Symptoms of uveitis and methods of treating eyeball pathology

Uveitis is an inflammation of the uveal tract, the choroid of the eye. In ICD 10 (International Classification of Diseases, 10th revision) it is coded H30-H36.

The disease is not common: it affects only 0.1-0.2% of people. But it is precisely this that becomes a common cause of low vision and blindness.

Let's find out what the types and symptoms of the disease are, why it occurs, and how to treat it correctly.

Uveitis is an inflammation of various parts of the choroid of the eye.

Types and causes of uveitis

Based on the reasons that caused it, uveitis is divided into:

• Infectious (viral, bacterial, fungal, parasitic).
• Non-infectious (allergic or caused by systemic diseases).

Attention! Systemic diseases are pathological conditions in which the functioning of entire body systems, rather than just one organ, is disrupted.

An infectious disease is contagious. Adenoviral uveitis is transmitted by airborne droplets, herpetic uveitis by contact, and enteroviral uveitis by fecal-oral route.

You can become infected with the toxoplasmosis form from infected pets and by consuming foods that have not undergone sufficient heat treatment.

In fungal and bacterial types of disease, the main route of transmission is contact.

Domestic animals are carriers of the toxoplasmosis form of the disease.

Uveitis is usually caused by endogenous (internal) causes. It develops against the background of pre-existing inflammatory diseases. It can be caused by: tuberculosis infection, ear, nose and throat diseases. In such cases, pathogens are transferred to the eyes through the blood.

There is also autoimmune uveitis, which is not contagious to others. The following diseases can cause it:

• psoriasis;
• sarcoidosis;
• Crohn's disease;
• Bekhterev's disease;
• juvenile rheumatoid arthritis;
• nonspecific ulcerative colitis.

Ophthalmologist Elena Stanislavovna Prokhvachova says:

“The usual cause of uveitis is an infection or a systemic disease of the body. In most cases, the patient himself does not pose a threat to others. It is easy to get infected from it only with tuberculosis. In other cases, this is only possible with very close contact with the patient, who does not follow the rules of personal hygiene.”

Poor hand hygiene is one of the causes of infection.

The disease happens:

• sluggish - with mild symptoms;
• with vivid symptoms - it begins as quickly as it ends.

If uveitis lasts less than three months, then it is called limited, if longer - persistent.

Depending on the nature of the course, the disease can be of the following types:

• Spicy. Begins abruptly, duration is limited.
• Recurrent. Sudden exacerbations are followed by remissions that last longer than three months without treatment.
• Chronic. Persistent acute periods are replaced by short remissions (up to three months without treatment).

Based on the location of inflammation, uveitis is classified into:

• anterior (iritis - inflammation of the iris);

Symptoms of iritis include red eyes, watery eyes, pain, and mild blurred vision.

• posterior (choroiditis - the choroid is inflamed - the back part of the choroid, which nourishes the retina);
• peripheral (cyclitis - the ciliary body is affected - the middle part of the uveal tract, to which the lens is suspended).

Sometimes the disease affects not only the uveal tract, but also adjacent tissues. Then the following are possible: iridocyclitis (inflamed iris and ciliary body), chorioretinitis (choroid and retina) and neuroretinitis (optic nerve and retina). If the inflammation has spread to the entire choroid, then they speak of the development of panuveitis.

Symptoms of the disease

Signs of anterior uveitis:

• photophobia;
• lacrimation;
• constricted pupils;
• Pain in the eyes;
• hyperemia of the sclera;
• increased intraocular pressure.

Symptoms of peripheral uveitis:

One of the symptoms of the peripheral form of the disease is spots before the eyes.

In the posterior form of the disease, patients complain only of blurred vision, and later of dull pain in the eyes. With panuveitis, signs of all types of uveitis are observed.

In ophthalmology, two methods are used to diagnose uveitis:

• Biomicroscopy of the eye (for iritis and iridocyclitis). The doctor examines the anterior structures of the eyeball under magnification using a slit lamp.

The process of eye biomicroscopy does not cause pain; the patient only observes the beam of light.

• Ophthalmoscopy (for cyclitis, choroiditis and chorioretinitis and neuroretinitis). An ophthalmologist examines the condition of the fundus of the eye using an ophthalmoscope, which provides magnification from 2 to 15 times.

Additionally, the patient may be prescribed general tests, x-rays, ultrasound examinations and other diagnostic procedures to identify systemic diseases that could cause the development of uveitis.

No measures can be taken without establishing the nature of the disease, since all its types are treated differently. An exception is anterior uveitis (iritis, iridocyclitis), which can lead to fusion of the edges of the iris with the lens or their complete soldering. First aid in this case is to prescribe drugs from the mydriatic group:

In the initial forms of the disease, the doctor may prescribe Midrimax.

• Irifrit;
• Visofrine;
• Tropicamide;
• Cyclomed.

By dilating the pupil, they will prevent it from completely overgrowing, which will allow the patient to maintain visual ability. An additional effect is a decrease in intraocular pressure.

Treatment methods

For uveitis , symptomatic treatment is carried out aimed at reducing the manifestations of the disease. For this, ophthalmologists prescribe the following medications:

• Drugs from the NSAID group to combat mild to moderate inflammation. The drugs can be taken both topically - in the form of eye drops (Diclofenac, Indocollir) and systemically - in the form of tablets (Ibuprofen, Naproxen, Ketoprofen). An additional effect is pain relief.

Indocollir fights ophthalmic inflammation and relieves pain.

• Glucocorticosteroids in the form of eye drops (Dexamethasone) or ointment (Hydrocortisone ointment 0.5%). They reduce inflammation in uveitis of an allergic or unknown nature, and prevent the iris from welding together.
• Antihistamines for allergic forms of the disease. Eye drops - Opantanol, Allegordil, Lecrolin. Inside - Suprastin, Tavegil, Claritin, Xizal.
• Antiviral drugs. Oftalmoferon drops (for adenovirus infection). Ointments Acyclovir, Zovirax (for herpetic eye lesions). Sometimes antiviral drugs are prescribed orally - Acyclovir, Cycloferon tablets, Arbidol capsules.
• Antibiotics for bacterial uveitis. In the form of drops: Tobrex, Tsipromed, Tsiprolet, Levomycetin. In the form of ointment: Tetracycline, Erythromycin. Inside: Amoxicillin, Ciprofloxacin, Gentamicin. It is possible to administer antibacterial drugs intramuscularly or under the conjunctiva.

For bacterial etiology of uveitis, antibiotics are prescribed, for example, Tobrex.

• Combined eye drops and ointments with glucocorticosteroids and antibiotics: Tobradex (tobramycin, dexamethasone), Sofradex (gramicidin, framycetin and dexamethasone).
• Mydriatics (Midriacyl, Midrium) for the prevention of adhesions and elimination of spasm of the ciliary muscles of the iris, which causes pain to the patient.

For uveitis, surgery is sometimes indicated. Usually prescribed:

• vitrectomy;
• phacoemulsification;
• injections under the conjunctiva;

The injections stop the inflammatory response.

• filtering glaucoma surgery.

Patients may be prescribed a biopsy to clarify the diagnosis or surgery to remove pathological structures for cataracts, retinal detachment or vitreous destruction.

Attention! If the cause of the disease (possible systemic diseases) is not treated, uveitis will first become recurrent and then chronic. Then the treatment will be long and ineffective.

Egor from Murmansk writes:

“I have uveitis. The ophthalmologist said that it was caused by some disease that needed to be identified and treated. I saw an infectious disease specialist, an immunologist, an endocrinologist and a rheumatologist. Tests show an inflammatory process in the body, but no one can find anything. The doctor said that this happens in half of the cases. And I will have to limit myself to symptomatic treatment only.”

Complications and consequences

Missing or incorrect treatment of the disease is fraught with the following consequences:

• development of cataracts;

A complication after uveitis is cataract.

• development of glaucoma;
• fusion of the pupil;
• vitreous opacification;
• damage to the optic nerve;
• the appearance of pathological vessels in the retina and its detachment;
• fusion of the iris with the lens (the diameter of the pupil remains fixed, and it cannot increase in the dark or decrease in the light).

10% of people who have lost their sight have become blind as a result of uveitis, which also causes low vision in 15% of cases.

Unlike adults, diagnosing the disease in children is very difficult. In them, it develops gradually without the appearance of obvious symptoms. A sick child usually complains of worsening vision: it becomes foggy. There is no pain. With iritis and iridocyclitis, the anterior structures of the eye become filled with blood, causing the sclera to appear red. There are no other signs.

Parents who complain of deteriorating vision suspect the development of myopia. They begin to limit the time the child spends on the computer and TV, and monitor how he writes and reads. They may insist on doing eye exercises. But this is the main mistake, because without treatment, uveitis causes retinal detachment within a few months.

He will see the problem after checking his vision using the Sivtsev table. With myopia, children see the top lines, and with uveitis, all letters will be blurred. Then the doctor will conduct additional diagnostics.

Only a doctor can diagnose a child.

Treatment of inflammation of the choroid in children is no different. They are also given local and systemic therapy, and in severe cases, surgery. A thorough examination of the body is recommended to detect indolent infections and other hidden diseases that could cause uveitis.

Daria from Saratov writes:

“I have been suffering from tuberculous uveitis since I was 7 years old. For 5 years, she underwent 2 courses of drug therapy per year. Now I’m 24 years old, there are no relapses, but I constantly use drops. Cataracts and glaucoma have developed, the pupil is fused with the lens, and with my right eye I can only see silhouettes. They offer me surgery. I'm at a loss".

Prevention of uveitis

To prevent inflammation of the choroid, you need to maintain hygiene and promptly treat infectious, autoimmune, as well as systemic diseases and allergies.

Prevention and timely treatment of eye diseases are very important.

If you ignore the symptoms of uveitis, vision deteriorates or blindness develops. Therefore, consult a doctor at the first signs of illness. Early treatment reduces the risk of complications and consequences. To ensure that your eyes no longer become inflamed, undergo a complete examination of your body. It will help identify hidden pathologies that may be the cause of the disease.

Alisa Nikitina

Source: https://ophtalmolog.ru/bolezni/uveit.html

Uveitis (inflammation of the choroid of the eye): causes, forms, signs, treatment

Illarionov Andrey Alekseevich, therapist, bacteriologist

Uveitis (incorrectly uevitis) is an inflammatory pathology of various parts of the uveal tract (choroid of the eye), manifested by pain in the eyes, hypersensitivity to light, blurred vision, chronic lacrimation. The term "uvea" translated from ancient Greek means "grape". The choroid has a complex structure and is located between the sclera and the retina, resembling a bunch of grapes in appearance.

The structure of the uveal membrane has three sections: the iris, the ciliary body and the choroid, located under the retina and lining it outside.

The choroid performs a number of important functions in the human body:

• Regulates the flow of solar radiation, thereby protecting the eyes from excess light;
• structure of the choroid of the eye
  Delivers nutrients to the cells of the retina;
• Removes decay products from the eyeball area;
• Participates in eye accommodation;
• Produces intraocular fluid;
• Optimizes the level of intraocular pressure;
• Performs a thermoregulatory function.

The most basic and vital function of the uveal membrane for the body is to supply the eyes with blood. The anterior and posterior short and long ciliary arteries provide blood flow to various structures of the visual analyzer. All three parts of the eye are supplied with blood from different sources and are affected separately.

The parts of the choroid are also innervated differently. The branching of the vascular network of the eye and slow blood flow are factors that contribute to the retention of microbes and the development of pathology. These anatomical and physiological features influence the occurrence of uveitis and ensure their high prevalence.

With dysfunction of the choroid, the functioning of the visual analyzer is disrupted. Inflammatory diseases of the uveal tract account for about 50% of all eye pathologies. Approximately 30% of uveitis lead to a sharp drop in visual acuity or its complete loss. Men suffer from uveitis more often than women.

variety of forms and manifestations of eye lesions

Main morphological forms of pathology:

1. Anterior uveitis is more common than others. They are represented by the following nosologies: iritis, cyclitis, iridocyclitis.
2. Posterior uveitis – choroiditis.
3. Median uveitis.
4. Peripheral uveitis.
5. Diffuse uveitis - damage to all parts of the uveal tract. The generalized form of the pathology is called iridocyclochoroiditis or panuveitis.

Treatment of uveitis is etiological, consisting of the use of local dosage forms in the form of eye ointments, drops, injections and systemic drug therapy. If patients with uveitis do not promptly consult an ophthalmologist and do not undergo adequate therapy, they develop severe complications: cataracts, secondary glaucoma, swelling and detachment of the retina, accretion of the lens to the pupil.

Uveitis is a disease, the outcome of which directly depends on the time of detection and consultation with a doctor. In order not to lead the pathology to loss of vision, treatment should be started as early as possible. If the redness of the eye does not go away for several days in a row, you should visit an ophthalmologist.

Etiology

The causes of uveitis are very diverse. Taking into account etiological factors, the following types of disease are distinguished:

• Infectious uveitis develops as a result of damage to the choroid of the eye by pathogenic microbes. It is divided in turn into bacterial, viral, parasitic, and fungal. Among the bacteria, the causative agents of uveitis are streptococci, staphylococci, toxoplasma, chlamydia, tubercle bacilli, Brucella, leptospira, treponema pallidum and some others. Viruses that cause inflammation of the uveal tract are cytomegalovirus, herpes virus, chickenpox virus, HIV, adenovirus and others. Infectious agents penetrate the vascular bed when there are foci of chronic infection in the body - caries, tonsillitis, sinusitis, as well as when the infectious process is generalized - sepsis, syphilis, tuberculosis.
• Non-infectious uveitis is a secondary pathology that develops against the background of systemic autoimmune diseases - rheumatism, spondyloarthritis, spondyloarthropathy, systemic lupus erythematosus, juvenile idiopathic arthritis, ulcerative colitis, ankylosing spondylitis, Crohn's disease, interstitial nephritis, polychondritis, glomerulonephritis and other collagenoses.
• Traumatic eye injury, burns and foreign bodies lead to the development of uveitis.
• Eye damage from chemicals.
• Idiopathic uveitis - with an unknown etiology.
• Genetically determined uveitis.
• Uveitis due to hay fever, food or drug allergies.
• Hormonal imbalance and metabolic disorders are factors contributing to the development of uveitis. In people suffering from diabetes mellitus and some other endocrinopathies, the disease is much more common. Menopausal women are also at risk of developing uveitis.
• Uveitis develops more often in people with a history of other eye diseases.

In children and the elderly, ocular uveitis is usually infectious in nature. In this case, the provoking factors are often allergies and psychological stress.

Foci of inflammation in the uveal membrane are cotton wool-like infiltrates with fuzzy contours of yellow, gray or red color. After treatment and the disappearance of signs of inflammation, the lesions disappear without a trace or a scar is formed, visible through the sclera and looking like a white area with clear contours and vessels along the periphery.

Symptoms

The severity and variety of clinical symptoms in uveitis are determined by the localization of the pathological focus, the general resistance of the body and the virulence of the microbe.

Anterior uveitis

anterior uveitis has the most noticeable manifestations

Anterior uveitis is a unilateral disease that begins acutely and is accompanied by a change in the color of the iris.

The main symptoms of the disease are: eye pain, photophobia, blurred vision, “fog” or “veil” before the eyes, hyperemia, excessive lacrimation, heaviness, pain and discomfort in the eyes, decreased sensitivity of the cornea. The pupil in this form of pathology is narrow, practically unresponsive to light and has an irregular shape.

Precipitates are formed on the cornea, which are an accumulation of lymphocytes, plasma cells, and pigments floating in the chamber moisture. The acute process lasts on average 1.5-2 months. In autumn and winter the disease often recurs.

Anterior rheumatoid serous uveitis has a chronic course and a mild clinical picture. The disease is rare and is manifested by the formation of corneal precipitates, posterior adhesions of the iris, destruction of the ciliary body, and clouding of the lens. Rheumatoid uveitis has a long course, is difficult to treat and is often complicated by the development of secondary ocular pathology.

Peripheral uveitis

With peripheral uveitis, both eyes are often affected symmetrically, “floaters” appear in front of the eyes, and visual acuity deteriorates.

This is the most diagnostically difficult form of pathology, since the focus of inflammation is located in an area that is difficult to study with standard ophthalmological methods.

In children and young people, peripheral uveitis is especially severe.

Posterior uveitis

Posterior uveitis has mild symptoms that appear late and do not worsen the general condition of patients. In this case, there is no pain or hyperemia, vision decreases gradually, and flickering dots appear before the eyes.

The disease begins unnoticed: patients experience flashes and flickering before their eyes, the shape of objects is distorted, and vision becomes blurred. They experience difficulty reading, twilight vision deteriorates, and color vision is impaired. Cells are found in the vitreous humor, and white and yellow deposits are found on the retina.

Posterior uveitis is complicated by macular ischemia, macular edema, retinal detachment, and retinal vasculitis.

The chronic course of any form of uveitis is characterized by the rare occurrence of mild symptoms. The patient's eyes become slightly red and floating spots appear before the eyes. In severe cases, complete blindness, glaucoma, cataracts, and inflammation of the eyeball membrane develop.

Iridocyclochoroiditis

Iridocyclochoroiditis is the most severe form of pathology, caused by inflammation of the entire vascular tract of the eye. The disease manifests itself with any combination of the symptoms described above. This is a rare and serious disease that is a consequence of hematogenous infection of the uveal tract, toxic damage or severe allergization of the body.

Diagnostics

Ophthalmologists diagnose and treat uveitis. They examine the eyes, check visual acuity, determine visual fields, and conduct tonometry.

The main diagnostic methods to detect uveitis in patients:

1. Biomicroscopy,
2. Gonioscopy,
3. Ophthalmoscopy,
4. Ultrasound of the eye,
5. Fluorescein angiography of the retina,
6. Ultrasonography,
7. Rheoophthalmography,
8. Electroretinography,
9. Anterior chamber paracentesis,
10. Vitreal and chorioretinal biopsy.

Treatment

Treatment of uveitis is complex, consisting of the use of systemic and local antimicrobial, vasodilating, immunostimulating, desensitizing drugs, enzymes, physiotherapeutic methods, hirudotherapy, and traditional medicine. Patients are usually prescribed drugs in the following dosage forms: eye drops, ointments, injections.

Traditional treatment

Treatment of uveitis is aimed at the rapid resorption of inflammatory infiltrates, especially in cases of indolent processes. If you miss the first symptoms of the disease, not only the color of the iris will change, its degeneration will develop, and everything will end in disintegration.

For drug treatment of anterior and posterior uveitis, the following is used:

• Broad-spectrum antibacterial agents from the group of macrolides, cephalosporins, fluoroquinolones. The drugs are administered subconjunctivally, intravenously, intramuscularly, intravitreally. The choice of drug depends on the type of pathogen. To do this, a microbiological examination of eye discharge is carried out for microflora and the sensitivity of the isolated microbe to antibiotics is determined.
• Viral uveitis is treated with antiviral drugs - Acyclovir, Zovirax in combination with Cycloferon, Viferon. They are prescribed for local use in the form of intravitreal injections, as well as for oral administration.
• Anti-inflammatory drugs from the group of NSAIDs, glucocorticoids, cytostatics. Patients are prescribed eye drops with prednisolone or dexamethasone, 2 drops into the affected eye every 4 hours - “Prenacid”, “Dexoftan”, “Dexapos”. Indomethacin, Ibuprofen, Movalis, Butadione are taken internally.
• Immunosuppressants are prescribed when anti-inflammatory therapy is ineffective. Drugs in this group inhibit immune reactions - Cyclosporine, Methotrexate.
• To prevent the formation of adhesions, eye drops “Tropicamide”, “Cyclopentolate”, “Irifrin”, “Atropine” are used. Mydriatics relieve spasm of the ciliary muscle.
• Fibrinolytic drugs have a resolving effect - “Lidaza”, “Gemaza”, “Wobenzym”.
• Antihistamines – “Clemastin”, “Claritin”, “Suprastin”.
• Vitamin therapy.

Surgical treatment of uveitis is indicated in severe cases or in the presence of complications. The adhesions between the iris and the lens are surgically cut, the vitreous body, glaucoma, cataracts, and eyeball are removed, and the retina is soldered with a laser. The outcomes of such operations are not always favorable. An exacerbation of the inflammatory process is possible.

Physiotherapy is carried out after acute inflammatory phenomena have subsided. The most effective physiotherapeutic methods: electrophoresis, phonophoresis, vacuum pulsed eye massage, infitatherapy, ultraviolet irradiation or laser blood irradiation, laser coagulation, phototherapy, cryotherapy.

ethnoscience

The most effective and popular methods of traditional medicine that can complement the main treatment (in consultation with the doctor!):

• Decoctions of medicinal herbs are used to wash the eyes.
• Aloe juice is diluted with cooled boiling water in a ratio of 1:10 and dropped into the eyes.
• Lotions made from crushed marshmallow root help speed up the treatment of uveitis.
• Treat your eyes daily with a freshly prepared pale pink solution of potassium permanganate. This is a good antiseptic used in various medical fields.

Prevention of uveitis consists of maintaining eye hygiene, preventing general hypothermia, injuries, overwork, treating allergies and various pathologies of the body. Any eye disease should begin to be treated as early as possible so as not to provoke the development of more serious processes.

Video: mini-lecture on uveitis

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Ocular uveitis (symptoms, diagnosis, treatment)

Content:

• What it is?
• Etiology
• Classification of the disease (types)
• Complications of uveitis
• Symptoms of uveitis of the eye
• Diagnosis of the disease
• The main methods of treating uveitis
• Treatment prognosis
• Video: mini-lecture on uveitis

Uveitis eyes

What it is?

Inflammatory processes localized on any part of the mucous membrane of the eyeball are collectively called “uveitis.”

The main causes of the disease lie in impaired blood supply to the uveal tract.

Most often, doctors, according to Obaglazar, have to deal with herpetic uveitis caused by bacteria or viruses, but the disease can also have a different nature. You will learn about this and more from this article.

Etiology

Etiology

Uveitis of the eye can be caused by the following reasons:

• Allergies;
• Infections;
• Systemic or syndromic disease;
• Trauma;
• Violation of metabolic processes;
• Hormonal imbalance.

Infectious uveitis of all varieties of this disease, as far as ObaGlaza knows from various sources, is much more common than others. The development of the inflammatory process in the area of ​​the choroid causes the appearance of a fungal, viral or bacterial infection in the uveal tract.

Bacteria and viruses can enter the uveal tract from other organs through the blood and lymphatic channels. Therefore, inflammation of the eye mucosa often develops due to caries, syphilis, tonsillitis, tuberculosis, sepsis or sinusitis.

Children and older people most often develop infectious inflammation. Treatment of children should be carried out without delay, because At this age, the risk of losing vision is too high.

Uveitis of a non-infectious nature manifests itself in the form of a secondary pathology, which is provoked by systemic and syndromic diseases.

Various injuries to the visual organ, foreign bodies, burns, or eye contact with chemicals can cause this disease. The disease can also occur due to a genetic predisposition to uveitis.

If the cause of the disease cannot be established, then such uveitis is of the idiopathic type.

Classification of the disease (types)

Uveil tract

Depending on the causes that provoked the disease, uveitis is divided into primary and secondary. Primary forms of pathology arise from diseases of various organs of the body, while secondary forms are caused by various eye diseases.

Based on the location of the source of inflammation, uveitis is classified into:

• Anterior uveitis . Inflammation is concentrated on the iris and ciliary body.
• Median (intermediate) uveitis. The inflammatory process occurs between the iris and the ciliary body, in the retina and optic nerve.
• Posterior uveitis . It affects the choroid, the area between the retina and the optic nerve.

Damage to the choroid of the entire visual organ is called panuveitis and is a generalized form of the disease.

According to the nature of the course, the inflammatory process is divided into:

• serous,
• purulent,
• mixed,
• hemorrhagic,
• fibrous-lamellar.

According to the clinical course, acute and chronic uveitis, as well as chronic recurrent uveitis, are distinguished.

According to morphological characteristics, uveitis can be focal, metastatic (granulomatous) or diffuse toxic-allergic, i.e. non-granulomatous.

Complications of uveitis

In the absence of proper treatment, ObaGlaza believes, inflammation of the choroid will progress. Having noticed the first symptoms, you need to contact an ophthalmologist, otherwise the following negative consequences are possible:

Symptoms of uveitis of the eye

Symptoms of uveitis

The symptoms of uveitis and the degree of their severity directly depend on where the inflammation is localized.

The most pronounced, according to ObaGlazaRu, external manifestations are in anterior uveitis. The inflammatory process affects only one eye and begins acutely. There is a change in the color of the iris.

The disease is accompanied by tearing and pain. The patient feels heaviness and blurred vision.

Photophobia, pain and discomfort in the visual organ occur, and the sensitivity of the cornea decreases.

With anterior uveitis, the pupil takes on an irregular shape, narrows and stops responding to light. This form of the disease is protracted and often recurs in the autumn-winter period.

If we talk about anterior rheumatoid serous uveitis, it can be noted that the clinical picture is blurred and the course of the disease is chronic. With this type of pathology, the ciliary body and lens of the eye are destroyed, but it is rare, according to both eyes Ru.

The difference between rheumatoid uveitis is the duration of the course and poor susceptibility to medications. Therefore, it often provokes secondary eye diseases.

Peripheral uveitis is characterized by damage to both eyes. In terms of diagnosis, this type of pathology is the most difficult.

Decreased vision and the appearance of midges before the eyes are accompanied by many eye diseases, and not everyone begins to sound the alarm when such symptoms are identified, while others may not exist.

Plus, standard ophthalmological methods do not allow us to see the source of inflammation in detail. Peripheral uveitis acquires its most severe form in patients of childhood and adolescence.

More noticeable signs of pathology that appear later:

The most severe form of uveitis, in which the entire uveal tract becomes inflamed, may be accompanied by symptoms similar to any other type of disease. This form of pathology is called iridocyclochoroiditis.

With uveitis associated with Vogt-Koyanagi-Harada syndrome, patients complain of headache, increased nervousness, and hearing loss. With sarcoidosis, the lymph nodes, lacrimal and salivary glands become enlarged. Shortness of breath and cough may occur.

Diagnosis of the disease

Diagnosis of the disease

Diagnosis of the disease is carried out during an ophthalmological examination, during which the doctor pays special attention to the condition of the skin of the eyelids and conjunctiva. Visometry and perimetry are performed, the reaction of the pupil is examined. Uveitis is often accompanied by changes in intraocular pressure, its increase or decrease. Therefore, the doctor must perform tonometry.

In addition to external inspection, specialists use modern equipment to carry out:

• Biomicroscopy , which allows you to identify the source of inflammation;
• Gonioscopy , with its help the doctor will detect fluid secreted by blood vessels due to inflammation and changes in the vascular structure of the iris;
• Ophthalmoscopy , which allows you to determine changes in the fundus, as well as to discern swelling or detachment of the retina;
• Ultrasound of the visual organs to determine the area of ​​retinal detachment;
• Fluorescein angiography of the retina , showing in detail the condition of the blood vessels of the eyes.

In addition to these diagnostic procedures, the ophthalmologist can refer you to:

• Ultrasonography;
• Rheoophthalmography;
• Electroretinography;
• Paracentesis of the anterior chamber;
• Vitreal and chorioretinal biopsy.

The ophthalmologist, also if necessary, prescribes additional consultations for the patient:

• A phthisiatrician performing x-rays of the lungs and the Mantoux test.
• A neurologist to examine the state of the brain using CT, MRI or lumbar puncture.
• A rheumatologist who will refer you for an x-ray of the spine and check the condition of the joint joints.
• An allergist for the purpose of conducting allergy tests and identifying allergens.

Laboratory tests for uveitis, according to ObaGlazaРу, are carried out if there are indications for this.

The main methods of treating uveitis

The treatment of ocular uveitis is mainly carried out by an ophthalmologist. If necessary, other specialists are involved in the process and complex therapy is carried out. It is important to diagnose the disease as early as possible and establish its etiology.

In the fight against uveitis, not only treatment of the disease plays an important role, but also preventing the development of complications and reducing the likelihood of encountering relapses, which are a real threat of complete loss of vision.

In parallel, treatment of the primary pathology that provokes the inflammatory processes of the choroid should be carried out.

For uveitis, the doctor prescribes several types of medications:

1. Medriatics , which relax the muscle tissue of the visual organs. This measure is aimed at preventing the fusion of the iris and lens of the eye or breaking existing fusions.
2. Steroids in the form of eye drops or ointments. Strong drugs are usually used. Steroids can be administered via suconjunctival, parabulbar, or intravitreal injection.
3. Immunosuppressive agents. They are included in the list of prescriptions provided that steroid treatment for ocular uveitis does not bring results.

To combat infectious uveitis, they resort to antiviral and antibacterial agents. In the presence of systemic diseases, obaglaza notes, non-steroidal anti-inflammatory drugs are used, and the allergic or toxic type is treated with antihistamines, like any allergy.

• There is also a folk treatment for ocular uveitis, but grandmother’s recipes should only be used after consulting an ophthalmologist and as a supplement to the main treatment, OglazaRu believes.
• Since uveitis is accompanied by changes in intraocular pressure, in addition to the main medications, suitable drops are selected to reduce IOP.
• When the patient is recovering, therapy can be supplemented with physiotherapy in the form of electro- or phonophoresis.

In severe cases of the disease, when drug treatment methods do not produce a positive effect, surgical intervention is required. Sometimes surgery is necessary to break up the adherence of the iris to the cornea or lens, to treat dystrophy and eye diseases and complications such as glaucoma and cataracts, retinal detachment and vitreous opacities.

Treatment of iridocyclochoroiditis often requires surgery to partially or completely remove the vitreous. In situations where it is impossible to save the affected visual organ, the patient is referred for evisceration of the eyeball.

Treatment prognosis

If uveitis is treated in a timely manner, in most cases this leads to complete recovery in 20-45 days.

Relapses occur due to exacerbations of primary diseases, so it is necessary to treat first of all the pathology, says ObaGlaza, which causes inflammation of the choroid.

Prevention of uveitis is based on timely treatment of eye diseases, regular visits to the ophthalmologist for examinations and the exclusion of traumatic external factors.

Video: mini-lecture on uveitis

Video on the topic of this eye disease:

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Source: https://obaglaza.ru/bolezni/242-uveit-glaza.html

Uveitis of the eye: causes, symptoms, diagnosis and treatment

Any disruption of the normal functioning of the eye membranes will lead to serious changes for the entire organ of vision. That is why eye uveitis, like any other ophthalmological pathology, must be treated quickly. What types of this disease there are, what caused its development and how it should be treated will be described in detail in this article. Uveitis is the medical term for an inflammatory process that can occur in different parts of the uvea of ​​the eye. This is a fairly rare disease and in 25% of cases it leads to vision impairment and sometimes even blindness.

In men, the pathology develops somewhat more often. This can be explained from an anatomical point of view. The uveal (vascular) tracts look like a branched vascular network with slow blood flow.

This becomes the main reason why infectious agents linger here.

With normal immunity, they do not affect human health in any way, but as a result of exposure to negative factors they begin to activate and cause an inflammatory process.

Important: you need to contact an ophthalmologist when the very first signs of eye pathology appear. This will allow you to stop the development of the disease in time and cure it.

Choroid: structure and its functions

The uveal membrane has a rather complex structure. It occupies the space between the retina and the sclera and looks like grapes. This is where its name comes from - “uvea”, which in Russian means “grape”. It has 3 main sections:

•          iris;
•          ciliary body;
•          choroid - the choroid itself (located directly under the retina, lining it on the outside).

The important functions assigned to the choroid include:

1.        Regulating the flow of sunlight. This protects the eyeball from excess light.
2.        Transport of nutrients throughout the retina.
3.        Removing decay products from the eye.
4.        Participation in the adaptation of the eyeball, i.e. changing the refractive power of the optical system of the eye for a clearer and clearer perception of different objects that are distant from it at different distances.
5.        Production of intraocular fluid.
6.        Normalization of pressure inside the eye.
7.        Thermoregulation.

The most important function of this membrane is to supply the organs of vision with blood. Thanks to the anterior, posterior short, and long ciliary arteries, blood is transported to all areas of the eye. However, due to the fact that each part of the eyeball is supplied with blood from its own source, infection also occurs separately.

Etiology

Uveitis of the eye can occur due to infection, the onset of allergies, poor metabolism, injury, severe hypothermia, or against the background of any general disease. The most common are considered to be infectious uveitis, leading to the development of inflammation.

The infection is caused by fungi, streptococci, mycobacterium tuberculosis, treponema, toxoplasma, herpes virus, etc. Acute allergic uveitis can begin as a result of consuming any foods or medications. Background diseases are rheumatism, rheumatoid arthritis, glomerulonephritis, ulcerative colitis, psoriasis or multiple sclerosis.

Injuries include eye burns of varying severity, foreign bodies and other penetrating injuries to the eyeball.

Hormonal dysfunction can also cause uveitis, the reasons for this are menopause, menstrual irregularities, etc.

Classification of the disease and its symptoms

The main morphological forms of pathology: anterior uveitis, median, posterior, peripheral and diffuse. The anterior one, in turn, is divided into iritis, cyclitis and iridocyclitis. The posterior one is called choroiditis, and the diffuse one is called panuveitis or iridocyclochoroiditis. Depending on the nature of the course, acute, chronic and recurrent uveitis are distinguished.

Each form of uveitis has a number of its own characteristics. The following symptoms are characteristic of anterior uveitis:

•          redness of the pupils;
•          fear of light;
•          chronic lacrimation;
•          constriction of the pupils;
•          Pain in the eyes;
•          increased intraocular pressure.

Peripheral uveitis of the eye, symptoms:

•          eye damage that is symmetrical in nature;
•          the appearance of “floaters” before the eyes;
•          noticeable deterioration in visual acuity and quality.

With posterior uveitis, symptoms appear later. A person will have the following symptoms:

•          vision becomes very blurred;
•          everything visible around is distorted;
•          impaired color perception;
•          the patient constantly sees “spots” floating in front of his eyes, and there may often be peculiar flashes;
•          visual acuity sharply decreases.

The severity of the inflammatory process also differs in different forms of the disease. It is most intense with anterior uveitis. The iris of the eye becomes greenish or rusty-brown, the pupil narrows greatly and almost does not react to light.

Tiny plaques appear on the cornea and move freely in the eye fluid. They arise as a result of the appearance of a large number of pigment proteins along with lymphocytes. The acute form lasts up to 1.5-2 months.

If left untreated, it goes into a chronic stage, which begins to recur with the onset of cold weather.

Peripheral uveitis is sluggish and has the most vague symptoms, so it is difficult to diagnose. It affects structures of the eye that are very difficult to examine. But if the necessary measures are not taken, serious complications and the development of secondary eye diseases may occur.

Diagnosis of the disease

To make an accurate diagnosis, it is necessary to conduct a complete analysis of the visual organs. Diagnostic tools include:

•          examination by an ophthalmologist;
•          determining how sharp the patient’s vision is;
•          microscopic examination of the retina;
•          ultrasound diagnostics;
•          angiography - examination of blood vessels and identification of the cause of blood flow;
•          biopsy followed by examination of the sample taken.

Treatment options for uveitis

If the course of the disease has been advanced, then treatment should have an integrated approach. Drug therapy involves the use of external agents and decoctions.

Traditional medicine

Experts include such drugs as:

•          mydriatics - cyclopentol, atropine and others. These medications eliminate muscle spasms and eliminate the consequences of adhesions;
•          steroids – prednisolone, dexamethasone and others. If there is no benefit from them, the doctor may prescribe immunosuppressive drugs;
•          eye drops;
•          antihistamines if an allergic reaction occurs;
•          in the presence of infections, antimicrobial and antiviral drugs.

Traditional medicine

Various herbs help in the fight against uveitis; treatment is carried out using these recipes:

•          a decoction of calendula, chamomile, birch buds and sage. To prepare it you need to mix 1 tsp. crushed plants, brew in 100 ml of boiling water and rinse with a warm solution 2-3 times a day;
•          aloe drops. They need to be diluted in warm water in a ratio of 1:10, and then instilled into each eye 3 times a day, 2-3 drops;
•          Grind fresh marshmallow root to a pulp, wrap in clean gauze and apply to the eyes for half an hour. After the procedure, they need to be washed with herbal decoction.

Prevention of uveitis

Complete relief from uveitis will occur in a few weeks if treatment is started on time. If the course of the disease is started or the patient has not completely completed the course of treatment, then there is a high probability of uveitis becoming chronic.

To cure it, you will need long-term and severe therapy, so it is better to avoid the onset of the disease. To do this, you need to maintain simple visual hygiene, avoid injury and the penetration of bacteria.

It is very important to immediately begin treatment for allergic diseases, since some of them can trigger the development of uveitis.

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