The anterior section of the eyeball consists of three parts - the vascular membrane, the iris and the ciliary (ciliary) body. Their inflammation is called (in order) the posterior uveitis , irite and cyclite. The last two pathologies are extremely rare in isolation, due to the general blood supply they often occur simultaneously.
Iridocyclitis - what is this disease?
Another name for this process is anterior uveitis. Eye disease Iridocyclitis is a combination of inflammation of the iris and the ciliary body. Sometimes, first, only one part of the anterior part of the eyeball is affected, but because of the close anatomical connection, the second one is always involved. The disease is diagnosed at any age, mainly from 20 to 40 years.
Acute Iridocyclitis
This variant of the pathology pathway is accompanied by pronounced and specific symptoms. Even subacute iridocyclitis has characteristic features, making the disease easier to detect and diagnose in the early stages of progression. This form of the disease is characterized by such a clinical picture:
- severe pain in the eye and near the temple;
- constant lacrimation;
- photophobia ;
- redness of the protein;
- deterioration of visual acuity ;
- swelling of the iris;
- narrowing of the pupil;
- visible widening of blood vessels;
- change the pattern and color of the iris.
Chronic iridocyclitis
Often (about 70% of cases), the disease in question goes into a slow form. Chronic recurrent iridocyclitis is accompanied by mild symptomatology, because of what patients do not address the ophthalmologist in a timely manner. Against the background of the sluggish course of pathology and the lack of therapy, severe complications develop, for example, the fusion of several areas of the pupil (synechia) or its complete infection.
It is dangerous to ignore chronic iridocyclitis - treatment in the late stages of the disease does not always help. As a result, develops obscure amblyopia with deformity and pathological constriction or infection of the pupil. It sometimes leads to irreversible damage to the entire anterior section of the inflamed eye and an absolute loss of vision.
Iridocyclitis - causes
The external and internal factors can provoke the described disease. Often diagnosed traumatic iridocyclitis, which occurs due to mechanical damage to the eyeball. These include contusions, ophthalmic operations, injuries and similar effects. Other factors that cause iridocyclitis are non-mechanical causes:
- rheumatoid conditions;
- bacterial, viral and protozoal infections;
- fungal lesions;
- foci of chronic inflammation in the oral cavity and nasopharynx;
- disturbances in metabolic processes;
- endocrine diseases;
- systemic pathologies of unknown origin;
- keratitis ;
- autoimmune processes.
Iridocyclitis - symptoms
Expression and features of the clinical picture of inflammation depend on its cause, the state of local and general immunity. The signs of iridocyclitis correspond to the form of pathology. Classify the following types of illness:
- serous;
- fibrinous;
- purulent;
- viral.
Serous iridocyclitis
This type of pathology proceeds more easily than others, has the most favorable predictions. Illness of iridocyclitis of serous shape is characterized by accumulation in the anterior chamber of the eye of serum exudate (turbid liquid). This is accompanied by the following symptoms:
- blurred pupil;
- lacrimation ;
- fear of bright light;
- cutting pain in the eye;
- edema and redness of the iris;
- slight widening of blood vessels;
- fluctuations in intraocular pressure;
- deterioration of visual acuity ("veil");
- narrowing of the pupil.
If timely diagnosed serous iridocyclitis, treatment will be quick and simple. This type of disease responds well to therapy in the early stages and very rarely provokes complications. With the progression of pathology, fibrinous anterior uveitis is often associated. In such cases, the risk of damage to the retina and the development of secondary glaucoma is high.
Fibrinous iridocyclitis
This type of disease is also characterized by the accumulation of exudate in the anterior chamber of the eye, but instead of whey it contains the protein that forms when the blood coagulates. Fibrinous-plastic iridocyclitis always begins acutely and is accompanied by all the expressed symptoms. In addition, the following signs are noted:
- opacity of the vitreous humor;
- feeling of bursting in the eye;
- fusion of some areas of the pupil;
- change in the shape and shade of the iris;
- blepharospasm;
- decreased intraocular pressure .
This form of the disease sometimes provokes severe and irreversible consequences. Synechia can quickly cover the entire surface of the pupil, which will lead to its complete infection (occlusion). It is important not to allow such iridocyclitis - treatment of a complicated type of disease is difficult and often inefficient. It is almost impossible to restore vision after a pupil infection.
Purulent iridocyclitis
The described variant of anterior uveitis develops against the background of infection with a bacterial infection. That purulent iridocyclitis of the eye arises as a consequence of prolonged angina, pyorrhea, furunculosis and other microbial lesions. This form of pathology proceeds hard, progresses rapidly. Within a few hours, a large amount of purulent exudate accumulates in the anterior chamber of the eyeball, and specific symptoms of iridocyclitis appear:
- significant deterioration of visual acuity;
- swelling and redness of the conjunctiva;
- unbearable pain in the injured eye and head from the appropriate side;
- blurred pupil;
- change in the color of the iris to rusty or greenish (depends on eye color);
- hyperemia of proteins;
- the formation of synechia along the edge of the pupil;
- decreased intraocular pressure.
Viral iridocyclitis
The presented type of illness debuts violently, but is accompanied by less painful sensations than other forms of pathology. Almost 90% of cases develop herpetic iridocyclitis, it arises from the recurrence of a viral infection in nearby areas (on the face, nose, throat). Specific symptoms of this type of anterior uveitis:
- redness sclera;
- congestion of serous or fibrinous exudate in the anterior chamber of the eye;
- blurred vision;
- lacrimation;
- single fusion of the pupil edges with a capsule of the lens;
- increased intraocular pressure.
Iridocyclitis - Diagnosis
Confirm the alleged disease can only a qualified ophthalmologist after a comprehensive examination. It is necessary to find out in what form and why iridocyclitis has begun - the treatment should correspond to the type of anterior uveitis and its causative agent. First, the doctor conducts an external examination of the damaged eye, collects an anamnesis, performs the palpation of the apple. After that it is carried out:
- biomicroscopy;
- measurement of intraocular pressure with tonometry;
- visual acuity check;
- ultrasonography.
To determine the cause of chronic or acute iridocyclitis of the eye, the following is prescribed:
- coagulogram;
- general and biochemical analyzes of blood, urine;
- rheumatic tests;
- enzyme immunoassay (ELISA);
- polymer chain reaction (PCR diagnostics);
- allergic tests;
- a study of the level of serum immunoglobulins in the blood and tear fluid.
Sometimes it is additionally recommended to perform a radiography of the lungs, paranasal sinuses. To clarify the diagnosis, an ophthalmologist can refer to a narrowly specialized specialists:
- to the stomatologist;
- rheumatologist;
- otolaryngologist;
- phthisiatrician;
- dermatovenereologist;
- allergist.
Iridocyclitis - treatment at home
The therapy of the considered illness is carried out in a hospital. Only a qualified doctor can decide how to treat iridocyclitis, based on the results of instrumental and laboratory studies. Independent attempts to stop the inflammatory process can result in a pathological transition to a chronic form and severe complications that threaten not only the visual acuity, but also the existence of the eye:
- cataract;
- pupil occlusion;
- chorioretinitis;
- secondary glaucoma;
- deformation of the vitreous body;
- retinal disinsertion;
- abscess;
- endo- and panophthalmitis;
- atrophy of the eyeball;
- blindness.
Iridocyclitis - treatment, preparations
The approach to therapy of the disease includes emergency and planned interventions. First, drugs are used to stop the inflammatory process, remove the pain syndrome and prevent the formation of synechia. In the first day of treatment, eye drops are prescribed for iridocyclitis, dilating the pupil (mydriatica):
- Irifrin;
- Atropine;
- Midratsil;
- Adrenalin;
- Cyclomed and analogues.
To strengthen the effect of these drugs and to stop the pathological process, anti-inflammatory drops are additionally applied in iridocyclitis with analgesic properties:
- Diclof;
- Indomethacin;
- Naklof and others.
If the inflammation is very severe and is accompanied by intolerable pain, and treatment with previous means does not help, the following are performed:
- subconjunctival injections of steroids ( dexamethasone );
- injections of antibiotics with a wide spectrum of action (Ciprofloxacin);
- pyloric and orbital blockades (Novokain).
To alleviate the symptoms of pathology help:
- antihistamines (Suprastin, Claritin);
- drugs that reduce the permeability of capillaries (Dicycin, Etamsilate);
- pain medication (Ibuprofen, Ketanov).
After the emergency treatment of iridocyclitis, planned therapy is developed. It is aimed at eliminating the cause of development of pathology, restoration of the functions of the ciliary body and iris, normalization of vision and prevention of complications. The scheme is selected by the ophthalmologist individually and can include such preparations and procedures:
- antiviral;
- antibiotics;
- corticosteroids;
- immunomodulators;
- antifungal;
- local proteolytics;
- antiseptics;
- antiallergic;
- immunosuppressors;
- multivitamins;
- electrophoresis;
- magnetic treatment;
- laser therapy;
- plasmapheresis;
- hemosorption;
- surgical intervention.
Iridocyclitis - folk remedies, treatment
Ophthalmologists categorically prohibit any means of self-control with anterior uveitis. It is especially dangerous to engage in alternative therapy, if purulent or fibrinous acute iridocyclitis progresses - treatment with non-drug methods always leads to increased inflammation and serious complications. Often, "amateur" ends in the flow of the disease into a chronic recurrent form. It is important to immediately consult a doctor and timely diagnose iridocyclitis - home treatment only contributes to worsening of the condition.