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23. Iridocyclitis
Iridocyclitis is an inflammation of the anterior choroid (iris and ciliary body).
The causes of the disease are general diseases of the body, often of an infectious nature, viral infections, rheumatism, tuberculosis, focal infections, eye injuries, syphilis, toxoplasmosis, diabetes, gout, gonorrhea, brucellosis. There are two forms of iridocyclitis acute and chronic.
Acute iridocyclitis is the cause of severe pain in the eye, photophobia, lacrimation, blepharospasm, and headache. Diffuse hyperemia of the sclera around the cornea with a purple tint (pericorneal injection), discoloration and blurring of the iris pattern, narrowing and deformation of the pupil, and its poor reaction to light are characteristic.
The moisture in the anterior chamber becomes cloudy, and a gelatinous exudate forms in the area of the pupil. So-called grayish-white precipitates, round-shaped deposits of exudate, appear on the posterior surface of the cornea. In severe cases, purulent exudate is visible and clouding is detected in the vitreous body. The disease is long-term, with relapses.
Influenza iridocyclitis occurs and proceeds acutely, the pain syndrome is expressed slightly. The pathological process is manifested in a sharp pericorneal reaction, the appearance of serous exudate.
Rheumatic iridocyclitis begins acutely and proceeds rapidly. Hemorrhage is observed in the anterior chamber, as well as under the conjunctiva, there is a sharp mixed injection of the eyeball. Exudation has a gelatinous character, insignificant, but there are numerous pigmented posterior synechia. Iridocyclitis in collagen diseases. The most studied is iridocyclitis in infectious nonspecific polyarthritis. The earliest signs are small precipitates on the posterior surface of the cornea near the inner and outer limbus. The course of chronic iridocyclitis is sluggish, sometimes with slight pain, moderate hyperemia, but exudation often occurs, which leads to the formation of coarse adhesions of the iris with the lens, the deposition of exudate in the vitreous body, and atrophy of the eyeball. An important role in the development of chronic iridocyclitis is played by the herpes simplex virus, tuberculosis, penetrating wounds of the eye.
Tuberculous iridocyclitis has a sluggish course, occurs gradually, is characterized by the appearance of new vessels in the iris, which sometimes fit and surround single or multiple tuberculomas. There may be flying nodules along the edge of the pupil. The precipitates are large, have a greasy appearance, contain a lot of exudate.
Treatment. Treatment of iridocyclitis is reduced to the treatment of the underlying disease and special ophthalmic treatment. The latter includes dilation of the pupil with mydriatics. With the formation of posterior adhesions, the introduction of fibrinolysin and a mixture of mydriatics by electrophoresis is recommended.
Anti-inflammatory and antiallergic drugs are prescribed: corticosteroids in the form of instillations of a 5% cortisol solution 56 times a day or subconjunctival injections.
Author: Shilnikov L.V.
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