Eye diseases. Detection of pathology of the vascular tract of the eye (the most important)

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Eye diseases. Detection of pathology of the vascular tract of the eye (the most important)

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22. Detection of pathology of the vascular tract of the eye

Having come into contact with the patient, one should briefly find out the timing and alleged causes of the disease, the nature of its course, the treatment performed, its effectiveness, etc. There are slight transient pains in the eye, redness of the eye, and sometimes a decrease in vision. Most often, iridocyclitis in children develop with influenza, tuberculosis, rheumatism, diseases of the paranasal sinuses, teeth, toxoplasmosis, childhood infections, etc. Examination of the patient should begin with checking the field acuity and color vision. Next, a general external examination of the face and eyes is performed. With the help of lateral illumination, the nature of the injection of the vessels of the eyeball is determined. A mixed injection of the eyeball may be indicative of iridocyclitis.

To make sure that there is a mixed injection, an adrenaline test is performed. Be sure to determine the state of the depth of the anterior chamber (it may be uneven due to a change in the position of the iris), the presence of its adhesions to the cornea (anterior synechiae) or to the anterior lens capsule (posterior synechiae). Particular attention is paid to the contents of the anterior chamber, since with iridocyclitis the moisture may become cloudy, and depending on the etiology and severity of the process, hyphema, hypopyon, gelatinous or serous exudate may appear.

When examining the iris of a diseased eye, it should be compared with the iris of a healthy eye. At the same time, it is possible to detect a change in its color (gray, brownish, yellowish, reddish, etc.), blurring of the pattern (smoothness of crypts and lacunae), the presence of separate dilated and newly formed vessels. A very important diagnostic sign of iritis is the condition of the pupil. It is almost always narrowed, reacts sluggishly to light, and often has an irregular shape due to the formation of posterior synechiae.

When examining the lens on its anterior capsule, it is often possible to detect brown clumps of remnants of the pigment epithelium after rupture of the posterior synechiae, but gray, yellowish, crumbly or membranous deposits of exudate can be detected, the type and severity of which depend on the nature of the process. The eye is examined in transmitted light, attention is paid to the nature of the reflex from the fundus. If there are precipitates on the posterior surface of the cornea, sweating of the endothelium, exudate deposits on the anterior and posterior capsules of the lens, the moisture of the anterior chamber is turbid, or opacities in the vitreous body are determined, then the reflex from the fundus will be unevenly pink. In those cases where there are opacities of the vitreous body, they are detected by shadows that have a different shape, size, intensity and mobility. Next, ophthalmoscopy is performed and the state of the retinal vessels (expansion, narrowing, uneven caliber, etc.), the optic nerve head (size, color, clarity of contours), the central zone and periphery of the retina (foci of various sizes, shapes, colors and localizations) are ascertained .

Author: Shilnikov L.V.

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