera and eyes as a whole is not pathological. However, malignant melanomas can develop from pigmented lesions, especially during puberty. In this regard, patients with melanosis should be under dispensary observation.

Scleral melanosis is also observed in alkaptonuria, a hereditary disease associated with impaired tyrosine metabolism. Suffering is due to a deficiency of the enzyme homogetinase, which leads to the accumulation of homogentisic acid in the body. Being deposited in the tissues, it stains them in a dark color. Darkening of the sclera and cartilage is characteristic. Brown granules are deposited in the cornea near the limbus at 3 and 9 o'clock. There is a symmetrical lesion of the eyes. With alkaptonuria, pigmentation of the skin of the ears and nose also occurs, urine turns black in air, and osteoarthritis is not uncommon.

Melanosis of the sclera is not subject to treatment.

Yellowish staining of the sclera in combination with exophthalmos, strabismus, retinitis pigmentosa and blindness may be a sign of a congenital disorder of fat metabolism (reticuloendotheliosis, Gaucher disease, Niemann-Pick disease). A change in the color of the sclera such as melanosis can be observed with a hereditary disorder of carbohydrate metabolism - galactosemia.

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Among the anomalies of the sclera, one can distinguish color anomalies - congenital (blue sclera syndrome, melanosis, etc.) and acquired (drug-induced, infectious), as well as anomalies in the shape and size of the sclera. Blue sclera syndrome. This is the most striking congenital anomaly in the color of the sclera. The disease is manifested by damage to the ligamentous-articular apparatus, skeleton, eyes, teeth, internal organs and otological disorders. Depending on the clinical manifestations, different forms of the disease are distinguished: the combination of blue sclera with increased fragility of the bones - Eddowsyndrome; with deafness - Van der Houweit syndrome. With this syndrome, increased vascularization of the episclera, hyperplasia of the elastic elements of the sclera and sclerosarteries feeding the sclera are detected. Sometimes there are also associated changes such as keratoconus, embryotoxon, corneal dystrophy, layered cataract, glaucoma, iris hypoplasia, as well as hemorrhages in various parts of the eyeball and its auxiliary apparatus.

Pediatricians should remember that the blue color of the sclera is a formidable pathological sign if it is detected later than the first year of a child's life. At the same time, one should not overestimate the fact of the natural bluish tint of the sclera in a newborn, due to its tenderness and comparative thinness. In the process of development and growth of the child, but no later than by the age of three, the sclera in children has a white or slightly pinkish tint.

Treatment is symptomatic and ineffective. Anabolic steroids, large doses of vitamin C, fluorine preparations, magnesium oxides are used.

Melanosis of the sclera. Melanosis of the sclera of congenital origin has a characteristic picture, including three symptoms: pigmentation of the sclera in the form of spots of a grayish or slightly purple color against the background of the rest of its normal whitish color; a darker iris, as well as a dark gray color of the fundus. Possible pigmentation of the skin of the eyelids and conjunctiva. Congenital melanosis is more often unilateral. Increased pigmentation corresponds to the first years of life of children and puberty. Melanosis of the sclera must be differentiated from melanoblastoma of the ciliary body and the choroid proper.

A congenital hereditary change in the color of the sclera such as melanosis can also be a consequence of a violation of the carbohydrate metabolism of galactosemia, when the sclera of a newborn appears yellowish and often at the same time a layered cataract is detected. Yellowish staining of the sclera in combination with exophthalmia, strabismus, retinitis pigmentosa and blindness is a sign of a congenital lipid metabolism disorder (malignant histiocytosis, Niemann-Pick disease). Darkening of the sclera is accompanied by a pathology of protein metabolism, alkaptonuria.

Treatment is symptomatic, ineffective.

Diseases such as infectious hepatitis (Botkin's disease), obstructive (mechanical) jaundice, cholecystitis, cholangitis, cholera, yellow fever, hemolytic jaundice, chlorosis, pernicious anemia (Addison-Birmer anemia) can lead to acquired anomalies in the color of the sclera. and sarcoidosis. The color of the sclera changes with the use of quinacrine (malaria, giardiasis) and an increase in the amount of carotene in food, etc. As a rule, all these diseases or toxic conditions are accompanied by icterus or yellowish coloration of the sclera. Icteric sclera is in many cases the earliest sign of pathology.

Treatment is general etiological. Ictericity and other shades of color of the sclera disappear during recovery.

Congenital changes in the shape and size of the sclera are mainly the result of an inflammatory process in the antenatal period or an increase in intraocular pressure and manifest themselves in the form of staphylomas and buphthalmos.

Staphylomas are characterized by local limited stretching. There are intermediate, ciliary, anterior equatorial and true (posterior) staphylomas of the sclera. The outer part of the staphyloma is a thinned sclera, and the inner part is the choroid, as a result of which the protrusion (ectasia) almost always has a bluish color. Intermediate staphylomas are located near the edge of the cornea and are the result of trauma (injury, surgery). Ciliary staphyloma is localized in the zone of the ciliary body, more often corresponding to the place of attachment of the lateral rectus muscles, but in front of them. The anterior equatorial staphylomas correspond to the exit area of ​​the vorticose veins under the lateral rectus muscles of the eye, posterior to their insertion. True posterior staphyloma corresponds to the cribriform plate, i.e., the place of entry (exit) of the optic nerve. It is usually accompanied by high myopia due to lengthening of the axis of the eye (axial myopia).

Before using the drugs listed on the site, consult your doctor.