Mooren’s ulcer, a rare optical illness, is an unpleasant chronic peripheral corneal ulceration with some evidence of an autoimmune origin. Severe limbal inflammation causes an opaque cornea to first appear. Progressive injury and corneal aging can cause permanent vision loss if unchecked.  Mooren’s ulcer is a severe, persistent case of peripheral ulcerative keratitis that starts in the periphery of the cornea, first spreads circumferentially, and eventually involves the cornea’s center.

 

Introduction:

 

Peripheral corneal ulceration that is painful and has no known cause is a hallmark of Mooren’s ulcer. Episclera and conjunctival edema, together with severe limbal inflammation, are typically the first symptoms of the condition. The superficial third of the cornea is affected first by gray swellings that quickly furrow, and alterations to the cornea begin within 2-3 mm of the limbus. Over the course of 4–12 months, these changes spread circumferentially and centrally. Vessels advance into the foundation of the ulcers’ weakened borders as the furrow’s bed becomes vascularized. These ulcers could leave underneath an opaque and edematous center cornea and are frequently described as crescent-shaped.

The corneal stroma can also be totally consumed in place of a thin fibrovascular membrane. Both the underlying Descemet’s membrane and the sclera next to the peripheral ulcers are unaffected by inflammation. The endothelium and epithelium are typically unaffected by corneal destruction, which typically solely affects stromal tissue. Neovascularization of the cornea may happen, stretching from the limbus into the ulcer bed, and the central borders of the ulcer may acquire an overlapping edge with or without opacification. Neovascularization can happen up to the ulcer’s expanding margin but not past it.

 

Causes:

 

Mooren’s ulcer’s pathogenesis appears to be caused by an immunological reaction to molecules produced in the corneal stroma, according to new research, despite the disease’s unclear etiology.  Mooren’s ulcer may be accompanied by specific illnesses:

• Alkali wounds.
• Trauma
• A simplex herpes infection.
• Zoster herpes infection.
• Parasitic diseases.
• Cataract operation.
• Cataract surgery.
• Malnutrition
• Metabolic illness.

 

Signs and Symptoms:

 

• Severe ocular pain that is typical
• Tearing up the Feeling of an outside body.
• Having a reddened eye
• Photophobia.
• Eyesight blur.

Men typically have more symptoms than women, according to several epidemiological research.

 

Risk Factors:

 

• Corneal trauma. The integrity of the cornea can be compromised by previous ocular trauma or infection, which can lead to the development of immune system-hiding tissue-specific antigens. The likelihood of becoming sensitized to corneal antigens and developing an immune system response against antigens produced in ocular tissues may increase as a result.
• HLA association. Mooren’s ulcer is believed to be connected to certain HLA haplotypes, like the majority of autoimmune disorders. In certain research, it was discovered that affected patients had higher frequencies of HLA-DR17 and HLA-DQ2 than healthy controls. These findings suggest a potential link between HLA and Mooren’s ulcer.

 

Diagnosis:

 

The absence of any ocular infections or systemic rheumatological conditions known to produce peripheral corneal ulcers is necessary for the diagnosis of Mooren’s ulcer. Partial peripheral, complete peripheral, and entire corneal ulcers are the three types of ulceration identified by Srinivasan and colleagues. Complete peripheral ulceration is characterized by a “central island of cornea” that is frequently opaque because the disease process has totally engulfed the corneal periphery. The corneal stroma has been entirely replaced by a fibrovascular membrane in total corneal ulceration. Nasal, temporal, superior, and inferior ulcerations are subcategories of partial peripheral ulceration, with temporal and nasal (also known as intrapalpebral cornea) involvement being more common.

 

Among the lab’s investigations are:

• Erythrocyte sedimentation rate (ESR), CBC, TC, and DC counts are all part of the blood analysis.
• Rheumatoid factor, antinuclear antibody, antineutrophil cytoplasmic antibodies, and the fluorescent treponemal antibody absorption (FTA-ABS) test are serology tests. Additionally, it may be necessary to perform other tests such a urinalysis, blood urea nitrogen, serum protein electrophoresis, and liver enzyme measurements.
• Eye surface topography

 

Homeopathic Treatment for the Disease:

 

Homeopathy can aid in Mooren’s ulcer even if it’s a challenging case to cure since homeopathic medications function naturally without any side effects and it will help the body repair itself naturally. Homeopathic medicines which can be used to lower the side effects of Moreen’s ulcer:

• Silicea Terra is recommended for corneal ulcers that are perforating or sloughing. Abscess. after an injury. Sharp aches irritated the eyes. When closed, the eyes are more sensitive to touch. Particularly impacted are canthi.
• All the time, Euphrasia officinalis causes eye watering. Lackluster coryza, acrid lachrymation, and copious, heated tears. frequent tendency to blink the eyes. Upon damage, opacities form. Ptosis and rheumatic discomfort. on the eyes, little blisters. corneal mucous that sticks. Photophobia. Intense pain in the eyes.
• Puffy eyelids on Apis mellifica are a sign of an allergy. Eyelids are erythematous, red, and swollen. severe chemosis of the ocular conjunctiva together with keratitis. An opaque cornea. suppurative eye irritation and a perforating corneal ulcer. Pains that come on suddenly, particularly in orbit. sharp, stinging, and burning pains.
• Argentum nitricum is recommended for corneal ulcers with profuse, purulent discharge. Red and swollen in the inner canthi. a painful, infected eye condition. Photophobia.
• Spots and ulcers on the cornea respond well to calerea carbonica. There is the normal calcarea carbonica makeup. Early in the morning, lachrymation in the open. eyesight that is so dim it seems foggy.
• For corneal superficial ulcers, use pulsatilla nigricans. on the cornea, spots. The eyeballs are discharged with a thick, yellow, plentiful, and bland discharge. I had to rub my itchy, burning eyes. Weeping eyes, copious lachrymation, and mucus discharge.
• With red and irritated eyes and lids and corneal ulcers, hepar sulphuris is suitable. painful eyes that feel like they are being dragged back into their orbits. extremely painful to touch eyeballs. Photophobia.
• Deep corneal ulcerations, severe photophobia, and acrid lacrimation are all characteristics of Mercurius corrosivus. Iris doesn’t enlarge or contract and has a muddy appearance. Eye pain that shoots, burns, and causes tears, especially at night. burning and eye discomfort.

 

Precautions:

 

You can take the following actions to prevent the condition:

• When removing your contact lenses, wash your hands thoroughly.
• Keep your contact lenses off at night.
• If you have an eye infection, seek treatment right away to avoid developing ulcers.

Your healthcare practitioner might also advise you to:

• Don’t use eye makeup.
• Never wear contact lenses, especially not at night.
• Utilize painkillers.
• Put on safety eyewear.