home Drugs Uveitis (inflammation of the eye). Uveitis - what is it, how to treat acute eye disease, causes Sluggish uveitis of the eye can be cured and

Uveitis (inflammation of the eye). Uveitis - what is it, how to treat acute eye disease, causes Sluggish uveitis of the eye can be cured and

The most common cause of uveitis is infection. Inflammation develops due to the penetration of streptococci, toxoplasma, mycobacterium tuberculosis, treponema pallidum, herpes viruses, cytomegalovirus, and fungi into the choroid. Pathogenic microbes get there from foci of chronic infection in the body.

Other causes of uveitis:

reaction to taking certain medications;
administration of vaccines or serums;
allergic reaction to external irritants;
hormonal disorders (diabetes mellitus, menopause);
eye diseases (keratitis, blepharitis, corneal ulcer);
systemic autoimmune diseases (rheumatoid arthritis, sarcoidosis, glomerulonephritis, rheumatism, colitis, autoimmune thyroiditis, Crohn's disease, etc.).

Uveitis can occur after injuries, contusions, chemical or thermal burns, or foreign bodies entering the eye. In this case, the cause of the development of the inflammatory process is the introduction of infection from the external environment.

Classification

Uveitis can be acute, chronic and chronic recurrent. The first develops very quickly, over several days or even hours. Usually it causes a lot of suffering to the patient. Fortunately, acute uveitis is easy to diagnose and responds well to treatment. With adequate and timely treatment, the disease goes away without any consequences.

Chronic uveitis has a sluggish course with scant symptoms. A person may suffer from the disease for many years. Such uveitis often recurs, that is, it worsens. During a relapse, the patient develops severe symptoms of the disease.

Depending on the location, there are:

Anterior uveitis (iridocyclitis). Affects the iris and ciliary body of the eye. Iridocyclitis is characterized by pathological immobility of the pupil, changes in the color of the iris, and the appearance of precipitates on the inner surface of the cornea. All these signs can be identified by an ophthalmologist during an examination of the patient.
Posterior uveitis (choroiditis). Characterized by inflammation of the posterior portion of the choroid. The pathological process involves the choroid, which lines the cavity of the eyeball from the inside. In this case, signs of inflammation can only be seen by ophthalmoscopy.
Peripheral uveitis. It affects the flat part of the ciliary body and the peripheral part of the choroid along with the adjacent retina. Pathology is rare, only in 8-10%. The inflammatory process usually affects both eyes. The difficulty in diagnosing the disease lies in the fact that it is very difficult for a doctor to identify pathological foci. He cannot see them during biomicroscopy and ophthalmoscopy.

Depending on the cause and mechanism of development of uveitis, they are divided into exogenous and endogenous. The former occur under the influence of environmental factors (trauma, infections, burns). The latter are the result of chronic diseases (tuberculosis, syphilis, rheumatoid arthritis, etc.).

Symptoms

The severity of uveitis symptoms directly depends on the activity of inflammatory processes. The acute form of the disease has a clear clinical picture, which allows it to be quickly diagnosed. But chronic, indolent uveitis can be practically asymptomatic for a long time.

Signs of anterior uveitis:

severe pain and cutting;
feeling of a foreign body in the eye;
intolerance to bright light;
lacrimation;
redness of the eye;
decreased visual acuity;
the appearance of a veil before the eyes;
lack of pupil reaction to light.

Posterior uveitis, unlike anterior uveitis, does not cause pain. This is explained by the fact that the choroid is completely devoid of sensory nerve endings. Due to the lack of painful sensations, a person may not go to the hospital for a long time.

Symptoms of posterior uveitis:

flickering flies in the field of view;
light flashes before the eyes;
color vision disturbance;
distortion and decreased visual acuity.

It should be noted that chorioretinitis is rarely isolated. Usually, not only the vascular, but also the retina of the eye is involved in the inflammatory process. Consequently, the patient also develops symptoms indicating retinitis.

Which doctor treats uveitis?

An ophthalmologist is involved in the diagnosis and treatment of uveitis. If necessary, an immunologist, dermatovenerologist, phthisiatrician, allergist, infectious disease specialist or other specialist is involved in the treatment process.

Diagnostics

Pathology can be suspected by the presence of characteristic symptoms in a person. However, to confirm the diagnosis, a thorough examination by a doctor and a full examination are required. The patient may be tested not only in the ophthalmology clinic, but also referred for consultations to other specialists.

Methods for diagnosing uveitis

Method	Description	results
Visiometry	The doctor sits the patient at a distance of 5 meters from Sivtsev’s table and asks him to read its different rows in turn. Thus, it determines the visual acuity of both eyes	With uveitis, patients often experience visual impairment that cannot be corrected with plus and minus lenses
Perimetry	An ophthalmologist determines visual fields manually or using a special device	Allows you to identify defects in the visual field, indicating the presence of inflammatory foci in the fundus
Biomicroscopy	Involves examining the external structures of the eye using a slit lamp.	During the examination, a specialist can identify characteristic signs of inflammation of the iris and ciliary body
Ophthalmoscopy	A method used to examine the fundus of the eye. During the examination, the ophthalmologist uses a direct or indirect ophthalmoscope	Ophthalmoscopy is indispensable in the diagnosis of posterior uveitis. With its help, the doctor can see inflammatory foci in the fundus

If necessary, the patient undergoes optical coherence tomography, angiography, electroretinography and rheoophthalmography. To clarify the cause of uveitis, you may need an x-ray of the lungs, a Mantoux test, allergy tests, CT or MRI of the brain, tests, etc.

Treatment

Treatment of ocular uveitis is carried out in an ophthalmological hospital, where the patient is required to be hospitalized. The treatment regimen is selected individually, taking into account the cause of inflammation.

The following drugs are used to treat uveitis:

Corticosteroids (Dexamethasone, Betamethasone, Prednisolone). Steroid hormones are used topically. They are prescribed in the form of drops, subconjunctival, parabulbar and even intravitreal injections. Medicines have a powerful anti-inflammatory effect, thereby accelerating recovery.
Midriatics (Atropine, Tropicamide, Cyclomed). The drugs in this group have the ability to dilate the pupil. They are prescribed to prevent the formation of posterior synechiae - adhesions between the iris and the anterior lens capsule. If the pupil has already become infected, mydriatics can help you cope with the problem.
Broad-spectrum antibiotics (fluoroquinolones, cephalosporins, macrolides). Used for uveitis caused by bacterial infection. Antibacterial agents can be administered locally (injections) or systemically, in the form of tablets or intramuscular injections.
Immunosuppressants (Methotrexate, Cyclosporine). They are used to treat autoimmune uveitis.
Antiviral agents (Ophthalmoferon, Zovirax, Acyclovir). Used to combat uveitis of viral etiology. Kill the infection that caused the development of inflammation.
Antihistamines (Suprastin, Claritin, Allergodil). Needed for uveitis of an allergic nature. Medicines inhibit the release of allergy mediators, thereby helping to get rid of inflammation and unpleasant symptoms.

The patient may also be prescribed vitamins, electro- or phonophoresis with proteolytic enzymes. In severe cases of the disease and the development of complications, the patient may need surgery (removal of adhesions, vitrectomy). Fortunately, the need for surgery is extremely rare.

Prevention

There is no specific prevention of uveitis. However, the development of the disease can be avoided through timely treatment of tuberculosis, syphilis, toxoplasmosis, rheumatoid arthritis and other systemic diseases.

If signs of acute uveitis appear, you should immediately consult a doctor. With adequate treatment, the disease will go away without any consequences within 3-6 weeks. If the necessary measures are not taken in time, the inflammatory process will become chronic. Naturally, dealing with chronic uveitis is much more difficult.

Uveitis is an inflammatory lesion of the choroid of the eye. The disease may be infectious, traumatic, allergic or autoimmune in nature. To treat uveitis, mydriatics, corticosteroids, antimicrobial and antiviral drugs are used. The treatment regimen is always selected on an individual basis.

Useful video about uveitis

The group of diseases of the organ of vision includes uveitis of the eye. With this pathology, the iris, ciliary body and choroid are affected. The human eye has a very complex structure. The apple is formed by 3 membranes: fibrous, choroid and retina. With uveitis, the vascular layer, which is rich in capillaries, becomes inflamed.

Uveitis is a collective term that refers to inflammation of the iris, ciliary body and choroid. This disease is very common among people under 40 years of age. Uveitis is often diagnosed in children and adolescents. A type of this disease is iridocyclitis. The following forms of uveitis are known:

front;
median;
rear;
generalized.

Iritis is an inflammation of the iris, and cyclitis is a lesion of the ciliary body. In the middle form of uveitis, the ciliary body, the choroid itself, the retina and the vitreous body are involved in the process. A feature of the posterior form of the disease is damage to the optic nerve. The greatest danger is panuveitis.

With it, all the membranes of the eye become inflamed. Depending on the nature of the exudate, serous, purulent, mixed and fibrinous-lamellar uveitis are distinguished. This pathology can be primary or secondary.

According to the nature of the course, uveitis is divided into acute, chronic and recurrent. There are also allergic, infectious, mixed, traumatic and systemic forms of the disease. Sometimes the cause of inflammation cannot be identified.

Etiological factors

With uveitis, the causes can be very different. The following etiological factors are of greatest importance:

Very often, uveitis develops against the background of influenza and ARVI. Possible causes include streptococcal diseases, gonorrhea, tuberculosis, malaria and chlamydia. Infectious anterior uveitis most often develops. Inflammation is caused by bacteria and viruses. Fungi are detected less frequently. Pathogens can enter the eye through the blood from chronic foci of infection.

Peripheral uveitis may be a manifestation of an allergic reaction. This is possible in response to the administration of immunological drugs (serums), consumption of certain foods and medications. Sluggish uveitis occurs with systemic diseases. The traumatic form most often develops from burns and penetration of foreign bodies.

Predisposing factors are the following:

The risk of developing this pathology increases with stress, intense physical work and an improperly organized daily routine.

General clinical manifestations

With uveitis, the symptoms are numerous. The clinical picture is determined by the underlying cause and location of the lesion. The most commonly observed manifestations are:

pain in the eyes on one or both sides;
lacrimation;
redness;
fear of bright light;
presence of floating spots before the eyes.

Acute purulent uveitis is the most severe. It causes severe pain. Maybe . Often these people have increased intraocular pressure. Glaucoma may develop. Chronic uveitis occurs with scant symptoms. The peripheral form of the disease is characterized by damage to both eyes.

The following symptoms are possible:

blurred vision;
decreased central vision;
hyperemia.

With posterior uveitis, visible objects are often distorted. The clinical picture largely depends on the underlying disease. In Vogt-Koyanagi-Harada syndrome, in addition to visual disturbances, hair loss, hearing loss, headache and psychosis are observed.

If the cause of uveitis is sarcoidosis, then the lymph nodes become enlarged and shortness of breath with cough appears.

Development of iridocyclitis in humans

The most commonly diagnosed pathology is iridocyclitis. This is anterior uveitis. Initially, only the iris or ciliary body becomes inflamed. Then the pathological process spreads to neighboring structures. The development of this pathology is based on the following disorders:

immune cytolysis;
production of inflammatory mediators;
vascular damage;
microcirculation disturbance.

The following symptoms are observed with iridocyclitis:

change in iris color to green or rusty red;
pain;
redness;
pain on palpation;
moderate vision impairment;
Availability .

A mild corneal syndrome is determined. It includes lacrimation, photophobia and blepharospasm. There may be accumulation of pus at the bottom of the anterior chamber. This condition is called hypopyon. A yellow-green stripe is visually identified. In severe cases, pupil deformation develops. It may narrow.

If uveitis is not treated, blindness is possible. The reason is pupil overgrowth. Intraocular pressure is increased or decreased. If the cause is tuberculosis, then yellowish tubercles are detected in the area of the iris. Posterior synechiae (fusions) are formed. Autoimmune uveitis is distinguished by the fact that it often recurs and is severe.

If the cause is injury, then after one eye the second is affected. This state is called. If iridocyclitis is caused by Reiter's syndrome due to chlamydia, then there are signs of damage to the conjunctiva, joints and urethra.

How does chorioretinitis occur?

Posterior uveitis can occur as chorioretinitis. With it, the choroid becomes inflamed along with the retina. The following forms of this disease are known:

peripapillary;
central;
equatorial;
peripheral.

If symptoms persist for less than 3 months, we are talking about. The peripheral form of the disease often occurs hidden. If an exacerbation occurs, the following symptoms are possible:

blurred vision;
dark spots;
distortion of objects;
violation .

Chorioretinitis develops against the background of infection, radiation, allergic reactions and autoimmune disorders. The risk group includes people with immunodeficiency.

How dangerous is uveitis for humans?

With peripheral and central uveitis, dangerous complications can develop. The following consequences of this disease are possible:

The autoimmune form of anterior uveitis causes cataracts, scleritis, etc. Glaucoma is a common complication. It is manifested by pain in the area of the superciliary arches, decreased visual acuity of objects, blurred vision, the appearance of rainbow circles before the eyes and loss of visual fields.

Recurrent uveitis of infectious etiology can cause the spread of microbes. This leads to endophthalmitis and.

Patient examination plan

With iridocyclochoroiditis, the symptoms are similar to other eye diseases. If uveitis is suspected, the following studies are performed:

external inspection;
assessment of visual acuity using special tables;
perimetry;
biomicroscopy;
gonioscopy;
ophthalmoscopy;
tonometry;
angiography;
coherence optical tomography;
rheoophthalmography;
electroretinography.

Gonioscopy is very informative. During it, the anterior chamber of the eye is examined. The condition of the iris root, ciliary body, Schwalbe ring, Schlemm's canal and trabecula is assessed. Using gonioscopy, you can identify the presence of synechiae and exudate, as well as determine the condition of the blood vessels. Biomicroscopy is required.

A slit lamp will be needed. It allows you to examine all the structures of the eye at high magnification. The fundus, retina, and optic nerve can be visualized during ophthalmoscopy. In the infectious form of the disease, it is necessary to identify the pathogen. A bacteriological or virological study is carried out.

If necessary, consultation with a phthisiatrician, rheumatologist, infectious disease specialist and other specialists is required. A blood test is performed for sugar and rheumatoid factor. Specific antibodies are detected. Differential diagnosis is carried out with primary glaucoma, keratitis and acute conjunctivitis.

Treatment methods for uveitis

The symptoms and treatment of this pathology are not known to everyone. For this pathology, drug therapy is carried out. The following groups of drugs may be prescribed:

To eliminate spasm of the ciliary muscle, drops are prescribed that dilate the pupil. These include Atropine. The basis of therapy for patients with uveitis is the use of corticosteroids. They are prescribed in the form of tablets, drops and ointments for the eyes.

Instillations are most often performed. Prednisolone Nycomed is used. If glaucoma develops, medications are used that reduce the accumulation of fluid in the eye. These can be adrenergic blockers and sympathomimetics.

In severe cases of infectious uveitis of the eye, treatment requires detoxification therapy. Enzymes are often prescribed to resolve exudate. After eliminating the pain syndrome, physical therapy (magnetic therapy, electrophoresis, laser correction) is carried out in the remission phase. If complications develop, surgical intervention is required. The resulting synechiae are dissected.

Radical treatment is also required in case of lens clouding, glaucoma and retinal detachment. Sometimes it is necessary to remove the vitreous. The indication is iridocyclochoroiditis. In more severe cases, evisceration is organized. It removes the internal structures of the apple.

The prognosis for uncomplicated uveitis is favorable. The duration of the disease is 3-6 weeks. Relapses are possible. When the retina is involved in the process, vision often decreases.

Prevention measures

This disease can be prevented. To do this, you must follow the following recommendations:

promptly treat infectious diseases;
Wear safety glasses when performing work that is hazardous to the eyes;
exclude injuries;
prevent eye burns;
visit an ophthalmologist periodically;
monitor hormonal levels;
do not contact with allergens;
lead a healthy lifestyle.

The most common causes of uveitis are infection, trauma, and systemic disease. They need to be prevented or treated in the early stages. Most often, uveitis is a complication of another pathology. Prevention should be carried out from a young age. To protect children from this pathology, it is necessary to prevent bacterial and viral infections.

If uveitis does develop, the goal is to prevent complications. To do this, you need to visit your doctor in a timely manner and follow all his prescriptions. Self-medication can lead to dangerous complications, including loss of an eye. Thus, uveitis is a very common ophthalmological pathology.

Video

3025 09/18/2019 5 min.

Eyes are an important component of the entire body. Sometimes, during diagnosis, the source of the problem is discovered in a completely different place than where it was previously looked for. The treatment of any health problem must be approached comprehensively. This is especially true for an eye disease such as uveitis. It is important to treat not only the symptoms, but to identify the cause of the disease.

What is uveitis?

Uveitis is a general concept that refers to inflammation of various parts of the choroid (iris, ciliary body, choroid). This disease is quite common and dangerous. Often (in 25% of cases) uveitis leads to and even blindness.

The appearance of this disease is facilitated by the high prevalence of the vascular network of the eye. In this case, blood flow in the uveal tract is slowed down, which can lead to retention of microorganisms in the choroid. Under certain conditions, these microorganisms are activated and lead to inflammation.

Watery eyes as one of the signs of uveitis

The development of inflammation is also influenced by other features of the choroid, including different blood supply and innervation of its different structures:

the anterior section (iris and ciliary body) is supplied with blood by the anterior ciliary and posterior long arteries, and is innervated by the ciliary fibers of the first branch of the trigeminal nerve;
the posterior section (choroid) is supplied with blood via the posterior short ciliary arteries and is characterized by the absence of sensory innervation.

These features determine the location of the lesion in the uveal tract. The anterior or posterior region may be affected.

Classification

The anatomy of the eye predisposes the disease to be localized in different locations of the uveal tract. Depending on this factor, there are:

Anterior uveitis: iritis, anterior cyclitis. Inflammation develops in the iris and. This variety is the most common.
Median (intermediate) uveitis: posterior cyclitis, pars planitis. The ciliary or vitreous body, retina, and choroid are affected.
Posterior uveitis: choroiditis, retinitis, neurouveitis. The choroid, retina, etc. are affected.
Generalized uveitis – panuveitis. This type of disease develops if all parts of the choroid are affected.

Forms

The nature of inflammation in uveitis can be different, and therefore the following forms of the disease are distinguished:

serous;
hemorrhagic;
fibrinous-plastic;
mixed.

Depending on the duration of inflammation, acute and chronic (more than 6 weeks) forms of uveitis are distinguished.

Causes of inflammation

Uveitis can develop due to a wide variety of reasons, the main ones being:

infections;
injuries;
systemic and syndromic diseases;
metabolic and hormonal regulation disorders.

Infectious uveitis is the most common: they occur in 43.5% of cases. Infectious agents in this case are mycobacterium tuberculosis, streptococci, toxoplasma, treponema pallidum, cytomegalovirus, herpesvirus, and fungi. As a rule, such uveitis is associated with infection entering the vascular bed from any source of infection and develops with sinusitis, tuberculosis, syphilis, viral diseases, tonsillitis, sepsis, dental caries, etc.

Increased specific sensitivity to environmental factors plays a role in the development of allergic uveitis - drug and food allergies, hay fever, etc. Serum uveitis often develops with the introduction of various serums and vaccines.

Uveitis can occur against the background of systemic and syndromic diseases, such as:

rheumatism;
rheumatoid arthritis;
psoriasis;
spondyloarthritis;
sarcoidosis;
glomerulonephritis;
autoimmune thyroiditis;
multiple sclerosis;
ulcerative colitis;
Reiter's, Vogt-Koyanagi-Harada syndromes, etc.

Post-traumatic uveitis occurs due to penetrating or contusive injuries to the eyeball, or foreign bodies entering the eyes.

The following diseases also contribute to the development of uveitis:

metabolic disorders and hormonal dysfunction (diabetes mellitus, menopause, etc.);
diseases of the circulatory system;
diseases of the visual organs (conjunctivitis, keratitis, blepharitis, scleritis, perforation of corneal ulcers).

And this is not the entire list of diseases as a result of which uveitis can arise and develop.

Symptoms and diagnosis

At the initial stage of the disease, the color of the iris changes and adhesions appear. The lens of the eye becomes cloudy. Further, uveitis can manifest itself in different ways, depending on the type and form of inflammation. Common symptoms are:

photophobia;
chronic lacrimation;
aching or sharp pain;
pain and discomfort;
deformation, ;
the appearance of a slight “fog” before the eyes;
deterioration of visual acuity, up to blindness;
unclear perception;
increased intraocular pressure (heaviness in the eye is felt);
transition of inflammation to the second eye.

Uveitis(wrong uevitis) - inflammatory pathology of various parts of the uveal tract (choroid), 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:

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:

Anterior uveitis is more common than others. They are represented by the following nosologies - iritis, cyclitis,.
Posterior uveitis – choroiditis.
Median uveitis.
Peripheral uveitis.
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:

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, and “floaters” before the eyes, 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 and hyperemia, vision decreases gradually, 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 perform tonometry.

The main diagnostic methods to detect uveitis in patients:

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:

Antibacterial agents broad spectrum of action 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 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 means “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!):

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

Uveitis is an inflammatory disease of the choroid of the eye. Its causes and manifestations are so diverse that even a hundred pages may not be enough to describe them; there are even ophthalmologists who specialize only in the diagnosis and treatment of this pathology.

The anterior and posterior parts of the choroid are supplied with blood from different sources, so isolated lesions of their structures most often occur. The innervation is also different (the iris and ciliary body are by the trigeminal nerve, and the choroid has no sensitive innervation at all), which causes a significant difference in symptoms.

The disease can affect patients regardless of gender and age and is one of the leading causes of blindness (about 10% of all cases) in the world. According to various sources, the incidence is 17-52 cases per 100 thousand people per year, and the prevalence is 115-204 per 100 thousand. The average age of patients is 40 years.

What it is?

Uveitis is a general term for an inflammatory disease of the choroid of the eyeball. Translated from Greek “uvea” means “grape”, since in appearance the choroid of the eye resembles a bunch of grapes.

Causes

In most cases, uveitis is provoked by such a cause - an infection that enters the eye through the bloodstream, transferred from another infected organ, or through eye injuries from the environment. There can be a variety of bacteria and viruses here. Basically, bacteria penetrate from the outside, and viruses and other microorganisms are carried through the bloodstream.

But let’s not rule out other causes of uveitis:

Hypothermia.
Low immunity.
Blood diseases.
Reiter's syndrome.
Allergic reaction to food or medicine.
Metabolic disorders or hormonal imbalances: diabetes, menopause.
Injuries to the eye when a foreign body, piercing objects or burns enter it.
Infectious or chronic diseases: psoriasis, rheumatism, etc.
Other eye diseases: scleritis, retinal detachment, etc.

Classification

In medicine, there is a certain classification of the disease. It all depends on its location:

Peripheral. With this disease, inflammation affects the ciliary body, choroid, vitreous body, and also the retina.
Front. A type of disease that is much more common than others. Accompanied by damage to the iris and ciliary body.
Rear. The optic nerve, choroid, and retina become inflamed.
When there is inflammation throughout the entire choroid of the eyeball, this type of disease is called “panuveitis.”

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.

Symptoms of uevit

Depending on where the inflammatory process develops, the symptoms of uveitis are determined (see photo). 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.

Peripheral uveitis occurs with the following symptoms:

often both eyes are affected symmetrically,
floaters before eyes,
deterioration of visual acuity.

Posterior uveitis is characterized by late onset of symptoms. They are characterized by:

blurred vision,
distortion of objects,
floating spots before the eyes,
decreased visual acuity.

Anterior uveitis is characterized by the following symptoms:

In the chronic course of anterior uveitis, symptoms occur rarely or are mild: only slight redness and floating spots before the eyes.

Diagnostics

The patient’s medical history and information about his immunological status play an important role in diagnosis. With the help of an ophthalmological examination, the localization of inflammation in the choroid of the eye is clarified.

The etiology of ocular uveitis is clarified by skin testing for bacterial allergens (streptococcus, staphylococcus or toxoplasmin). In the diagnosis of a disease of tuberculous etiology, the decisive symptom of uveitis is the combined damage to the conjunctiva of the eyes and the appearance of specific pimples on the patient’s skin - phlyctenas.

Systemic inflammatory processes in the body, as well as the presence of infections when diagnosing ocular uveitis, are confirmed by analyzing the patient’s blood serum.

What uveitis looks like: photo

The photo below shows how the disease manifests itself in adults.

Complications

Serious complications of uveitis include profound and irreversible loss of vision, especially if the uveitis was unrecognized or the wrong therapy was prescribed.

Also among the most common complications are retinal, optic disc or iris detachment and cystoid macular edema (the most common cause of vision impairment in patients).

Treatment of ocular uveitis

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.

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

Vitamin therapy.
Antihistamines - “Clemastin”, “Claritin”, “Suprastin”.
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.
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.
Immunosuppressants are prescribed when anti-inflammatory therapy is ineffective. Drugs in this group inhibit immune reactions - Cyclosporine, Methotrexate.
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.
Fibrinolytic drugs have a resolving effect - “Lidaza”, “Gemaza”, “Wobenzym”.
To prevent the formation of adhesions, eye drops “Tropicamide”, “Cyclopentolate”, “Irifrin”, “Atropine” are used. Mydriatics relieve spasm of the ciliary muscle.

Folk remedies

When treating uveitis, you can use some traditional medicine methods, after discussing the possibility of such treatment with your doctor:

You can use crushed marshmallow root. To do this, you need to pour 3-4 tablespoons of marshmallow root into a glass of water at room temperature. You need to infuse it for 8 hours and then use it for lotions.
A decoction of chamomile, rose hips, calendula or sage helps with uveitis. To prepare it, you need 3 tablespoons of herbs and a glass of boiling water. The mixture should infuse for about an hour. Then you should strain it and rinse your eyes with this decoction.
Aloe can also help. You can use aloe juice for eye drops, diluting it in cold boiling water in a ratio of 1 to 10. You can make an infusion from dry aloe leaves.

As a rule, folk remedies are additional treatment options that are used comprehensively. Only timely adequate therapy for an acute inflammatory process in the eyeball gives a good prognosis, that is, 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.

Surgery

Surgery is required if the disease occurs with serious complications. As a rule, the operation involves certain stages:

the surgeon cuts the adhesions that connect the membrane and the lens;
removes vitreous humor, glaucoma or cataracts;
removes the eyeball;
using laser equipment, attaches the retina.

Every patient should know that surgery does not always result in 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.