Uveitis – general concept, indicating inflammation various parts choroid eyes (iris, ciliary body, choroid). The main factor that contributes to the development of uveitis is a certain slowness of blood flow in the ocular uveal tract. We will look in more detail about what kind of eye disease this is, what symptoms are characteristic of it, as well as treatment methods in this article.
Uveitis is a group of diseases characterized by partial or complete inflammation of the uvea of the eye. In most cases, a person develops infectious inflammation caused by the proliferation of bacteria or viruses (herpetic uveitis). However, some patients develop allergic or toxic uveitis.
What is the choroid? This is the middle layer of the eye, penetrated by vessels that supply blood to the retina. The vessels are located in the choroid in a certain order. The largest vessels lie in the outer part, and on the inner border with the retina there is a capillary layer. The choroid of the eye performs certain functions, the most important of which is to provide necessary nutrition four layers of the retina located on the outside. These layers contain photocells important for vision - rods and cones.
Medical statistics are that in 25% clinical cases it is this disease that causes the decline visual function or even blindness. On average, uveitis is diagnosed in one person in 3,000 (12-month data).
According to the nature of the course, uveitis is divided into:
The causative and triggering factors of uveitis are infections, allergic reactions, systemic and syndromic diseases, injuries, metabolic disorders and hormonal regulation. The most common are infectious uveitis. This type of disease is caused by a bacterial or viral infectious agent.
Most often, uveitis develops due to penetration of the following infectious agents into the uveal tract:
In children and the elderly, ocular uveitis is usually infectious in nature. In this case, the provoking factors are often allergies and psychological stress.
Depending on these factors, the signs of the disease may worsen and have a certain sequence. The main symptoms of uveitis include:
Cardinal sign When the pathology appears, as a rule, there is a constriction of the pupil, a blurred pattern of the iris and a change in its color (the blue iris can become dirty green, and brown eyes take on a rusty hue).
| Symptoms | |
| Anterior uveitis | This form is diagnosed in patients more often than others (from 40 to 70% of cases). Manifests:
If you check a patient’s vision using plus or minus glasses, you will find that visual acuity does not improve. |
| Peripheral | This is the rarest form of this disease. In this case, inflammation affects the area located immediately behind ciliary body; |
| Rear | Posterior uveitis has mild symptoms that appear late and do not worsen general condition sick. In this case, there is no pain or hyperemia, vision decreases gradually, and flickering dots appear before the eyes. |
Depending on the nature of the inflammation, there are:
In uveitis associated with Vogt-Koyanagi-Harada syndrome, the following are observed:
In sarcoidosis, in addition to ocular manifestations, as a rule, the following is noted:
In children, uveitis often occurs only due to eye injuries. In second place it occurs due to allergic reaction, metabolic diseases or infectious spread. The symptoms here are the same as in adults.
The sooner the patient consults a doctor, the sooner the specialist will determine the causes of inflammatory process in the area of the choroid eyeball. If uveitis is not treated promptly, it can lead to unpleasant consequences:
As soon as the first signs of uveitis appear, you should immediately consult a doctor. To diagnose such a serious pathology accompanied by inflammation, specialists use modern equipment.
Basic diagnostic methods, allowing to identify uveitis in patients:
The main thing in the treatment of uveitis is to prevent the development of complications that threaten vision loss and treat the underlying disease. pathological changes(if possible).
To treat uveitis use:
Purpose medicines depends on the causative agent of uveitis:
To resolve the resulting infiltrates (areas in which blood and lymph have accumulated), the following are prescribed: pharmacological agents as "Lidaza" or "Gemaza". As for antihistamines, Suprastin or Claritin are usually prescribed.
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 dissected and removed vitreous, eyeball, the retina is soldered with a laser. Outcomes similar operations not always favorable. An exacerbation of the inflammatory process is possible.
Comprehensive and timely treatment Acute anterior uveitis usually leads to recovery in 3-6 weeks. Chronic uveitis is prone to relapse due to exacerbation of the leading disease.
To prevent uveitis, it is necessary to maintain eye hygiene, avoid infection, injury, and hypothermia. It is also important to treat promptly allergic diseases in order to prevent non-infectious uveitis. Chronic diseases also need to be identified and treated. infectious diseases, which can become a potential source of infection for the eyes.
Another important part of prevention is regular visit ophthalmologist. Children and adults should have their eyes examined at least once a year.
Uveitis – this is not just one disease, but a whole complex of them. This pathology means an inflamed uveal tract - the so-called choroid of the eyes.
What kind of disease is this?
Among eye lesions with an inflammatory course, uveitis is diagnosed in almost half of the cases.
Uveitis: photo
Anatomically, the uveal tract is considered the middle layer of the eye and is located under the sclera. Its structure is formed by the ciliary (ciliary) body and the choroid (choroid):
Uveal tract of the eye
ICD-10 code
International classification uveitis is classified as a disease of the eye and its adnexa(classes H00-H59), diseases of the sclera, cornea, iris of the ciliary body (classes H15-H22).
Uveitis belongs to the class H20.0, which stands for acute and subacute iridocyclitis. In addition to uveitis, this group includes cyclitis and iritis.
Causes
There are many possible factors for the development of uveitis:
Uveitis in children for the most part there are:
Video:
Classification
Uveitis is classified according to several criteria:
To distinguish uveitis by location, they are divided into anterior, median, posterior and generalized.
According to the nature of the inflammatory process, it may refer to serous, fibrinous-lamellar, purulent, hemorrhagic or mixed type.
There are causes of uveitis exogenous And endogenous character.
Due to the causes of uveitis, it can be primary or secondary. Primary inflammation occurs independently, and secondary inflammation occurs against the background of another ophthalmological disease (as a complication).
According to the time course, uveitis can be acute, chronic and recurrent.
The symptoms of uveitis depend on the characteristics of the disease.
For acute inflammation is typical following signs:
IN chronic During the course of the disease, sluggish uvitis of the eye is more often observed. Symptoms may not appear at all or may be mild (slight redness).
Front uveitis can result in certain complications:
At peripheral In uveitis, both eyes are affected, central vision decreases, and floaters appear before the eyes.
Rear uveitis may be accompanied by pathologies:
Only an ophthalmologist can determine ocular uveitis, recognize symptoms and prescribe treatment. There are several diagnostic methods in this case:
One of the main areas of treatment is topical steroid use.
It could be Prednisolone or . Steroids can be used as ointments or injections. If such therapy does not have an effect, then immunosuppressive drugs are prescribed.
If uveitis is a consequence of chlamydia, then treatment includes antihistamines, antibiotics, and fluoroquinolones.
When carrying out therapy, it is necessary to treat the root cause of the disease. When inflammation occurs against the background of an allergic reaction, it is prescribed antihistamines. For infections, antimicrobial and antiviral drugs are included.
When the severity of inflammation decreases, they resort to physiotherapy - phonophoresis(use enzymes) or electrophoresis.
If there are no complications, uveitis can be treated at home.
It is important to remember that for processing you need to use sterile materials, and for each eye separately. Apply traditional medicine should be included complex therapy. A consultation with an ophthalmologist is required first. Self-medication can also lead to negative consequences.
With timely and correct treatment of acute uveitis, in most cases the prognosis is favorable. At chronic course The disease often relapses.
As preventive measures it is necessary to promptly and competently treat any ophthalmic and general diseases, exclude acute manifestations allergies, avoid eye injury.
When the choroid of the organ of vision becomes inflamed, this indicates that uveitis of the eye is developing. A common disease that can only be diagnosed by a specialist. He will appoint effective treatment and will monitor the patient's condition.
The choroid performs numerous important functions. Due to the fact that it consists of vessels, blood enters the eyeball, and with it nutrients. It protects it from excess light and controls intraocular pressure. And this is an incomplete list of what the choroid is responsible for. Outwardly, it looks like a grape, which is what its definition means in translation from Greek.
To understand what it is - eye uveitis, you need to seek help from a qualified doctor.
Ophthalmological practice shows that this disease occurs quite often. The development of the inflammatory process can occur in any part of the human eyeball.
The pathology may be located in the anterior part of the choroid. This is anterior uveitis. In this case, the disorders affect the iris and ciliary body.
Posterior uveitis develops when the disease affects the corresponding part of the choroid. This is evidenced by pronounced symptoms, namely damage to the choroid, retina, and optic nerve.
The development of the disease is caused by numerous factors, including:
In addition, a disease in the area of the choroid, which is characterized by inflammation, may be a consequence of the fact that another pathology is already developing in the eye.
Infectious uveitis most often affects children or the elderly. The cause of the disease is usually an allergic reaction or a stressful situation.
Attention! Medicine cannot fully determine the cause of some types of uveitis, for example, idiopathic.
Depending on where the inflammatory process develops, the symptoms of uveitis are determined. In addition, it matters how much the human body can resist the pathogens of the disease and at what stage of development it is.
Depending on these factors, the signs of the disease may worsen and have a certain sequence. The main symptoms of uveitis include:
If the eyeball is inflamed at the back of the membrane, then sluggish uveitis is formed. Its symptoms appear much later and proceed without exacerbations.
For example, the patient is not bothered by pain and redness in the eyes. Signs of the disease appear slowly. But vision becomes blurry (everything is foggy), the outlines of objects are distorted, dots in front of the eyes float, and of course, visual acuity is significantly reduced.
The inflammatory process of a chronic nature is rarely accompanied by pronounced severe symptoms. Some patients notice slight redness of the eyeball, as well as small spots in front of the eyes.
When peripheral uveitis develops, both eyes are affected. Patients note that the disease is accompanied by a decrease in central vision, and “spots” appear before the eyes.
In medicine, there is a certain classification of the disease. It all depends on its location:
As for the duration of the process, an acute type of the disease is distinguished, when the symptoms intensify. Chronic uveitis is diagnosed if the pathology worries the patient for more than 6 weeks.
There are situations when the disease affects both eyes in turn. Characteristic symptoms Iridocyclitis and cataracts of complex (sequential) form are considered. In addition, ribbon-like changes are observed in the cornea area.
This type of uveitis is called “rheumatoid”. The symptoms are similar to those of arthritis, but with prolonged development the inflammatory process does not affect the joints.
There are enough varieties of uveitis; they differ not only in the course and duration of the disease. In medicine, there is a classification taking into account the nature of the inflammatory process in the eyeball area. For example, serous (exudative) uveitis, fibroplastic, purulent, and also hemorrhagic.
As soon as the first signs of uveitis appear, you should immediately consult a doctor. To diagnose such a serious pathology accompanied by inflammation, specialists use modern equipment.
To obtain accurate information, the doctor prescribes biomicroscopic examinations of the anterior segment. Fundus ophthalmoscopy is performed and ultrasound scanning all ocular structures.
It is not always possible to determine with a high degree of probability the true source of uveitis. Modern specialists conduct a thorough examination of the patient, prescribe studies and tests. But this approach does not allow obtaining the most accurate data..
Therefore, treatment involves general rules using local anti-inflammatory, antibacterial, vasodilating, immunostimulating therapy. In addition, the doctor prescribes physical therapy.
Treatments can be ointments or injections, but the most effective are drops that dilate the pupil. In this way, the formation of adhesions or fusion can be prevented. There are more serious situations where medications that are designed to reduce high pressure inside the eyeball. For example, drops or hirudotherapy.
Such actions help stop the inflammatory process in the eye, but do not guarantee that uveitis will not recur in an acute form. Therefore, during diagnosis, the doctor suggests conducting a more thorough examination of the entire body.
The main goal of therapy is to get rid of the form of the disease that caused the appearance of pathology with inflammation.
Important! Assign effective therapy Only a specialist can do this; you should not self-medicate. Otherwise, the situation may worsen.
Medicine provides several treatment options for uveitis:
The duration of the inflammatory process in the area of the choroid depends on which part was infected. For example, anterior uveitis can be treated in a few days to a couple of weeks. But provided that the disease was diagnosed by a qualified doctor and prescribed adequate treatment.
Posterior uveitis can last not just a couple of weeks, but several years. Thus, pathology is quite capable of entailing serious complications related to the patient's health.
In addition, you should not think that the disease can be defeated forever. Your doctor will help you avoid relapse if you visit him periodically.
In addition, treatment for uveitis is prescribed taking into account the source of the pathogen. For example, if it is tuberculous uveitis, doctors prescribe drugs such as isoniazid, as well as rifampicin. Herpetic uveitis is treated with acyclovir or valacyclovir, but strictly as prescribed by a doctor. Self-prescribing medications is not recommended.
Surgery is required if the disease occurs with serious complications. As a rule, the operation involves certain stages:
Every patient should know that surgery does not always end with a positive result. The specialist warns him about this. After surgery, there is a risk of exacerbation of the inflammatory process. Therefore, it is important to promptly identify the disease, diagnose it, and prescribe effective therapy.
There are “grandmother’s recipes” that can be used during the treatment of inflammation. But before using such methods, you need to consult a doctor.
Traditional medicine has numerous recipes that will help stop the inflammatory process:
Important! Any manipulations should be discussed with your doctor. Only a qualified doctor will tell you about the symptoms and treatment of uveitis. As soon as the first signs of the disease appear, you must immediately go to an appointment. Self-medication can lead to sad consequences or complications.
As a rule, folk remedies- These are additional treatment options that are used comprehensively. Only timely adequate therapy acute inflammatory process in the eyeball gives a good prognosis, i.e., it guarantees that the patient will recover. This will take a maximum of 6 weeks. But if this is a chronic form, then there is a risk of relapse, as well as exacerbation of uveitis as the underlying disease. Treatment in this case will be more difficult, and the prognosis will be worse.
It is important to identify any disease at the stage of its inception. This is one of the rules for a speedy recovery and safe treatment.
The sooner the patient consults a doctor, the sooner the specialist will determine the causes of the inflammatory process in the area of the choroid of the eyeball. If uveitis is not treated promptly, it can lead to unpleasant consequences:
The problem is that pathological complications can also affect the second eye. Therefore, only a qualified ophthalmologist should diagnose the disease and prescribe treatment.
It is important to remember that uveitis is a serious disorder in the choroid of the eye. This is an inflammatory process, as a result of which the patient may completely lose vision. Therefore, it is necessary to diagnose the pathology in time and begin timely treatment.
Quite common ophthalmological disease is uveitis of the eye, in which an inflammatory reaction appears in the choroid of the visual organ. The disease can manifest itself due to rheumatoid arthritis, mechanical damage to the eye structures, exposure to infection and the influence of other factors. If you have inflammation of the choroid, you should contact an ophthalmologist, who will determine the sources of the disease and select the optimal treatment.
Clinical signs of uveitis may differ in each patient, depending on the type pathological process. If there is a violation, damage to one visual organ or both may occur, as a result of which a bilateral disease is diagnosed. The table shows other types of disease, taking into account some parameters.
| Classification | View |
|---|---|
| Downstream | Spicy |
| Chronic | |
| Recurrent | |
| Due to the appearance | Exogenous |
| Endogenous | |
| Primary | |
| Secondary | |
| By the nature of inflammation | Serous-exudative |
| Fibrous-plastic | |
| Purulent | |
| Hemorrhagic | |
| Herpetic | |
| Mixed | |
| By localization | Posterior with inflammation of the optic nerve, choroid, retina |
| Anterior, associated with damage to the iris and ciliary body | |
| Peripheral, combining the 2 previous types | |
| Panuveitis, characterized by inflammation of all structures of the eyeball | |
| According to morphological characteristics | Granulomatous |
| Non-granulomatous |
Often the cause of such a disease in humans is a fungus.
Inflammatory disease eye disease is widespread and is diagnosed not only in adults, but also in children. Inflammation of the ocular structures is a consequence infectious focus in the body, as well as weakened protective function immune system. Sluggish uveitis is often observed, in which clinical signs not clearly expressed. There are the following reasons leading to the development of eye disease:
Posterior or anterior uveitis in the eye area can occur due to an allergic reaction associated with the ingestion of certain foods.
As the pathology progresses, a person’s pupils become constricted. Anterior and posterior uveitis in children and adults can for a long time remain unnoticed and proceed dimly pronounced signs. The weaker the patient protective functions immune system, the more pronounced the symptoms appear. Often, against the background of uveitis, a person suffers from the following clinical manifestations:
If rheumatoid uveitis is diagnosed, then clinical picture accompanied by pain and stiffness of the joints. As the disease progresses in pulmonary sarcoidosis, the patient is concerned about an increase in nearby lymph nodes. Uveitis also causes copious discharge tears and saliva. A person complains of constant shortness of breath and coughing attacks.
To identify causative factor A gonioscopic examination is performed. It is impossible to cure uveitis without identifying the source of its occurrence. For this purpose, they contact an ophthalmologist, who will help find out the causes of the deviation and tell you how to treat the disease. For staging accurate diagnosis The following diagnostic procedures are used:
Additionally, in case of ocular uveitis, consultation with an endocrinologist, rheumatologist, nephrologist, infectious disease specialist and other highly specialized specialists may be required.
Group Subgroup Means Medicines that eliminate the pathogen Syphilitic "Doxycycline" "Tetracycline" "Erythromycin" Tuberculous "Isoniazid" "Rifampicin" Brucellosis "Aminoglycozd" Tetracycline ointment Helminthic "Mebentazole" "Tiabendazole" Leptospiral "Amoxicillin" Sulfone Toxoplasma "Sulfadimezin" "Folic acid" Herpetic "Acyclovir" "Valacyclovir" Steroid drugs "Betamethasone" "Dexamethasone" "Prednisolone" Antihistamines "Okumetil" "Cromohexal" "Allergodil" Mydriatics, eliminating spasms of the eye muscle "Atropine"
The term “Uveitis” usually refers to a group of diseases associated with inflammation in the eyes (from the Greek uvea). At the same time, inflammation anterior section the eye represented by and is called iritis or.
Inflammation of the posterior region, localized between and, is called chorioretinitis. Both sections of the choroid make up the vascular (uveal) tract. In cases where inflammatory processes affect all departments, they speak of panuveitis.
Factors of inflammation of the choroid can be various reasons: infections, metabolic disorders, autoimmune processes, depressed immunity, etc. Sometimes uveitis is a secondary disease, and the main focus of inflammation is located far from the eyes, and the infection enters the eyeball through the bloodstream (with tonsillitis and sinusitis, septic endocarditis, meningitis) . It is not uncommon for uveitis to develop after a penetrating injury to the eye.
However, pathogens and viruses are the most common reason the appearance of uveitis. As a rule, inflammation is caused by chlamydia, herpes virus, Koch, toxoplasma, brucella and cytomegalovirus. Uveitis often occurs against the background systemic pathologies connective tissue (rheumatoid arthritis, SLE, rheumatism, Reiter's syndrome, etc.) or chronic internal diseases (for example, diabetes mellitus). Sometimes it is not possible to determine the cause of uveitis, despite a thorough, comprehensive examination.
Modern ophthalmology distinguishes acute and chronic forms of the disease. Acute uveitis becomes chronic when the inflammatory process develops over several months in the absence of treatment or inadequate therapy. Sometimes the process is not clinically expressed, then doctors use the term “sluggish uveitis.”
As a rule, the disease occurs for the first time. It is characterized by pronounced manifestations: decreased vision, pain in the eye, eyeball. Caused by infectious agents: bacteria, viruses, etc.
Chronic uveitis is more often autoimmune, or is the consequence of an untreated acute condition. The disease is characterized by alternating periods of exacerbations (for example, with decreased immunity) and periods of remission - when clinical manifestations are minimal or may be completely absent.
The term is used to describe the severity of the inflammatory process. More often applicable to acute condition, in which symptoms and manifestations are mild for 1-2 months. After this, we can talk about the transition of the process to a chronic form.
Absent in the choroid of the eye nerve endings, which makes it possible for uveitis to occur for a long time without obvious symptoms and pain. Actually, the manifestations of the disease depend on its cause, the extent of the lesion, the state of the immune system and the pathogenicity of the microorganisms themselves.
The initial stage of anterior uveitis can be manifested by a feeling of a slight "" or "veil" before the eyes, accompanied by heaviness in the eye and a slow decrease in visual acuity. If these manifestations are ignored by the patient, as the process progresses, severe vision loss appears, vision continues to fall, and heaviness and pain increase. In addition to these symptoms, intraocular pressure may increase. In severe cases of uveitis, the outcome of the disease can be blindness.
Posterior uveitis is characterized by late detection of symptoms, absence of pain and redness of the eye. There is a slowly progressive deterioration in visual acuity, with the appearance of a “fog” or “spot” in front of the affected eye. As the process of inflammation develops, blunt nerves may appear. mild pain c, which indicates involvement of the optic nerve in the process of inflammation.
Only an ophthalmologist can diagnose uveitis, and most importantly, determine the extent of the spread of the inflammatory process after a detailed examination. As a rule, confirmation of the diagnosis requires the following studies: the anterior part of the eye and the eyeball.
Lack of adequate treatment for uveitis can lead to complications:
Treatment of uveitis should only be carried out by a doctor to prevent severe complications (including loss of vision); self-medication is absolutely contraindicated. Treatment is prescribed after identifying the main cause that caused the appearance of uveitis.
If the disease is infectious, antibacterial and anti-inflammatory therapy is recommended locally (drops, ointments, parabulbar injections), systemically (tablets or injections). Be sure to prescribe medications that dilate the pupil, which are especially important for anterior uveitis in the first day of the disease. The use of vasodilators, immunostimulants, positive results also provides physiotherapeutic treatment. In cases where uveitis is accompanied by an increase in intraocular pressure, antiglaucomatous drugs (drops) are additionally prescribed.
When choosing a clinic for the treatment of uveitis, you need to pay close attention to the possibility of one or another medical institution provide you with complete timely diagnosis and modern effective methods therapy. It is the level of equipment of the clinic, as well as the qualifications of the personnel working in it, that will be the decisive factors. successful treatment and achieving the best results.
Treatment specialized ophthalmology clinics Moscow is a guarantee of diagnosing eye diseases at the best in the world medical equipment and consultations with highly qualified ophthalmologists with solid clinical experience.
