Случай тяжелого роговично-конъюнктивального ксероза, вызванного длительным местным применением инокаина, у больного вирусным конъюнктивитом (COVID-19)

Abstract

The article describes a rare case of conjunctivitis in a 25-year-old patient that developed 5 days before the first typical signs of COVID-19 disease appeared, and led to cicatricial changes in the conjunctiva in the form of bilateral partial external symblepharon and mild dry eye syndrome, and later chronic dacryocystitis of the right eyes. Surgical treatment of simblepharon led to its relapse in the right eye with gradual development of severe DES with a significant decrease in visual acuity. The prescribed complex therapy with drops of dexamethasone, restasis, vitabact and tear-suppressing drugs (Oftagel, Vita Pos ointment) for several days, however, led to extensive detachment of the corneal epithelium and the development of a superficial ulcer of the right eye with a keratomalacia area in its lower part. In the process of inpatient treatment recommended to the patient at one of the councils, it suddenly turned out that the patient had been periodically instilling inocaine into his right eye for anesthesia for several months on his own. It was the decrease in sensitivity against the background of prolonged instillations of the local anesthetic inocaine that aggravated the violation of the stability of the tear film, led to a significant decrease in tear secretion and a cytotoxic effect, which gradually led to the development of severe corneal-conjunctival xerosis. The performed inpatient treatment and subsequent outpatient treatment led to the relief of inflammation, epithelialization of the ulcer. Key words: conjunctivitis, COVID-19, complication, simblefaron, inocaine anesthetic, corneal-conjunctival xerosis.