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INTEGRATED APPROACH TO THE TREATMENT OF
CORNEAL ULCERS IN EARLY CHILDHOOD
Z.R. Nazi o a1, D.M. Tu akulo a2, D.M. Mu a o a3
Tashken S a e Medical Uni e si y1,2,3
h ps://doi.o g/10.5281/zenodo.17538733
Abs ac . This a icle p esen s da a om a s udy on op imizing he comp ehensi e
ea men o co neal ulce s in child en. The au ho s p esen da a on he e ec i eness o combined
app oaches o accele a e healing, educe ocula in lamma ion, and p e en co neal opaci ica ion.
F om 2023 o 2025, 265 pa ien s wi h in lamma o y co neal diseases we e hospi alized in he
oph halmology depa men o he Tashken Pedia ic Medical Ins i u e (TashPMI). O hese, 87
(32.8%) child en we e diagnosed wi h co neal ulce s, and 178 (67.2%) had ke a i is o a ious
o igins.
Keywo ds: eye diseases in child en, co neal opaci ies, co neal ulce s, in lamma o y
p ocess.
In oduc ion
I is widely acknowledged ha co neal p oblems pose a signi ican h ea o child en. The
de elopmen o eye diseases and ision loss in child en is one o he main causes. Co neal diseases
a e known o be a majo ac o leading o ision loss and he de elopmen o oph halmological
pa hologies in child en. Co neal in lamma ion, o ke a i is, accoun s o 3-10% o all eye
in lamma ions in child en [1, 2, 3, 4]. In pedia ic oph halmology, ke a i is is diagnosed in 11-13%
o cases o in lamma o y p ocesses in he an e io segmen o he eye and is o en se e e, wi h a
isk o se ious complica ions, especially in young child en [4, 5].
Resea ch has consis en ly demons a ed ha co neal ulce is a lesion o he ou e memb ane
o he eyeball. A s udy o local and in e na ional li e a u e e ealed ha he causes o his condi ion
can be di ided in o endogenous and exogenous. Co neal ulce s a e mos o en caused by in ec ious
diseases, p ima ily caused by bac e ia (S aphylococcus au eus, gonococcus, E. coli), ungi, and
i uses (Shipiguzo a S.A., 2021) [14]. Acco ding o esea ch by a numbe o au ho s, in addi ion
o being an independen nosological en i y, a co neal ulce can be conside ed bo h a complica ion
and a cou se o ke a i is, wi h he p og ession o des uc i e p ocesses in he co nea in e ms o
pene a ion dep h and damage a ea as a esul o un imely and ine ec i e ea men [5,6,7]. I can
be clea ly obse ed ha esea ch in ecen yea s shows, co neal ulce s a e less common in young
child en; howe e , hey a e associa ed wi h a wo se p ognosis, o en leading o pe sis en co neal
opaci y and dec eased ision.
By e iology, co neal ulce s a e di ided in o:
- auma ic inju ies;
- congeni al co neal anomalies;
- complica ions ollowing ke a i is [1,2,8,9].
The nume ous s udies on co neal ulce s ha e been conduc ed ecen ly, bu mode n
oph halmology lacks a uni ied, s anda d app oach o ea ing co neal ulce s in child en. Va ious
he apeu ic egimens a e used, including d ug he apy, ke a op o ec o s, i amins, and
an imic obials. Howe e , he e ec i eness o hese p o ocols emains a iable, and he isk o
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sca ing and loss o co neal anspa ency emains [4,9,10,11,12]. I is e iden om he da a ha
di icul ies in diagnosing co neal ulce s in young child en p ima ily a ise due o age- ela ed lipids
and he inabili y o pe o m s anda d oph halmological examina ions, such as biomic oscopy and
onome y. Follow-up is also di icul , which hinde s he imely assessmen o ea men
e ec i eness [13,14].
Aim o he esea ch: Fo imp o ing he e ec i eness o comp ehensi e ea men o
co neal ulce s in young child en by using combined echniques aimed a ac i a ing epa a i e
cycles, elimina ing he in lamma o y esponse, and p e en ing co neal cica icial changes.
Ma e ials and me hods: The s udy included 265 pa ien s hospi alized in he Oph halmology
Depa men o he Tashken Pedia ic Medical Ins i u e Clinic be ween 2023 and 2025 wi h a
diagnosis o in lamma o y co neal diseases. Co neal ulce s we e diagnosed in 87 pa ien s (32.8%),
and ke a i is o a ious e iologies was diagnosed in 178 pa ien s (67.2%).
The s udy inclusion c i e ia we e as ollows:
- P esence o a clinically con i med co neal ulce ;
- Pa ien s we e aged 7 yea s o younge ;
- No congeni al isual anomalies ha could a ec co neal assessmen [15, 16, 17].
The exclusion c i e ia included:
- P esence o sys emic in ec ious o au oimmune diseases ha could a ec co neal
eco e y;
- Se e e congeni al eye pa hologies, such as ani idia o mic oph halmos;
- Indi idual in ole ance o he medica ions used.
The indings indica e ha due o hospi aliza ion, all child en unde wen a comp ehensi e
oph halmological examina ion. This included a isual examina ion, a de ailed biomic oscope
examina ion o he an e io segmen o he eye, a co neal sensi i i y es , and a de e mina ion o
isual acui y based on he child's age. Using an Ica e onome e , in aocula p essu e was measu ed
in child en [11, 16, 18].
The ollowing labo a o y es s we e pe o med in he child en:
- comple e blood coun ;
- u inalysis;
- s ool analysis;
- glucose le el changes;
- TORCH in ec ion sc eening;
- ASL-O es s;
- heuma ic es s;
- C- eac i e p o ein le els.
The goal o hese diagnos ic measu es was o es ablish he cause o he co neal ulce and
iden i y concomi an in ec ious, in lamma o y, o sys emic pa hologies in luencing disease
p og ession [18, 19, 20].
Resul s and discussion. In 87 pa ien s wi h co neal ulce s, he s udy was conduc ed using
he classi ica ion (A.A. Kaspa o a 2000). Supe icial, deep, and pe o a i e o ms we e iden i ied,
he la e equi ing su gical in e en ion. Supe icial co neal ulce s we e cha ac e ized by limi ed
damage o he an e io s omal and epi helial laye s, as well as a mode a e in lamma o y eac ion,
while main aining anspa ency o he deep co neal laye s.
The ollowing clinical mani es a ions we e obse ed in 24 pa ien s (27.6%) wi h co neal
ulce s:
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- mino in il a ion in he pe ilesional zone;
- ascula injec ion;
- epi helial edema.
Deep co neal ulce s wi h damage o he deep s omal laye s we e de ec ed in 51 pa ien s
(58.6%). This was mani es ed by se e e pe ilesional in lamma ion, co neal opaci y, and edema.
Pe o a ing ulce s we e de ec ed in 12 pa ien s (13.8%). This condi ion was cha ac e ized by o al
s omal mel ing wi h co neal pe o a ion, i is p olapse, and he o ma ion o an e io synechiae.
This g oup o pa ien s expe ienced se e e pain, pho ophobia, lac ima ion, and a sha p dec ease in
isual acui y, necessi a ing immedia e su gical in e en ion. I is gene ally accep ed ha among
he child en examined, 32.2% had small co neal ulce s up o 3 mm in diame e . Medium-sized
ulce s, anging om 3 o 6 mm, accoun ed o 42.5% o cases. La ge lesions, exceeding 6 mm in
diame e , we e obse ed in 9.2% o pa ien s, and comple e damage o he en i e co neal su ace
( o al ulce ) occu ed in 16.1% (Fig. 1).
Figu e 1. Co neal Ulce Sizes
By loca ion, co neal ulce s we e mos o en ound in he cen al egion o he eye (55.2%).
Ulce s we e obse ed in he pa acen al zone in 33.3% o child en, while hose in he pe iphe y
occu ed in only 11.5%. Cen al co neal ulce s we e associa ed wi h dec eased isual acui y, a
slowe p og ession, and a high isk o de eloping pe sis en sca ing in he op ic zone. Pa acen al
ulce s we e cha ac e ized by mode a e co neal anspa ency impai men and a ela i ely a o able
clinical p ognosis wi h imely ea men . Pe iphe al ulce s ypically mani es ed wi h less
p onounced clinical symp oms and esul ed in he o ma ion o a limi ed sca wi hou signi ican
impac on isual unc ion. I has been shown h ough analysis ha mos pa ien s wi h co neal ulce s
had concomi an in lamma o y changes in he an e io segmen o he eye.
Conjunc i al hype emia, co neal edema, and ulce ma gin in il a ion we e obse ed in
almos all cases. Hypopyon o a ying se e i y was de ec ed in 26 child en (29.9%), mos o en
wi h deep and pe o a ed ulce s. Co neal angiomas we e obse ed in 34 pa ien s (39.1%). In some
cases, his condi ion led o he o ma ion o cica icial opaci ies and i e e sible changes in he
co nea, ul ima ely causing a signi ican and pe sis en educ ion in isual acui y. Seconda y
glaucoma also de eloped in 7 pa ien s (8.0%). This complica ion was associa ed wi h impai ed
32.20% 42.50%
9.20%
16.10%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
Мелкие язвы -3 мм Средние язвы -до 6
мм
Крупные язвы -
больше 6 мм
Полное поражение
роговицы
Мелкие язвы -3 мм Средние язвы -до 6 мм
Крупные язвы -больше 6 мм Полное поражение роговицы
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aqueous humo ou low, adhesions be ween he i is and co nea, and i is de o ma ion. In some
cases, pene a ing ulce s esul ed in i is p olapse and co neal opaci y, equi ing p omp su gical
ea men .
The li e a u e e eals ha analysis o he causes o co neal ulce s in child en e ealed ha
i al in ec ions we e he mos common cause, occu ing in 52 cases (59.8%). Vi al ulce s ypically
mani es ed as supe icial o mode a ely deep lesions. Bac e ial ulce s, iden i ied in 22 cases
(25.3%), we e cha ac e ized by a mo e acu e cou se, se e e in lamma ion (in il a ion), pu ulen
discha ge, and o en esul ed in he o ma ion o pus in he an e io chambe (hypopyon). Bac e ial
in ec ions o en a ec ed he deep laye s o he co nea, causing signi ican opaci ica ion. Fungal
ulce s exhibi ed a ch onic, indolen cou se wi h jagged edges and a dense, g ayish-whi e in il a e.
Fungal ulce s we e de ec ed in 8 (9.2%) pa ien s, and neu o ophic ulce s in 5 (5.7%) (Fig. 2).
Figu e 2. Causes o Co neal Ulce s
I is necessa y o highligh he ac ha depending on he he apy used, pa ien s wi h co neal
ulce s we e s a i ied in o wo g oups: a con ol g oup and a s udy g oup. The con ol g oup,
ep esen ing he adi ional ea men app oach, ecei ed s anda d he apy, including sys emic
an ibio ics and an i-in lamma o y d ugs. The s udy g oup o pa ien s, who ecei ed an
expe imen al complex ea men p o ocol, in addi ion o s anda d he apy, also ecei ed:
- Sys emic adminis a ion o an i ungal d ugs, epi helializa ion s imula o s, and i amin
complexes (B i amins o mul i i amins);
- Topical adminis a ion o a simila ange o medica ions – an ibio ics, an i i al,
an i ungal, an i-in lamma o y, and mois u izing solu ions.
Pa ien s in he s udy g oup demons a ed mo e p onounced clinical imp o emen :
accele a ed co neal epi helializa ion, educed in il a ion and edema, and a sho e ime in e al
o he in lamma o y esponse o esol e. C i ical analysis has e ealed ha pa ien s ecei ing
combina ion he apy including epi helializing and i amin supplemen s ( he s udy g oup)
demons a ed a s a is ically signi ican educ ion in he incidence o complica ions, such as
neo ascula iza ion and ib osis in he op ic zone o he co nea. Fu he mo e, a mo e p onounced
es o a ion o co neal op ical anspa ency was obse ed. The incidence o in lamma o y
ecu ence du ing he h ee-mon h ollow-up was signi ican ly lowe in he s udy g oup (6.8%)
compa ed o he con ol g oup (18.4%). The e o e, his app oach o co neal ulce he apy p omo es
in ensi ica ion o epa a i e p ocesses, p o ec ion om complica ions, and op imiza ion o
unc ional ou comes.
0
10
20
30
40
50
60
70
80 52
22
85
59.80% 25.30% 9.20% 5.70%
Количество
Проценты
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Conclusion. I is a well-es ablished ac ha analysis o in lamma o y co neal diseases in
child en e ealed ha ulce a i e o ms accoun o 32.8% o all cases. Vi al e iology was he
dominan e iology among ulce s, eaching 59.8%, con i ming he leading ole o i al in ec ions
in he pa hogenesis o pedia ic co neal lesions. The mos un a o able cou se o he disease was
obse ed wi h deep and pe o a ed ulce s, especially hose loca ed cen ally. These condi ions we e
accompanied by se e e in lamma ion, dec eased co neal anspa ency, and a high isk o
de eloping pe sis en cica icial changes. The inclusion o epi helializing agen s and B i amins
in combina ion he apy, along wi h an ibac e ial, an i i al, an i ungal, and an i-in lamma o y
d ugs, con ibu ed o accele a ed epi helializa ion, educed he in lamma o y esponse, and
dec eased he incidence o complica ions.
REFERENCES
1. I ano a N.A., Pisa e a E.A., Kuzne so a O.V. Clinical and mo phological ea u es o
ulce a i e co neal lesions in child en. Bulle in o Oph halmology. 2021; 137(5):22–28.
2. Leon ye a T.V., Klimo a S.V., Akhmadee a L.R. Combina ion he apy o i al ke a i is
using epi helializing agen s. Oph halmology. 2022;19(3):45–52.
3. Laza e a M.V., Se gee V.P. Ke a i is and co neal ulce s in child en: mode n app oaches o
diagnosis and ea men . Russian Pedia ic Oph halmology. 2021;2(1):13–19.
4. Nazi o a Z.R., Tu akulo a D.M., Buz uko S.B. Su gical ea men o congeni al glaucoma
in child en using Glau ex d ainage // Bulle in o Oph halmology. - 2020. - Vol. 136. - No. 6-
2. - P. 202-206.
5. Nazi o a Z. R., Khadzhime o A. A., Tu akulo a D. M. The impo ance o he ole o
media o s o he immune esponse and coagula ion ac i i y o lac imal luid in alle gic eye
diseases in child en // Russian pedia ic oph halmology. - 2014. - No. 2. - P. 14-16.
6. Nazi o a Z. R., Tu akulo a D. M., Musabae a R. Sh. Resul s o su gical ea men o
congeni al glaucoma using glau ex d ainage // Mode n echnologies in oph halmology. - 2020.
- No. 4. - P. 140-141.
7. Nazi o a Z. R. Coagula ion ac i i y and immunological pa ame e s o lac imal luid in
child en wi h alle gic eye diseases // Pos g adua e doc o . – 2013. – V. 60. – No. 5.3. – P. 480-
486.
8. Nazi o a, Zul iya Rus amo na, and Dil uza Mukhi dino na Tu akulo a. "The concen a ion
o immunoglobulins and he coagula ion ac i i y o lac imal luid in he de elopmen o
alle gic eye diseases in child en." Young scien is 11 (2016): 1164-1166.
9. Pe o a I.V., Sa ono A.V. Mode n app oaches o he ea men o in lamma o y diseases o
he co nea in child en. Medical jou nal o Uzbekis an. 2023; 4 (6): 72–77.
10. Rakhma ullina D.Sh., Islamo a G.N. The e ec i eness o B i amins in he ea men o
an e io segmen diseases o he eye. Medical Bulle in o Uzbekis an. 2020;2(4):56–60.
11. Tu akulo a D. M., Nazi o a Z. R. RESULTS OF DIAGNOSIS AND TREATMENT OF
FAMILIAL CONGENITAL GLAUCOMA // Science and inno a ion. – 2024. – Vol. 3. – No.
Special Issue 54. – P. 458-460.
12. Kham ae a L. S., Kham oe a Yu. A., Buz uko B. T. Su gical ea men o child en wi h
congeni al glaucoma combined wi h o he de elopmen al de ec s // Russian Oph halmological
Jou nal. – 2014. – Vol. 7. – No. 4. – P. 60-62.
13. Kham ae a L., Kham oe a Yu. A., Alimdzhano a Z. R. Complica ions o pene a ing wounds
o he o gan o ision in child en / /in Lib a y. – 2014. – Vol. 2. – No. 2. – P. 6-9.
SCIENCE AND INNOVATION
INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 10 OCTOBER 2025
ISSN: 2181-3337 | SCIENTISTS.UZ
225
14. Shipiguzo a S.A. Su gical ea men o co neal ulce s / S.A. Shipiguzo a // Bulle in o
ope a ional su ge y and opog aphic ana omy. – 2021. – No. 1 (2), Vol. 1 – P. 51-54
15. Rahman I., Ca ley F., Hilla by M.C. Co neal ulce a ion in child en: e iology and ou comes.
B i ish Jou nal o Oph halmology. 2020;104(7):918–923.
16. Kuma A., Pandey A., Sha ma N. Role o i amin B complex in co neal wound healing. Indian
Jou nal o Oph halmology. 2019;67(9):1402–1408.
17. Whi che J.P., S ini asan M., Upadhyay M.P. Co neal blindness: a global pe spec i e.
Bulle in o he Wo ld Heal h O ganiza ion. 2001;79(3):214–221.
18. Dua H.S., Fa aj L.A., Said D.G. Co neal s em cells and epi helial egene a ion. Eye (Lond).
2019;33(2):157–164.
19. Chen J., Wang W., Li R. Pedia ic in ec ious ke a i is: clinical ea u es and ea men
ou comes. Ame ican Jou nal o Oph halmology. 2022;239:95–104.
20. Plesko a A.V., Ka a gina L.A., Iomdina E.N., Mamakae a I.R., Pano a A.Yu. Fi s
Expe ience o Combined T ea men o Co neal and G a Ulce s in P eschool Child en Using
Local Ul a iole C osslinking (Clinical Cases). Oph halmology in Russia. 2023;20(2):358-
362. (In Russ.) h ps://doi.o g/10.18008/1816-5095-2023-2-358-362
