Iridocyclitis: description of the disease, causes, methods of treatment and diagnosis

Iridocyclitis or anterior uveitis is an acute or chronic inflammatory disease affecting the anterior parts of the eyeball. Due to anatomical features of the structure of the eye, the disease quickly spreads to many nearby departments, so in the affected area can be not only the ciliary body, but also the iris, eyelashes, in rare cases, eyelids. Such a pathology develops transiently and tends to relapse, therefore at the first signs of ailment it is necessary to apply to a specialist in time to avoid possible complications.

Description of the disease

From a medical point of view, iridocyclitis is a generalized disease for two forms of uveitis (inflammation of the choroid of the eye).It combines irit - an inflammatory process in the iris, as well as cyclite - inflammation of the ciliary body and, in fact, is a neglected form of any of the above ailments.

The mechanism of the formation of a similar pathology is explained by the close arrangement and dependence in the functioning of these two parts of the visual apparatus.In addition, both departments are connected by one nerve and common blood vessels.

If there is inflammation in the iris, it passes to the ciliary body for several days and vice versa.

Iridocyclitis can develop in a person of any age, but more often the disease affects people from 25 to 45 years. Children from 12 to 14 years of age can develop a toxic-allergic iridocyclitis, which is customarily allocated separately. Depending on the duration of the inflammation and the overall clinical picture, there are several classifications of the disease:

• By the nature of the inflammatory process:serous, exudative, metastatic, fibrous and hemorrhagic iridocyclitis;
• According to the peculiarities of the disease: granulomatous or sedimentary (there are specific deposits on the cornea of ​​the eye) and not granulomatous (there is no sediment, only purulent exudate);
• Depending on the etiology: infectious, allergic, post-traumatic, combined and iridocyclitis of unknown origin;
• By duration: acute (up to 3 months), chronic (the course of the disease is characterized by a change in remissions and relapses).

Exacerbation of the disease has a pronounced clinical picture - increased tearing, there is a strong redness and swelling in the eye, the pupil is distorted, the shade of the iris changes.

Causes

There are many endogenous and exogenous causes that trigger the onset of the disease.It is generally believed that iridocyclitis is an infectious disease, but its causative agent may be completely different. There are several triggers that trigger the onset of the disease:

• Presence of infections in the body. They can be bacterial (tuberculosis, staphylococcal or streptococcal infection) or viral (gonorrhea, measles, influenza, chlamydia).
• Systemic diseases of the body,especially affecting connective tissues (arthritis, sarcoidosis, rheumatoid conditions);
• Prolonged course of infectious diseases in the nasopharynx(tonsillitis, sinusitis or deep caries);
• Chronic eye diseases of an inflammatory or allergic nature;
• Injuries and wounds of conjunctiva, eyeball or eyelid skin.

In almost all cases, the onset of development of iridocyclitis is accompanied by hypothermia, weakened immunity of the body, stress, or severe overwork.

In 40% of cases, iridocyclitis occurs in patients with advanced rheumatic and infectious diseases.

Symptoms

Due to the infectious nature, in most cases, unilateral iridocyclitis is diagnosed, but with a severe course of the disease and non-observance of medical prescriptions, the ailment can amaze the second eye.The first and most common symptom of the disease is a pulling pain of varying intensity and a sudden decrease in visual acuity. In addition, there may be other symptoms of iridocyclitis:

• Photosensitivity and photophobia;
• Pain and discomfort in the eyeball;
• The appearance of fog or "black flies" before the eyes;
• Abundant tears;
• Severe pain during palpation of the eyeball;
• Changes in the shade and pattern of the iris of the eye, the appearance on it of characteristic yellow tubercles;
• Change in blood flow in the affected eye, which manifests itself in the form of numerous broken blood vessels;
• The contraction of cells of internal and external cells around the iris or lens(synechia), which leads to pupil deformation and loss of vision.

Severe pain is associated with abnormal narrowing of the pupils and changes in the functionality of the blood vessels in the mucous membrane of the eye during an acute form of the disease.

Possible complications

Even with timely competent treatment, there is a possibility of the transition of iridocyclitis into a chronic form with prolonged relapses, especially in winter and spring.Therefore, the main task in the period of therapy is to reduce the risk of possible complications. The prolonged course of the disease often leads to a deterioration in visual acuity, up to complete one-sided or two-sided blindness.In addition, other ophthalmological disorders may develop - glaucoma, retinal detachment, lens deformation or fusion of the pupil cells.In neglected forms, removal of the eye is required, because with the help of conservative therapy it is impossible not only to restore its functionality, but also to reduce the clinical manifestations of the disease.

According to statistics, in 50% of all clinical cases, iridocyclitis passes into a chronic form, especially if there are serious autoimmune diseases or tuberculosis.

Diagnostics

As a rule, the reference to the ophthalmologist begins with the detection of the characteristic signs of the disease - a change in the color of the iris and pain during palpation of the eyeball.That is why the primary diagnosis is often made already with a visual examination of the patient and complete collection of anamnesis. To exclude other possible diseases, additional methods are prescribed:

• Visual acuity check;
• Biomicroscopy of the eye;
• Instrumental ophthalmic methods- ophthalmoscopy, perimetry, tonometry and echometry;
• Ultrasound of the eyeball;
• Magnetic resonance or fluorescent angiography;

Auxiliary methods to determine the root cause - x-ray of the sinuses of the nose, clinical blood and urine tests, ultrasound of internal organs, tests for rheumatism and allergies.

Treatment

A favorable prognosis for a full recovery depends on the period of treatment to a specialist in case of suspected iridocyclitis.As a rule, only 15-20% of all patients recover completely from this disease. As with the treatment of uveitis, the use of traditional medicine is completely useless, in addition, it can strengthen the infection and lead to the development of complications. Traditional treatment consists of taking medications and surgical intervention if conservative therapy is ineffective.

Medication Methods

Conservative treatment with iridocyclitis is always complex. The choice of drugs, their dosage and form should be performed only by the doctor, depending on the age of the patient and the clinical manifestations of the disease. As a rule, three groups of medicines are prescribed:

• Means for dilating the pupil;
• Hormonal preparations in the form of drops or injections based on corticosteroids;
• Reception of antiviral agents and antibiotics of a wide spectrum.

Great value during the treatment is given to physiological procedures.The most effective of them - electrophoresis, as well as UHF procedures. Plus, they always prescribe vitamins and mineral supplements to strengthen the protective functions of immunity.

If you do not eliminate the primary disease that caused iridocyclitis, the therapy will be completely useless. Therefore, first of all, methods are selected for the treatment of the underlying cause.

Surgery

Operative methods are resorted only when iridocyclitis has led to ophthalmologic disorders in the form of glaucoma, cataracts, retinal detachment or the appearance of an adhesion process in the pupil. In most cases, the operation is a laser therapy, depending on the location of complications. In rare cases, a complete amputation of the eye is performed if it is impossible to at least partially restore its functionality.

Prevention

There are no preventive measures to prevent the occurrence of iridocyclitis.However, doctors recommend diagnosing and treating infectious diseases on time, regardless of their etiology.

The most topical issue is the prevention of the occurrence of iridocyclitis in functional autoimmune disease. To avoid the development of eye disorders, it is necessary to monitor the course of the underlying disease, not neglect immunotherapy, and at the first signs of pathologies of vision to turn to the doctor.

Early diagnosis of the disease significantly increases the risk of complete recovery.

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conclusions

Iridocyclitis is one of the most serious ophthalmic diseases, which often turns into a chronic form even with proper and timely treatment. Taking care of your health and regular medical examinations is the only way to detect the presence of pathology in time and take the necessary measures to eliminate it.

Also read about diseases such as pterygium eyes and uveitis.