Acute Iridocyclitis: Causes, Symptoms and Treatment

The human eye is a very thin and complex optical structure, and its functionality depends on the well-coordinated work of absolutely all constituent elements. However, those areas that are most at risk are those that depend not only on endogenous (internal) factors but, to a much greater extent, on environmental factors (exogenous). Among these eye structures are the iris and ciliary body, which are located side by side and therefore the inflammation of one of them necessarily spreads to the other.

Definition of disease

Iridocyclitis, or anterior uveitis, occurs in the inflammatory processes of various etiologies in the iris and ciliary body.

Everyone knows what an iris is, but few people realize how important the healthy state of this structure is in visual acuity.In addition to the pigment cells that give it color, the iris includes the circular muscles responsible for the narrowing of the pupil, and the radial ones that lead to its expansion.

In addition, the so-called trabecular network is located in the iris, which provides an outflow of intraocular fluid in addition to its main outlet through the iris-corneal angle.

The ciliary body is part of the middle shell of the eye, to which the lens is suspended on its peculiar fastenings. Providing the accommodation function, the ciliary body is the main lever for changing the curvature of the lens depending on the range of the subject under consideration. Another important function of the ciliary body is to participate in the production of watery moisture. Besides,Through the ciliary body, the iris is attached to the choroid.

Thus, the development of inflammation in any of the structures leads to a disruption of several important functions necessary for the normal operation of the eye.

Causes

The incidence of iridocyclitis does not exceed 5%, but the disease, moreover, in acute form, carries a considerable threat to the health of the eyes.All forms of the disease are dangerous, but the acute one is accompanied by the most pronounced symptoms.

Depending on the nature of the causative factors, the following types of iridocyclites are distinguished:

• Infectious:ODS, influenza, herpes, candidiasis, venereal diseases, tuberculosis, helminthic invasions;
• Allergic:pollinosis, all-the-year-round allergic reactions to foods, smells, dust, chemicals, medicines;
• With systemic diseases: gout, rheumatoid arthritis, rheumatism, sarcoidosis, etc. ;
• In the presence of chronic infections: caries, tonsillitis, sinusitis, etc. ;
• Post-trauma(including postoperative complications).

Among the provoking factors include hypothermia, psychological stress, inappropriate nutrition. Iridocyclitis of unclear etiology is a separate group.

Symptoms

The acute form of the disease is characterized by the manifestation of symptoms suddenly and quickly:

• Strong painin the affected eye, giving to the corresponding part of the head;
• In the area of ​​the projection of the ciliary body, there are painful sensations when touching;
• Strengthening the pain syndromeat night due to compression of nerve endings and blood stagnation;
• Characteristic features:photophobia, lacrimation, blepharospasm;
• Later, there is a slight swelling of the eyelids and another characteristic symptom: on the outer edge of the iris even visually visible are the translucent vessels radiating through the sclera. With the development of inflammation, they acquire a violet hue;
• The iris thickens and swells, and the pupil narrows and becomes immobile.

The initial stage of the disease is characterized by an increase in IOP, but with the progression of inflammation there is a disruption of intraocular moisture production, which causes its decrease. The duration of the acute form of the disease is on average 7-10 days. Symptoms may vary depending on the etiological factors.With some forms of inflammation, there is a significant deterioration in the general condition, accompanied by a headache, an increase in t, a decrease in visual perception.

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Any form of the disease should be treated at the initial stage, however, during the course of acute iridocyclitis timeliness is of particular importance: both for the relief of severe symptoms and for the prevention of severe complications.

Possible complications

Iris and ciliary (ciliary) body are among the most important structures that provide the functionality of the eyes.Therefore, untimely or incorrect treatment can lead to significant changes in the quality of vision or even complete blindness.

Ignoring the symptoms of iridocyclitis can trigger the development of inflammation in the adjacent areas of the eye and cause a number of eye diseases:

• Infringements of a transparency of a lens and a vitreous;
• Cataracts and glaucoma;
• Dystrophic processes in the cornea;
• Retinal detachments;
• Formation of adhesions.

The most dangerous complications in the spread of inflammation to neighboring areas are: chorioretinitis (inflammation of the retina), fusion and infection of the pupil,abscess of the vitreous, atrophy of the eyeball, endophthalmitis and panophthalmitis. With the progression of these processes, there is a threat not only of loss of vision, but often appears the need to remove the eyeball in order to stop inflammation and prevent infection adjacent areas.

Complete recovery in acute iridocyclitis is projected only in 15-20% of cases, in 45-50% of the disease takes a subacute recurrent course with more erased symptoms. The frequency of relapses in this case is directly dependent on the course of the etiological factor: rheumatism, gout, arthritis.

Treatment

Diagnosis of the disease, in addition to traditional local (tonometry, biomicroscopy, visometry, etc.. ) and system (the analysis of a blood general and biochemical, allergoproby, a roentgenography of additional sinuses) character, includes alsorheumatic tests, coagulogram, PCR and ELISA, ultrasound of the eye.In addition, in the presence of systemic chronic pathologies, it may be necessary to consult a specialist: rheumatologist, dermatovenerologist, infectious disease specialist, and others.

Tonometry

Medication Therapy

The tactics of medication treatment should first of all be aimed at eliminating the etiologic factor that caused the disease: infectious, allergic, systemic.

Conservative treatment should be comprehensive and conducted in a timely manner. Only in this case one can hope for positive results. Perhaps outpatient treatment by appointment of a doctor. However, in the absence of the expected effect for 5-6 days, treatment is continued in the hospital.

For therapy use medicines from the following groups:

• Antibiotics and antiviral drugs: Poludan, Floksal, Ophthalmoferon, Gentamicin and others. The drugs are used when the infectious nature of the inflammatory process is identified;
• Hormonal remedies: Medrol, Hydrocortisone-pos, Novo-prednisolone and others. The drugs are used as an anti-inflammatory and immunosuppressive agent;
• NSAIDs (non-steroidal anti-inflammatory drugs): Indomethacin, Aspirin, Metindol. Used in the presence of contraindications to the use of hormonal drugs;
• Midriatica:Atropine, Cyclomed, Irifrin. The drugs are used to prevent the fusion of the pupil, since they have an expanding action;
• Antihistamines:Suprastin, Claritin, Loratadin. The drugs have a pronounced anti-allergic effect and are effective for inflammations of an allergic nature;
• Immunomodulants:Cyclosporine, Imusporin, Evoral. Medicines are mandatory with a general weakened state of the body.

  Ophthalmoferon is used in the treatment of iridocyclitis

As an additional treatment, the doctor can prescribe the reception of multivitamins and the passage of physical procedures: applications with paraffin, UHF, warming compresses. If the patient has already had adhesions or opacities of the vitreous, electrophoresis with the use of hormonal drugs can help.

Surgically

To an operative intervention resort in extreme cases, if there was a development of complications:

• In the form of adhesionsThen cut them;
• Development of secondary glaucoma- an operation is performed to restore the functioning of the drainage system of the eye.

In the most severe cases with a progressive purulent process, the doctor can prescribe an operation to remove the eye.

Folk remedies

Iridocyclitis is a rather complex and dangerous disease, so treatment should take place first after a qualified diagnosis under the supervision of an ophthalmologist. However, folk remedies can be used, but only as an adjunct to drug therapy:

• In freshly prepared lemon juice(1 L) add 400 grams of garlic crushed in a blender. The mixture is thoroughly mixed, placed in a glass container and stored in a refrigerator. Take 1 hour. l., previously diluted in 1 tbsp. boiled water 1 p. per day;
• Crushed aspen bark(1 tbsp. l. ) boil in, l of water for 15 minutes, after which it is insisted for 3 hours. Take infusion of 200 ml every other day, after adding 1 tbsp. l. honey. Course of treatment - 21 days;
• Leaves of 3-year-old aloe(, kg) is placed in a refrigerator for 7 days, after which it is twisted in a meat grinder. Prepare a decoction of St. John's wort (30 grams of dry herb per liter of boiling water) over, h. and then insisted for 40 minutes. Add to crushed aloe and strained broth, l of white wine and, kg of honey, mix and store in a dark cool place. Take for a month three times a day: the first 5 days - for 1 hour. l., After a dose increase to 1 tbsp. l.

Some recommendations of folk treatment consist in warming up with warm compresses of the eyes: salt, sand, sun baths. However, the process is inflammatory, therefore, when using any folk remedy, you should consult an additional doctor.

Prevention

The main measure in the prevention of iridocyclitis is the prevention of the progression of major diseases,as well as their exacerbations, getting rid of foci of chronic infection in the body, both local and systemic.

To prevent the development of this formidable disease,to monitor the state of general health and pay increased attention to strengthening immunity: fully eat, exercise and tempering procedures, vaccinate, avoid hypothermia, observe precautions during periods of epidemics.

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conclusions

Iridocyclitis is a severe inflammatory eye disease affecting important eye structures. Iris and ciliary body perform several functions, largely affecting the visual acuity and eye health in general. In addition, the inflammation can spread to the adjacent areas and cause a complete loss of vision or even the eye.

Therefore, with the very first signs of discomfort, you need to get qualified medical help, and if necessary, then go to the hospital. Timely diagnosis and competent use of medicines will increase the chances of a successful outcome and prevent the risk of complications.