Ophthalmology

Iridocyclitis

Iridocyclitis is inflammation of iris, and also ciliary bodies of uvea. A word «iridocyclitis» came to us from Latin: «iridos» – a rainbow, «kykios» – a circle, shell. Another name of disease is front uveit. Separately inflammation of iris (iritis) or inflammation of ciliary body of vascular shell (cyclitis) meets sufficiently rare, it is therefore accepted to examine these processes exactly complex. In default of the in good time begun treatment

In the absence of early therapeutic intervention, an iridocyclitis quite often results in a decline or even loss of eyesight.

An iridocyclitis can arise up for the man of any gender and age, but most commonly affects people between the ages of 20-40 years. Most dangerous time of origin – from October for March, i.e. in the cold months of year, when our organism is weakened.

Symptoms

More frequent than all the symptoms of iridocyclitis are brightly expressed on one eye – it is at that rate accepted to talk about the hemilesion of eyes. Also symptoms depend on the form of disease – acute or chronic. And however it is possible to select the row of signs and form the general symptoms of iridocyclitis:

  • Worsening of sight.
  • Photophobia.
  • Fog before eyes.
  • Redness of the eye.
  • Pain in the eye (especially at night), at pressure on an eye pain increases yet more.
  • Change the color of the iris.

At an acute iridocyclitis symptoms are brightly expressed: pain in an eye is strong, head pain, enhanceable light-sensitivity, tears flow involuntarily. At a chronic iridocyclitis symptoms flow more soft: there is not acute pain, turning of eye red is not such sharp. However much a sharp form better responds to treatment, than chronic.

Causes

Both external and internal factors can become cause of iridocyclitis. Almost half of the cases the cause is an autoimmune disease (eg, sarcoidosis, rheumatoid arthritis, Reiter’s syndrome, ankylosing spondylitis). Very often an iridocyclitis arises up as a result of trauma of eye – at a blow, wound or ophthalmology operation. Other possible causes:

  • Inflammation of the iris.
  • Viral infections – measles, herpes simplex, gonorrhea, malaria, toxoplasmosis, influenza, tonsillitis, an inflammation of the paranasal sinuses and others.
  • Endocrine diseases – diabetes, gout.
  • The followings factors promote the risk of origin of iridocyclitis: developed vasoganglion of eye, decline of immunity, physical fag, supercooling of organism.

Types

  • In grain flowings of illness – acute iridocyclitis, subacute, recurrent, chronic.
  • Due to the occurrence – infectious (rheumatic, gonorrheal, influenza, herpes), metastatic (tuberculous, syphilitic), traumatic.
  • By the type of inflammatory process – hemorrhagic, plastic, purulent, serous, mixed.

Diagnostics

At presence of symptoms of iridocyclitis it is needed to appeal to the ophthalmologist. After questioning of patient about complaints a doctor will conduct examination of eye by a slitlamp – this inspection will allow to define the type of inflammatory process and distinguish it from other eye diseases (it is possible to entangle an iridocyclitis with a conjunctivitis or glaucoma). After authentication of iridocyclitis it is needed to expose its cause, therefore it is necessary to conduct an additional inspection for rheumatologist, otolaryngologist, endocrinologist and others. Sometimes it takes a special study – a reaction to the introduction of antigens focal reaction, serology, determination of immunoglobulins in the tear fluid.

Treatment

First of all, the treatment of iridocyclitis should be timely, it will significantly increase the chances of avoiding serious complications. The treatment process is rarely fit in a couple of weeks, usually takes several months. It is necessary to take measures on the removal of inflammation, also parallel to point efforts at avoidance of appearance of scars and joints which can cause complications.

For the removal of inflammation hormonal preparations (usually prednizolon, gidrokortizon) are used – as pills or natively. At a festering iridocyclitis strong antibiotics are appointed.

For the prophylaxis of formation of joints mydriatics are appointed – medical preparations which extend a pupil and prevent the union of iris with the lens of the eye. Additionally non-steroidal anti-inflammatory drugs, electrophoresis, warming, ultraviolet irradiation, laser therapy are used.

For treatment of iridocyclitis of infectious or autoimmune nature corticosteroids are applied. Antiseptics, antiviral drugs, immunostimulants, cytotoxic agents, antihistamines in the form of drops or intravenous injection are additionally appointed

For the treatment of rheumatic, tuberculosis, toxoplasmic iridocyclitis specialized doctors are involved, because the main measures should be directed to treatment of the underlying disease. The same applies to diabetes, gonorrhea, syphilis. If not to treat a basic disease, becoming cause of iridocyclitis, the simple isolated therapy of eye will be effective only in a short-term period and, probably, in the future there will be relapses.

It is sometimes necessary to use surgical treatment of iridocyclitis, which is directed on the division of appearing joints. At the heavy festering form of illness evisceration of eye is sometimes conducted – removal of the contents of the eyeball.

Prognosis of recovery the higher, than timely treatment has begun. In general, the prognosis is favorable: the complete recovery occurs in 20% of cases, partial – in 60% of cases (periodic relapses, as there is inflammation at exacerbation of underlying disease). A chronic iridocyclitis can gradually reduce sight. After convalescence it is necessarily needed to conduct regular prophylactic examination of eyes for an ophthalmologist. At the heavy form of illness atrophy of eyeball, cataract, glaucoma, entophthalmia, decline of sharpness of sight and even blindness is possible.

Prevention

  • Prevention of infectious diseases, viral diseases.
  • Timely measures for treatment of the underlying disease.
  • At the first sign of inflammation in the eyes consult an eye specialist.
  • Avoidance of eye injuries.
  • Avoiding hypothermia.
  • Strengthening of immunity.

In general, iridocyclitis is often a symptom or consequence of other serious diseases in the body. It is the most dangerous in the colder months of the year. Self-treatment is small effectively, the help of specialists is required. Timely treatment substantially promotes chances on complete convalescence, helps to prevent heavy complications of disease – cataract, glaucoma and even blindness.