Eye diseases. Uveitis (most important)

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Eye diseases. Uveitis (most important)

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25. Uveitis

Uveitis is inflammation of the choroid (uveal tract) of the eye. Distinguish between the anterior and posterior sections of the eyeball. Iridocyclitis, or anterior uveitis, is inflammation of the anterior iris and ciliary body, and choroiditis, or posterior uveitis, is inflammation of the posterior, or choroid. Inflammation of the entire vascular tract of the eye is called iridocyclochoroiditis, or panuveitis.

The main cause of the disease is infection. The infection penetrates from the external environment with eye injuries and perforated corneal ulcers and from internal foci with general diseases.

In the mechanism of development of uveitis, the protective forces of the human body play an important role. Depending on the reaction of the choroid, atopic uveitis associated with the action of environmental allergens (pollen, food, etc.) is distinguished; anaphylactic uveitis caused by the development of an allergic reaction to the introduction of immune serum into the body; autoallergic uveitis, in which the allergen is the choroid pigment or lens protein; microbial-allergic uveitis, which develops in the presence of a focal infection in the body.

The most severe form of uveitis is panuveitis (iridocyclochoroiditis). It can occur in acute and chronic forms.

Acute panuveitis develops due to the entry of microbes into the capillary network of the choroid or retina and is manifested by sharp pains in the eye, as well as decreased vision. The process involves the iris and ciliary body, and sometimes the vitreous body and all the shells of the eyeball.

Chronic panuveitis develops as a result of exposure to brucellosis and tuberculosis infections or herpes viruses, and occurs in sarcoidosis and Vogt-Koyanagi syndrome. The disease lasts a long time, with frequent exacerbations. Most often, both eyes are affected, resulting in decreased vision.

When uveitis is combined with sarcoidosis, lymphadenitis of the cervical, axillary and inguinal lymphatic glands is observed, and the respiratory mucosa is affected.

Peripheral uveitis affects people in their twenties and is usually bilateral. The disease begins with decreased vision and photophobia. With peripheral uveitis, the following complications are possible: cataract, secondary glaucoma, secondary retinal dystrophy in the macular region, swelling of the optic nerve head. The basis for the diagnosis of uveitis and its complications is eye biomicroscopy. Conventional research methods are also used.

Treatment. For the treatment of acute uveitis, it is necessary to administer antibiotics: intramuscularly, under the conjunctiva, retrobulbar, into the anterior chamber of the eye and vitreous body. Provide rest to the organ and put a bandage on the eye.

In chronic uveitis, along with specific therapy, hyposensitizing drugs and immunosuppressants are prescribed, and, according to indications, vitreous body moorings (adhesions) are excised.

Author: Shilnikov L.V.

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