Uveitis

Description:

Uveitis — an eyeglobe choroid inflammation. Anatomically the choroid of an eyeglobe is divided into an iris, a ciliary body and the idiovascular cover located behind a ciliary body and making nearly 2/3 choroids (actually covers a retina outside). Blood supply of an idiovascular cover is carried out by generally back short ciliary arteries, and an iris and a ciliary body - front and back long ciliary arteries, i.e. blood supply of these 2 departments comes from different sources therefore front and back departments of a choroid traditionally are surprised separately that served as the reason of division of uveites on front and back.

Uveitis symptoms:

Front uveitis (about 80% of patients with uveites):
Usually acute beginning, most often — unilateral (95% in case of the uveitis associated with presence at HLA-B27 blood)
Complaints — decrease in visual acuity and the pain in an eyeglobe amplifying at its palpation. The pericorneal or mixed injection, iris discoloration (greenish or rusty color, the drawing indistinct). Narrowing of a pupil of the affected eye, a pupil form wrong, the photoharmose is broken. Existence on a cornea endothelium (from an anterior chamber of an eye) polymorphic precipitated calcium superphosphates or exudate in an anterior chamber (hypopyon in case of purulent character of exudate, a hyphema in case of hemorrhagic), is probable emergence of back commissures of an iris (an union of the back plane of an iris with the front capsule of a crystalline lens). In certain cases commissures can cause a circular union of an iris and a crystalline lens that leads to fusion of a pupil and increase in intraocular pressure — develop secondary glaucoma and бомбаж irises (its protrusion in an anterior chamber of an eye in the form of the roller)
Manifestations of a basic disease as in case of an endogenous, and exogenous origin of a uveitis are possible.
Back uveitis. In view of a close prileganiye of a retina and frequent involvement it in inflammatory process put the term a chorioretinitis into practice. Beginning traditionally imperceptible. Decrease in visual acuity. Complaints — emergence of photopsias (flashes before eyes), metamorphopsias (distortion of a form of objects), a hemeralopia (a sight illegibility at bad lighting) at peripheral localization of process.
At a research of fields of vision — scotomas of various sizes (this method of a research does not demand participation of the qualified ophthalmologist, but allows to suspect a choroiditis).
Lack of pain is characteristic that considerably complicates diagnosis.
Intermediate uveitis — inflammatory infiltration of a vitreous, exudation and formation of the membranes which are partially covering a ciliary body. The symptomatology reminds that at back twine.
Laboratory researches are not specific (a disease polietiologichno). Find signs of a basic disease more often (laboratory indicators at collagenoses are most informative).

Uveitis reasons:

Frequency - 0,3 — 0,5 cases on 1 000 population, about 40% of cases of a uveitis arises against the background of a general disease. The prevailing floor: at front twine, Ag of HLA-B27 associated with presence at blood, men get sick more often (2,5:1).
Etiology:
- Viruses, bacteria, protozoa, fungi
- Immune factors — assume participation of autoimmune and immunocomplex mechanisms at diffusion diseases of connecting fabric
- Idiopathic reasons (about 25%). Genetic aspects. In 50 — 70% reveal Ag of HLA-B27 (at an ankylosing spondylitis, Rayter's diseases). Risk factors — diffusion diseases of connecting fabric, the centers of persistent infection.

Treatment of the Uveitis:

Mode. Urgent consultation of the ophthalmologist as quite often the uveitis quickly progresses with development of dangerous complications is necessary.
Front uveitis:
- Treatment of a basic disease.
- Antibacterial agents.
- Anti-inflammatory drugs: NPVS, glucocorticoids, cytostatics — depending on a uveitis etiology
- Prednisolonum acetate — on 2 drops of 1% of suspension in a sore eye at first in 4 h, and then, in process of improvement reducing a daily dose sodium Dexamethasone phosphate of 0,1% solution in eye drops.
- The medicinal tsikloplegiya interfering formation of back commissures of an iris and promoting a rupture of already educated
- Choice drugs: homatropine hydrobromide on 2 drops of 2% of solution in a sore eye 2 р / or at it is necessary for days budetst through in 3 h, Scopolaminum hydrobromide on 2 drops of 0,25% of solution to 3 р / days
- Alternative products: adrenaline, cocaine
- Administration of atropine is not recommended, especially at the expressed exudation.
- When subsiding inflammatory process — resorptional products in the form of an electrophoresis or a fonoforeza (enzymes).

Back uveitis:
- Treatment of a basic disease
- Antibacterial agents
- Anti-inflammatory drugs: NPVS, glucocorticoids, cytostatics — depending on a uveitis etiology.