MOOREN’S ULCER

It is a  painful, progressive, and chronic disease of the cornea, which often is bilateral and may cause severe vision loss or even loss of the eye, characterised by painful peripheral corneal ulceration 

It is strictly a peripheral ulcerative keratitis (PUK) with no associated scleritis. It occurs completely in absence of any diagnosable systemic disorder that could be responsible for the progressive destruction of the cornea. The cause of Mooren's ulcer remains uncertain.

Mooren's ulcer was first described by Bowman in 1849, and then by McKenzie in 1854 

Mooren's ulcer usually complain of redness, tearing, and photophobia, but pain is typically the outstanding feature. The pain often is incapacitating and may well be out of proportion to the inflammation. There may also be a complaint of decreased visual acuity, which may be secondary to associated iritis, central corneal involvement, or irregular astigmatism due to peripheral corneal thinning.

SYMPTOMS:

• Severe ocular pain which is characteristic
• Watering from the eyes
• Foreign body sensation.
• Redness in the eye
• Photophobia.
• Blurring of vision.

CAUSE:  of  Mooren’s ulcer is unknown, but evidence suggests an autoimmune affection.

Certain conditions may be associated with Mooren’s ulcer:

• Alkali injuries.
• Trauma
• Herpes simplex infection.
• Herpes zoster infection.
• Parasitic infections.
• Cataract surgery.
• Corneal surgery.
• Malnutrition
• Metabolic disorder.
• Trophic disturbances involving the trigeminal cranial nerve.
• Deficiency of vitamin B1.

DIAGNOSIS:

BY CLINICAL EXAMINATION AND UNDERSTATED.

Laboratory investigations include:

Blood examination: CBC ,TC ,DC counts , erythrocyte sedimentation rate (ESR).

Serology:  rheumatoid factor, antinuclear antibody, antineutrophil cytoplasmic antibodies, (VDRL) test and fluorescent treponemal antibody absorption (FTA-ABS) test.

In addition, certain tests like measurement of liver enzymes, blood urea nitrogen, serum protein electrophoresis and urinalysis may also be required.

Corneal topography

Though it’s a difficult case to treat ,homoeopathy can help in this condtions as homoepathic medicines act naturally without any side affects and it will help heal the body naturally. 

HOMOEOPATHIC MANAGEMENT:

• Euphrasia– a very good remedy for many ulcers; used topically in saline eye wash, or given orally in potency (or both)
• Aconitum – if the ulcer is very painful, and developed recently
• Apis, Argentum nitricum, Arsenicum alb., Hepar sulph., Mercurius, Rhus tox., Silicea, Sulphur, Thuya– other remedies to help heal ulcers
• Silicea or Thuja– to complete healing of stubborn, indolent ulcers