Iridocyclitis: distribution and symptoms of the inflammatory process. How to deal with it.

It happens that eye diseases concern one particular department, tissue or structure of an organ. So, with cataracts we talk about clouding of the lens, with keratitis - with inflammation of the cornea, with macular degeneration - with damage to the retina. Something else happens when several departments are involved in the pathological process at once. Such diseases are called combined, and it is to this group that the disease discussed in this article, iridocyclitis, belongs.

Iridocyclitis
is an inflammation of both the ciliary (ciliary) body and the iris of the eyeball.
The name of the disease comes from the Greek words iris - rainbow, and kykios circle, eye. Iridocyclitis is also called anterior uveitis. The disease is distinguished from uveitis proper by the localization of the inflammatory process: with ordinary uveitis, the choroid of the eye (uveal tract) is affected. The combination of lesions characteristic of ocular iridocyclitis occurs due to the anatomical similarity: the blood supply and innervation of the departments are closely related, and when one of them is affected, the inflammation quickly spreads to the other. Sometimes there are inflammatory processes in only one of the mentioned sections - the iris or the ciliary body. In these cases, we will talk about individual diseases: cyclitis and iritis.

You can get iridocyclitis at any age. Somewhat more often it affects young people 20-40 years old.

What is iridocyclitis

Inflammation of the iris is called iritis, and inflammation of the ciliary (ciliary) body is called cyclitis. But since these two sections of the eyeball are anatomically located nearby, they are supplied with blood by one branch of the vascular network, which is why inflammation from one section instantly affects the other.

Therefore, the disease of these two structures was combined into one name - iridocyclitis (inflammation) of the eye. Another name is anterior uveitis.

Pathology develops due to a violation of the permeability of the blood-ophthalmic barrier. This barrier is a kind of membrane between the general blood flow of the body and the vascular network of the eye. The barrier works as a biological filter for very small thin vessels of the retina and eyeball.

The function of the blood-ophthalmic barrier is to retain all large molecules, compounds, toxins, bacteria, viruses, antigens, microorganisms, and immune complexes. Also, this filter does not allow most medications to pass through, which makes treatment much more difficult, leaving only topical medications.

Under the influence of reasons from outside the body or, conversely, from within, the permeability of the barrier is disrupted. And in the presence of any infectious inflammation in the body, antigens penetrate through the vessels into the iris, and then into the ciliary body, forming a new focus of inflammation. The pathology can affect both or one left or right eye.

The disease can occur with the formation of exudate (liquid) in the vitreous body, which causes the optical media of the eye to become cloudy. The iris becomes inflamed and swollen, which leads to physical contact with the wall of the lens. In the presence of exudate, fusion of the lens with the iris and the formation of posterior synechiae (adhesions) are possible.

In the video, see clearly what iridicyclitis is:

https://youtu.be/zb8BSR-ujBg

Adhesions deform the pupil, dystrophy occurs, tissue scarring occurs, changes in the shape, elasticity, and width of the pupil occur, which greatly reduces visual acuity. With significant inflammation, proliferation, melting of the walls of the lens, or complete occlusion of the pupil may occur.

Complications of the disease:

complete or partial loss of vision;
cataract;
amblyopia;
vasculitis;
glaucoma;
retinal disinsertion;
chorioretinitis;
endophthalmitis;
eyesore;
iris abscess;
perforation, atrophy of the eyeball;
amputation of the eye.

Is iridocyclitis contagious?

Iridocyclitis of the eye is a non-infectious disease; it occurs due to the introduction of pathological antigens with the bloodstream, and therefore is not transmitted. For inflammation to occur, there must be a failure in the immune system, a violation of the permeability of the blood-ophthalmic barrier, as well as the presence of infection in the body.

A healthy person, even if in contact with a sick person, will not develop this disease.

Iridocyclitis - what kind of disease is it?

Another name for this process is anterior uveitis. The eye disease iridocyclitis is a combined inflammation of the iris and ciliary body. Sometimes only one part of the anterior part of the eyeball is initially affected, but due to the close anatomical connection, the second is always involved. The disease is diagnosed at any age, mainly from 20 to 40 years.

Acute iridocyclitis

This variant of the pathology is accompanied by pronounced and specific symptoms. Even subacute iridocyclitis has characteristic symptoms, making the disease easier to detect and diagnose in the early stages of progression. This form of the disease is characterized by the following clinical picture:

severe pain in the eye and temple area;
constant lacrimation;
photophobia;
redness of the white;
deterioration of visual acuity;
swelling of the iris;
constriction of the pupil;
visible dilation of blood vessels;
change in the pattern and color of the iris.

Chronic iridocyclitis

Often (about 70% of cases) the disease in question passes into a sluggish form. Chronic recurrent iridocyclitis is accompanied by mild symptoms, which is why patients do not consult an ophthalmologist in a timely manner. Against the background of a sluggish course of the pathology and lack of therapy, severe complications develop, for example, the fusion of several sections of the pupil (synechia) or its complete fusion.

It is dangerous to ignore chronic iridocyclitis - treatment in the later stages of the disease does not always help. As a result, obscuration amblyopia develops with deformation and pathological narrowing or fusion of the pupil. It sometimes leads to irreversible damage to the entire anterior part of the inflamed eye and complete loss of vision.

Classification

According to the form of the course of iridocyclitis, they are distinguished:

Sharp form.
Subacute course.
Chronic iridocyclitis.
Recurrent iridocyclitis.

Forms of iridocyclitis according to the nature of inflammation:

exudative;
serous iridocyclitis;
fibrinous-plastic (with the appearance of synechiae) iridocyclitis;
hemorrhagic.

Due to its origin, iridocyclitis occurs:

Infectious.
Allergic.
Viral (herpetic).
Metabolic.
As a complication of general systemic diseases of the body.
Post-traumatic iridocyclitis or traumatic.
Idiopathic.
Iridocyclitis of unknown origin.

The most dangerous of all these forms is considered fibrinous-plastic; this iridocyclitis is accompanied by the appearance of adhesions, as well as synechiae. They destroy the iris, narrow the diameter of the pupil, contribute to clouding of the vitreous, and decrease the quality of vision.

Iridocyclitis - symptoms

The severity and characteristics of the clinical picture of inflammation depend on its cause, the state of local and general immunity. The signs of iridocyclitis also correspond to the form of the pathology. The following types of disease are classified:

serous;
fibrinous;
purulent;
viral.

Serous iridocyclitis

This type of pathology occurs more easily than others and has the most favorable prognosis. The disease serous iridocyclitis is characterized by the accumulation of serum exudate (turbid liquid) in the anterior chamber of the eye. This is accompanied by the following symptoms:

clouding of the pupil;
lacrimation;
fear of bright light;
cutting pain in the eye;
swelling and redness of the iris;
slight dilation of blood vessels;
fluctuations in intraocular pressure;
deterioration of visual acuity (“veil”);
constriction of the pupil.

If serous iridocyclitis is diagnosed early, treatment will be quick and simple. This type of disease responds well to treatment in the early stages and very rarely provokes complications. As the pathology progresses, fibrinous anterior uveitis often develops. In such cases, there is a high risk of damage to the retina and the development of secondary glaucoma.

Fibrinous iridocyclitis

This type of disease is also characterized by the accumulation of exudate in the anterior chamber of the eye, but instead of serum it contains a protein formed during blood clotting. Fibrinous-plastic iridocyclitis always begins acutely and is accompanied by all severe symptoms. Additionally, the following signs are noted:

vitreous opacification;
feeling of fullness in the eye;
fusion of some areas of the pupil;
change in the shape and shade of the iris;
blepharospasms;
decreased intraocular pressure.

This form of the disease sometimes provokes severe and irreversible consequences. Synechiae can quickly cover the entire surface of the pupil, which will lead to its complete closure (occlusion). It is important to prevent such iridocyclitis - treatment of a complicated type of disease is difficult and often ineffective. It is almost impossible to restore vision after a closed pupil.

Purulent iridocyclitis

The described variant of anterior uveitis develops against the background of a bacterial infection. That purulent iridocyclitis of the eye occurs as a consequence of prolonged sore throat, pyorrhea, furunculosis and other microbial lesions. This form of pathology is difficult and progresses quickly. Within several hours, a large amount of purulent exudate accumulates in the anterior chamber of the eyeball, and specific symptoms of iridocyclitis appear:

significant deterioration in visual acuity;
swelling and redness of the conjunctiva;
unbearable pain in the injured eye and head on the corresponding side;
clouding of the pupil;
change in the color of the iris to rusty or greenish (depending on eye color);
protein hyperemia;
formation of synechiae along the edge of the pupil;
decreased intraocular pressure.

Viral iridocyclitis

The presented type of disease debuts violently, but is accompanied by less painful sensations than other forms of pathology. In almost 90% of cases, herpetic iridocyclitis develops; it occurs as a result of a recurrence of a viral infection in nearby areas (on the face, nose, throat). Specific symptoms of this type of anterior uveitis:

redness of the sclera;
accumulation of serous or fibrinous exudate in the anterior chamber of the eye;
blurred vision;
lacrimation;
single fusion of the edges of the pupil with the lens capsule;
increased intraocular pressure.

Causes

The causes of ocular iridocyclitis are varied. Iridocyclitis never occurs on its own, but is always a consequence or complication of some other pathology.

Iridocyclitis, main causes:

The cause of the development of about 50% of all cases of ocular iridocyclitis is rheumatism.
Traumatization of the eyeball: penetrating wounds, foreign body, bruise.
Development of iridocyclitis as a complication after surgery.
Burns of the organs of vision: thermal, chemical, ultraviolet, radiation.
Viral diseases: herpes, flu, measles.
Bacterial diseases: gonorrhea, typhoid, tuberculosis, syphilis.
Keratitis, blepharitis, stye, uveitis.
Protozoal pathogens: toxoplasmosis, chlamydia, malaria.
Infectious diseases: staphylococcus, streptococcus, enterococcus.
Sarcoidosis, arthrosis, spondyloarthrosis.
Foci of chronic infections in the body: otitis media, sinusitis, tonsillitis, caries, cystitis.
Allergic history.

Stress, dry eye syndrome, vitamin deficiency, hypothermia, significant visual stress, decreased immunity also contribute to the disruption of the permeability of the blood-ophthalmological barrier.

What causes the development of iridocyclitis?

The causes of iridocyclitis can be both external and internal factors. External factors that provoke the development of the disease include:

Injuries to the visual organs.
Surgical intervention.
Stress.
Hypothermia.
Fatigue due to excessive physical exertion.

The list of internal factors leading to the appearance of iridocyclitis looks like this:

Infections.
Chronic diseases in an acute form.
Disturbances in the functioning of the immune system.
Deviations of the insulin-dependent and rheumatic type.
Inflammatory processes of the eyes (keratitis, conjunctivitis).
Overdeveloped vascular network in the visual organs.

Sometimes iridocyclitis develops against the background of toxic poisoning that causes an allergic reaction. This phenomenon is typical for children aged 4 to 12 years. Sometimes the cause of iridocyclitis cannot be determined, as in this case:

A possible treatment regimen is also described here.

Symptoms

Acute iridocyclitis of the eyes differs from chronic iridocyclitis in the following ways: sudden onset of symptoms, severe course with pronounced symptoms, pain syndrome. Usually one eye is affected; less often, bilateral inflammation is possible.

Iridocyclitis of the eye, main symptoms:

redness, hardening of the eye;
severe pain syndrome;
lacrimation, photophobia;
change in iris pattern;
the iris becomes greenish or rusty red;
change in the diameter and shape of the pupil;
the appearance of synechiae (fusion);
the appearance of fog before the eyes, blurred images;
clouding of the optical media of the eye;
Fibrin, exudate, pus or blood may settle in the anterior eye chamber;
increased intraocular fluid pressure;
decreased quality of vision.

Many signs are characteristic not only of iridocyclitis, but also of most inflammatory diseases of the visual apparatus. The main thing you should pay attention to is a change in the color and pattern of the iris, as well as a violation of the shape and diameter of the pupil. These two symptoms are specific to iridocyclitis and will help you accurately identify it.

The structure of the choroid of the eye

The choroid of the eye consists of three sections - the iris, the ciliary body and the choroid.
It is customary to distinguish two parts in the iris - anterior and posterior. Numerous blood vessels pass through the anterior section. The main function of this part of the eye is the role of the so-called diaphragm. In the center is the pupil - an opening that, due to the work of its muscles, provides the optical function of the iris. The next section of the choroid is the ciliary, or ciliary body. A characteristic feature that distinguishes this part of the eye from others is its versatility. Firstly, it produces intraocular fluid, which is a nutritional component for the avascular structures of the eye - the lens and the inner layer of the cornea. The lens is suspended from the processes of the ciliary body on its own zonular ligament, which includes the ciliary body in the act of accommodation. And finally, having parasympathetic innervation of the muscle of the same name included in the ciliary body, it provides sensitive function. As in other vascular sections, the ciliary body is rich in small vessels, ciliary arteries. The iris and ciliary body are united in the anterior section of the vascular tract of the eyeball.

The posterior section is represented directly by the choroid - the choroid. In none of the structural components of the eyeball does there exist such a variety of arteries as in it.

The choroidal vessels have a certain organization. It is divided into three layers - small, medium and large arteries, which are separated by a vitreous plate. All vessels are located in the suprachoroidal space and are a continuation of the orbital artery.

The anterior part is innervated from the trigeminal nerve system, which provides high pain sensitivity of the iris and ciliary body, as well as motor innervation of the pupillary muscles and ciliary body.

The venous system also has its own characteristics. The veins of the uveal tract merge into the vortex veins, which in turn exit into the superior ophthalmic vein. Whirlpool veins are involved in the regulation of intraocular pressure, so inflammatory processes in the middle part of the eyeball can be accompanied by an increase in ocular pressure and masquerade as glaucoma.

Considering the structural features of the vascular tract, inflammatory processes in it last a long time due to the low blood flow rate due to the presence of numerous small vessels, are very painful as a result of innervation by the first branch of the trigeminal nerve, are accompanied by decreased vision, since the accommodative function may be impaired, and provoke the development of secondary glaucoma .

Diagnostics

Diagnostics consists of a set of measures and studies, laboratory analysis, and external examination of the patient. It is aimed at accurately establishing a diagnosis, and then at finding the root cause, the source of infection in the body. Therefore, during the examination, consultations with related specialists are often added.

What is needed to clarify the diagnosis:

External examination of the visual organs by a doctor, collection of anamnesis of the disease and patient complaints.
Passing the main labs. tests (blood, urine) and others, if necessary.
Checking refraction and visual acuity.
Palpation of the eyeball to determine its density.
Ultrasound, computed tomography, IOP measurement.
Biomicroscopy of the eye with taking a smear for microflora.
X-ray of the ocular vessels with the introduction of a contrast agent.
If necessary, consultations with: allergist, endocrinologist, rheumatologist, otolaryngologist, dentist, dermatovenerologist, phthisiatrician and other specialists.

Diagnosis of iridocyclitis. Treatment

Patients with any form of the disease should undergo treatment under the supervision of a specialist. Self-diagnosis and self-medication in this case are unacceptable: after all, the consequences can be too severe.

To clarify the diagnosis, the ophthalmologist will prescribe general tests: blood tests for various parameters, X-ray and ultrasound examinations, and, if necessary, tests for allergens and rheumatism. Local examination will consist of examination with a slit lamp, palpation, measurement of intraocular pressure, and biomicroscopy of the eye.

The doctor will develop a treatment plan. Most likely, it will be carried out in a hospital. The set of drugs will depend on the cause of the disease. In addition to medications, a specialist may prescribe a course of physiotherapeutic procedures, for example, electrophoresis.

How to treat iridocyclitis of the eye

Treatment of ocular iridocyclitis depends on the underlying cause, the severity of the disease, the severity of symptoms and the condition of the body as a whole. At the initial stages, conservative methods are used, with the main emphasis on eliminating the source of infection.

In acute and subacute forms, it is necessary to provide first aid in the form of various methods that are used to separate adhesions:

it is necessary to dilate the pupil to prevent its fusion with the anterior wall of the lens; for this, mydriatics are used: “Atropine”, “Irifrin”, “Cyclomed”, “Tropicamide”, “Midriacyl”, “Midrimax”;
analgesics for local anesthesia: “Inocaine”, “Diklo F”, “Alcaine”, “Naklof”, “Lidocaine”.

Mydriatics help to physically break the formed synechiae and adhesions. These drugs completely relax the eye muscles, dilate the pupil as much as possible and block accommodation.

The effect lasts for several hours, during which time the following side effects are possible: lacrimation, fear, pain in bright light, increased pressure of intraocular fluid, impaired visual acuity (farsightedness for the duration of the drug).

These are first aid drugs that you can run to the pharmacy for and treat an acute attack at home. After this, you need to see a doctor, he will make an accurate diagnosis, find the cause of the condition, prescribe medications and prescribe treatment. How long you will have to be treated depends on the individual case and the cause.

Treatment options and medications for ocular iridocyclitis, depending on the underlying disease:

Anti-inflammatory therapy: Metindol, Indomethacin, Prednisolone, Hydrocortisone, Dexamethasone.
Eye drops for iridocyclitis of allergic origin: Claritin, Citrine, Diazolin, Suprastin, Loratadine.
Local and general antibacterial agents: “Tobrex”, “Okomistin”, “Miramistin”, “Albucid”, “Sulfacyl”, “Floxal”, “Gentamicin”, “Oftaquix”, “Ceftriaxone”, “Tsiprolet”, “Cefazolin” , "Ceftum", "Metronidazole".
Antiviral: “Anaferon”, “Aktipol”, “Gerpevir”, “Poludan”, “Oftan Idu”, “Oftalmoferon”.
Vitamins and products that improve trophism, regeneration, tissue nutrition: “Taufon”, “Equoral”, “Lidaza”, “Trypsin”, “Collalizin”.
Physiotherapeutic procedures: physiotherapy, heating, electrophoresis are used.
If all of the above remedies do not produce results, surgical intervention and physical dissection of adhesions are prescribed.

The drugs should not be used independently, without a prescription from an ophthalmologist. You must pass all the tests and undergo an examination, otherwise it is unknown what needs to be treated.

https://youtu.be/U2NtcQhQEB4

Establishing diagnosis

Diagnosis of iridocyclitis begins with listening to the patient’s complaints and collecting an anamnesis of life and illness, visual examination of the organ of vision and its palpation. To confirm or refute the suspected diagnosis, all patients must undergo a comprehensive examination, including laboratory diagnostics and auxiliary instrumental methods. Some patients require consultation with doctors of related specialties.

Research methods to make a correct diagnosis:

Determination of visual acuity using tables consisting of letters, numbers and special characters. Typically, acuity is reduced due to corneal edema and accumulation of exudate in the anterior chamber.
Biomicroscopy allows you to determine various lesions of the ocular structures.
Determination of refraction and color perception.
Tonometry, perimetry, echometry, ophthalmoscopy.
Fluorescein angiography is a diagnostic method that allows you to visualize small vessels of the fundus of the eye, as well as assess the state of blood flow in the retina. The subject is injected intravenously with a contrast agent, and then a series of photographs of the vessels of the fundus of the eye are taken with a special camera.
X-ray of the lungs and sinuses is an auxiliary method used to exclude chronic processes: pneumonia, sinusitis, ethmoiditis, frontal sinusitis.

Laboratory diagnostics consists of conducting general clinical blood and urine tests, coagulation tests, tests for rheumatism and allergens. Serum immunoglobulins M, I, G are determined in the blood and tear fluid.

Kinds

Since the disease is considered extremely common, doctors distinguish several classifications of the disease. The simplest classification is based on the origin of the disease, because there are two types:

a disease caused by endogenous factors, that is, occurring against the background of other diseases;
a problem that develops against the background of exogenous factors, that is, due to the negative influence of the external environment.

Iridocyclitis is also classified according to the degree of development of the disease and the reason for its occurrence.

Visual signs of the disease

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Chronic variety

This form is characterized by peculiar symptoms. Which ones should you pay attention to:

The state of health is gradually deteriorating.
Swelling and inflammation may appear and disappear.
The patient’s well-being changes depending on external factors (for example, when working at a computer for a long time, visual acuity may noticeably decrease).
Eradicating the problem takes from one to three months.

The chronic form of iridocyclitis occurs against the background of tuberculosis or herpetic infection.

Symptoms such as burning eyes, persistent discharge, pain and swelling develop gradually, but this does not mean that they should be ignored. If a person does not begin immediate treatment, his health will noticeably worsen.

Redness and lacrimation are the initial signs

A physiological feature or sign of disease is the cause of yellow eyes.

Acute and subacute form

The acute form of the disease develops according to a completely different scenario. Symptoms overtake a person immediately, and they develop so rapidly that within a week after infection it literally becomes painful for a person to open his eyes.

The cause of the development of an acute form of the disease can be injury or an allergic reaction, but most often the problem arises due to the influence of pathogens.

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Often a visual examination of the patient is sufficient for diagnosis.

The average period of such iridocyclitis is 3-6 weeks. If a person ignores treatment for the acute stage of the disease, it can become chronic.

The patient is concerned about the following symptoms:

change in iris color;
redness and swelling of the eyes;
severe pain in the eyes;
constant release of tears and pus;
possible bleeding from the eyes;
noticeable decrease in visual acuity.

Iridocyclitis has an ICD 10 code - H20.

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The acute form is characterized by rapid development

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Fibrous-plastic

This form develops with penetrating eye injuries. Often, when this type of complication develops, a person develops adhesions on the back of the eye, which leads to its gradual fusion.

Symptoms do not develop abruptly, but if left untreated, there is a high probability of the disease progressing to the chronic stage.

With the development of fibroplastic iridocyclitis, a person’s objective vision gradually decreases. Over time, it may disappear completely, and the human eye will only begin to react to the influence of light on the retina.

Dangerous diseases that require timely treatment are optic nerve atrophy and congestive disc.

Fibrous appearance

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Depending on the cause of development

Another type of classification of iridocyclitis is based on the cause of the disease. Ophthalmologists identify a dozen problems that stimulate the gradual development of such a scourge, and each of them should be discussed separately.

The disease often develops against the background of traumatic injury to the eye, due to serious contusion or injury.
Iridocyclitis develops against the background of viral or bacterial diseases, such as measles, malaria, chlamydia, influenza, tuberculosis and others.
Metabolic disorders or the development of diseases such as diabetes, gout.
Rheumatoid conditions also stimulate the appearance of iridocyclitis.
Infection with microbes or toxins when they come into direct contact with the iris stimulates inflammation.
The problem may be directly related to an acute allergic reaction.

Toxic-allergic iridocyclitis often occurs in children aged 4-12 years. A disease of unknown etiology cannot be discounted when it is difficult for doctors to determine the cause of the problem.

The method of treatment depends on the type of disease and the cause of its occurrence. Doctors urge you to always undergo diagnostics to find out why the problem arose.

An increase in intraocular pressure is characteristic of the initial and late stages of the disease

Drugs, the norm or a medical problem are the causes of constricted pupils.

Diagnosis of the disease

To identify the pathology in question, a comprehensive examination is carried out (ophthalmological, laboratory, x-ray). An external examination of the eyeball is performed first. Anamnestic data are then collected.

To clarify the diagnosis, visual acuity is checked, intraocular pressure is measured, and eye biomicroscopy is performed. If necessary, an ultrasound of the visual organs is prescribed. Ophthalmoscopy in iridocyclitis is difficult due to altered primary parts of the eyes.

To identify the etiology of the disease, laboratory diagnostics are performed, a coagulogram, and rheumatic and allergy tests are performed. Using ELISA and PCR, the ophthalmologist determines the causative agent of the inflammatory process. Assessing the state of the immune system requires studying the level of indicators such as IgA, IgG.

If necessary, consultation with a phthisiatrician, rheumatologist, otolaryngologist, or dentist may be required. Additionally, an x-ray of the lungs and sinuses is performed. Differential diagnosis allows us to exclude keratitis, conjunctivitis, and glaucoma.

Pathogenesis

The development of the pathological process is caused by toxic and immunological damage to the iris. Microbes and their toxins cause the formation of immune complexes, which are carried through the bloodstream into the iris and damage it.

Against the background of pronounced immunological reactions, a clinic of inflammation of the iris and ciliary body is developing. At the same time, microcirculation is disrupted in the damaged areas, cell destruction increases and, as a result, an inflammatory reaction develops. After inflammation subsides, scars and areas of atrophy form in these important ocular structures.

Treatment of the disease

Therapy is carried out long and persistently, sometimes months are spent on it, because everything must be consistent.

Therapy for iridocyclitis should be carried out as quickly as possible and aimed at eliminating the main cause that provoked the appearance of anterior uveitis.

Traditional therapy is focused on preventing the appearance of posterior adhesions and eliminating the possible risk of complications. It includes emergency care and planned treatment. First aid for iridocyclitis consists of taking antihistamines, instilling eye drops that dilate the pupil (mydriatics), corticosteroids and NSAIDs.

Planned treatment is carried out in a hospital under the direct supervision of doctors. Therapy includes the use of powerful local and general antiseptics (Poludan, Miramistin, Albucid), antiviral (Floxan, Okoferon, Acyclovir), antibacterial drugs (Torbex, Oftavix), hormonal agents (Prednisolone), NSAIDs (Indomethacin) and corticosteroids in the presence of autoimmune or toxic-allergic iridocyclitis. Mydriatics (Atropine, Tropicamide, Mezaton, Ifirin) and agents to reduce capillary permeability (Dition) are used. The drugs are used in the form of drops, ointments, administered intravenously and intramuscularly, and parabulbar injections are performed (injections are made through the skin of the lower eyelid).

Detoxification is carried out (Hemodez, Reosorbilact and a solution of five percent glucose are administered intravenously), in the presence of severe inflammation, hemosorption, plasmapheresis, and instillation of mydriatics are performed, which prevent fusion of the lens and iris. Prescribe vitamin-mineral complexes, immunostimulants, immunosuppressants, enzymes to eliminate exudate and adhesions. Physiotherapy is also carried out for iridocyclitis, including electrophoresis, laser and magnetic therapy.

Anterior uveitis of syphilitic, rheumatic, tuberculous nature requires specific therapy under the direct supervision of highly specialized specialists.

Surgery for iridocyclitis is prescribed in cases of complications (formation of adhesions, secondary glaucoma).

Prevention

It is important to treat emerging ailments in a timely manner. And also remember that decreased immunity, viruses, infections, or diseases that were caused by them can serve as a source of the development of iridocyclitis.

Preventive measures include:

increasing immunity;
good nutrition;
treatment of all infectious diseases on time;
flu vaccination;
avoiding hypothermia;
women planning a pregnancy need to be examined in advance, since iridocyclitis is easily inherited.

Important! If you treat diseases in a timely manner and be attentive to your health , this will help prevent the occurrence of iridocyclitis and, thus, carry out its prevention.

In half of the cases of iridocyclitis, the factor influencing its appearance is other infectious and non-infectious diseases or eye injuries.

Classification of iridocyclitis

Uveitis is usually classified according to several criteria, among which are:

Source of infection. The source of infection refers to the route through which the infection reached the eye. Endogenous uveitis (primary) occurs when an infectious agent enters the vascular bed of the eye through metastatic or toxic-allergic entry. Exogenous uveitis (secondary) occurs when an infection enters the vascular bed of the eye from the external environment through eye trauma, after surgery, as a complication of a corneal ulcer.
According to the course: acute, subacute, chronic, recurrent.
By the nature of the process (by the nature of the contents of the chambers of the eye):

3.1. Serous, in which a grayish deposit in the form of flakes appears in the anterior chamber of the eye. Flakes are complexes of formed blood elements; they are distinguishable during a diagnostic examination of the anterior chamber of the eye.

3.2. Fibrinous, in which a pronounced inflammatory reaction is observed, adhesions appear along the edge of the iris, which looks like a change in the shape of the pupil from an even circle to a “ragged” one.

3.3. Purulent (hypopyon), in which a horizontal level of pus is visible in the moisture of the anterior chamber.

3.4. Hemorrhagic (hyphema), in which blood accumulates in the anterior chamber.

3.5. Mixed. Characteristic signs of different forms of iridocyclitis may be present.

Possible complications and consequences

Treatment of iridocyclitis gives a favorable prognosis for the patient. In 15-20% of cases , complete recovery is observed, in 50% it becomes chronic, which can lead to deterioration of vision. If the disease is not treated in a timely manner, this can lead to consequences: cataracts, secondary glaucoma, retinal detachment and vitreous distortion. Such complications lead to loss of vision, and in worst cases, removal of the eye.

Attention! At the first signs of iridocyclitis, you should contact a specialist to avoid consequences.

Will vision be restored after illness?

Complications lead to deterioration of vision . Recreating it is not an easy task, since new surgical interventions can provoke an exacerbation of inflammation. Before offering a patient surgery, it is necessary to carefully examine him.

Once vision is lost due to glaucomatous optic atrophy, it cannot be restored.

Symptoms of pathology

Iridocyclitis is an inflammation that in most cases affects one eye , but the development of a bilateral form of the disease is also possible.

Depending on the form in which the disease developed, signs characteristic of acute or chronic forms can be distinguished, but in both cases the same symptoms will occur, manifesting themselves as follows:

The appearance of fog or a veil before the eye .
Deterioration of vision sharpness.
Acute painful reaction of the eye to light sources.
Redness of the affected tissues.
Pain that intensifies with pressure on the eye.
The iris changes color or becomes cloudy.

In the acute form, these symptoms are more pronounced, especially at night.

In acute iridocyclitis, the symptoms are pronounced : severe pain in the eye, headache, increased photosensitivity, tears flow involuntarily.

With chronic iridocyclitis, the symptoms are milder : there is no acute pain, the redness of the eye is not so sharp. However, the acute form is more treatable than the chronic form.

Iridocyclitis: treatment at home

As one might have already guessed, the disease in question is very dangerous and is not to be trifled with. In any case, the patient needs to consult a specialist to avoid frightening consequences. If you are suddenly struck by acute iridocyclitis, treatment at home is justified if used to alleviate your condition until you have the opportunity to visit a doctor. Therapy consists of relieving the acute form of inflammation. Moreover, home treatment may involve not only the use of folk remedies, but also medications.

Iridocyclitis: general description of the disease

Iridocyclitis, keratouveitis, cyclitis, iritis in ophthalmology refer to the so-called anterior uveitis - inflammatory processes of the ocular choroid.
Due to the close functional and anatomical interaction of the ciliary body and the iris, the process of inflammation, which began in one of these parts of the ocular choroid, quickly passes to the other and occurs in the form of iridocyclitis. Iridocyclitis can be detected in people of any age, but most often in people 25-45 years old.

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According to the course of the disease they are distinguished:

chronic;
acute iridocyclitis.

Upon the passage of inflammatory changes:

exudative;
serous;
hemorrhagic;
fibrinous-plastic.

By origin:

infectious-allergic;
infectious;
post-traumatic;
allergic non-infectious;
caused by syndromic and systemic diseases;
unknown etiology.

The duration of chronic iridocyclitis is several months, acute - 4-5 weeks. Moreover, relapses and disease most often appear in the cold season.

Prognosis of iridocyclitis

With prompt consultation with a doctor and proper treatment, the prognosis is favorable. Nevertheless, complete recovery is observed only in 1/5 of cases, and more than half of the patients subsequently suffer from a recurrent form of the disease (this is more true for iridocyclitis occurring against the background of a systemic disease).

If treatment is delayed or its duration is not observed, iridocyclitis becomes chronic, and visual acuity slowly but steadily decreases. Without therapy, there is a high risk of complications of iridocyclitis with glaucoma, chorioretinitis, endophthalmitis and panophthalmitis, eye atrophy, damage to the vitreous body, etc. Any of these conditions can lead to blindness.

Course of the disease

Acute iridocyclitis is accompanied by the appearance of a greenish or rusty-red color of the inflamed iris. At the same time, the clarity of its pattern decreases. Exudate of a different nature is detected in the anterior chamber.

If the exudate is purulent, then a strip of hypopyon and hyphema appear. Inflammation can reduce visual acuity. Acute serous iridocyclitis provokes the appearance of precipitates and exudates on the posterior surface of the cornea.

At the same time, pigment lumps appear. Due to swelling of the iris and its close contact with the lens, synechia and miosis are formed. Then a spike appears. The rapid course of the disease contributes to the complete overgrowth of the pupil.

Intraocular pressure in this disease is low, since the secretion of moisture in the primary chamber is inhibited. In the acute course of the disease, which is accompanied by severe exudation, intraocular pressure increases. Each type of iridocyclitis is characterized by a specific clinical picture:

acute, subacute, chronic, recurrent;
allergic-toxic (gouty, rheumatic, gonorrheal).

With granulomatous iridocyclitis, symptoms manifest as the appearance of a granuloma in the iris. Viral types of the disease are characterized by a torpid course and the formation of exudates of a different nature.

With tuberculous iridocyclitis, mild symptoms are observed, large “greasy” precipitates appear. In this case, powerful posterior stromal synechiae are formed, and blurred vision is observed.

Autoimmune iridocyclitis occurs in severe form. It quickly recurs if the underlying disease worsens or its complication appears (cataract, secondary glaucoma, scleritis). Each subsequent relapse is more severe than the previous one.

This quickly leads to blindness. In the traumatic form of the disease, sympathetic ophthalmia develops. The disease associated with Reiter's syndrome, caused by chlamydia, provokes conjunctivitis and urethritis. In this case, the joints are affected and the choroid becomes inflamed.

Unconventional methods of therapy

Any disease requires a careful approach, including iridocyclitis. Treatment and medications can be either strictly individual (if the patient has allergies) or general.

Drug treatment is prescribed depending on the form of the disease:

The nonspecific form of iridocyclitis is treated with hormonal therapy using drugs such as Prednisolone and Hydrocortisone. The drugs have an anti-inflammatory effect and have a powerful effect not only for treatment, but also to prevent the disease from developing into a more complex form, as well as possible complications.
The purulent form of iridocyclitis can be cured with broad-spectrum antibiotics. At the same time, analgesics can be prescribed to relieve painful eye sensations that accompany iridocyclitis. Treatment with antibiotics coupled with painkillers gives a good effect. Discomfort is easily relieved with infraorbital novocaine pterygopalatine-orbital blockades. In addition to antibiotics, the purulent form of the disease also requires daily thorough treatment of the skin around the eyes with mash or a special gel. In some cases, the doctor may decide to prescribe a subcutaneous injection of biostimulants.

Regardless of the form and stage of the disease, the formation of synechiae (i.e., adhesions), as well as fusion of the eye lens with the iris, mydriatic drugs are used, which include:

Medriacil solution.
Adrenaline solution in a ratio of 1:1000.
Atropine sulfate solution (used at 1% concentration).
Drops "Diclof" (non-steroidal, they can be replaced with "Na-klof" and "Indomethacin"), used to enhance the therapeutic effect of the mydriatics listed above.

These funds are aimed primarily at dilating the pupil. If iridocyclitis is caused by any systemic disease, treatment of the eye disease should take place in conjunction with getting rid of the cause. Isolated therapy is unable to give the long-term desired result.

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In addition to drug treatment, physiotherapeutic procedures will also be useful. An ophthalmologist may prescribe magnetic therapy, electrophoresis using trypsin and lidase, as well as UV irradiation. Additional treatment for iridocyclitis will prevent relapses and can also overcome residual symptoms of the disease.

Unconventional therapy is suitable for those who are plagued by chronic iridocyclitis. Treatment in this case involves:

Hirudotherapy, or treatment with leeches. You should place two leeches on the temple above the sore eye. The main condition for such therapy is the supervision of a qualified specialist.
Treatment with dry heat (applied to the sore eye).

Treatment

Diagnosis of the disease, in addition to traditional examinations of a local (tonometry, biomicroscopy, visometry, etc.) and systemic (general and biochemical blood test, allergy tests, radiography of the paranasal sinuses) nature, also includes rheumatic tests, coagulogram, PCR and ELISA, ultrasound of the eye . In addition, in the presence of systemic chronic pathologies, consultation with a specialist may be necessary: rheumatologist, dermatovenerologist, infectious disease specialist, etc.

Tonometry is the measurement of intraocular pressure.

Drug therapy

Treatment tactics with medications should first of all be aimed at eliminating the etiological factor that caused the disease: infectious, allergic, systemic.

Conservative treatment should be comprehensive and carried out in a timely manner. Only in this case can we hope to obtain positive results. Outpatient treatment is possible as prescribed by a doctor. However, if there is no expected effect within 5-6 days, treatment is continued in the hospital.

For therapy, drugs from the following groups are used:

Antibiotics and antivirals: Poludan, Floxal, Oftalmoferon, Gentamicin, etc. The drugs are used when the infectious nature of the inflammatory process has been identified;
Hormonal agents: Medrol, Hydrocortisone-pos, Novo-prednisolone, etc. The drugs are used as an anti-inflammatory and immunosuppressive agent;
NSAIDs (non-steroidal anti-inflammatory drugs): Indomethacin, Aspirin, Methindol. Used when there are contraindications to the use of hormonal drugs;
Mydriatics: Atropine, Cyclomed, Irifrin. The drugs are used to prevent pupillary fusion because they have a dilating effect;
Antihistamines: Suprastin, Claritin, Loratadine. The drugs have a pronounced antiallergic effect and are effective against allergic inflammation;
Immunomodulators: Cyclosporine, Imusporin, Evoral. Medicines are required for the general weakened state of the body.
Oftalmoferon is used in the treatment of iridocyclitis

As an additional treatment, the doctor may prescribe taking multivitamins and undergoing physical procedures: paraffin applications, UHF, warm compresses. If the patient has already developed adhesions or opacities of the vitreous, electrophoresis using hormonal drugs may help.

Surgically

Surgical intervention is resorted to in extreme cases if complications develop:

In the form of the appearance of adhesions, then they are dissected;
Development of secondary glaucoma - surgery is performed to restore the functioning of the drainage system of the eye.

In the most severe cases with a progressive purulent process, a doctor may prescribe surgery to remove the eye.

Folk remedies

Iridocyclitis is a rather complex and dangerous disease, so its treatment should be carried out primarily after qualified diagnosis under the supervision of an ophthalmologist. However, folk remedies can also be used, but only as a supplement to drug therapy:

Add 400 g of garlic chopped in a blender to freshly prepared lemon juice (1 l). The mixture is thoroughly mixed, placed in a glass container and stored in the refrigerator. Take 1 tsp. , previously diluted in 1 tbsp. boiled water 1 r. per day;
Crushed aspen bark (1 tbsp) is boiled in 0.5 liters of water for 15 minutes. , then leave for 3 hours. Take 200 ml infusion every other day, after adding 1 tbsp. l. honey The course of treatment is 21 days;
Leaves of 3-year-old aloe (0.5 kg) are placed in the refrigerator for 7 days, after which they are twisted in a meat grinder. Prepare a decoction of St. John's wort (30 g of dry herb per 0.5 liter of boiling water) for 0.5 hours and then leave for 40 minutes. Add 0.5 liters of white wine and 0.5 kg of honey to the crushed aloe and strained broth, mix and store in a cool, dark place. Take for a month three times a day: the first 5 days - 1 tsp. , after which the dose is increased to 1 tbsp. l.

Some recommendations for traditional treatment include warming the eyes with warm compresses: salt, sand, sunbathing. However, the process is inflammatory, so when using any folk remedy you should additionally consult a doctor.

Other treatments

If adhesions have formed as a result of the pathological process or secondary glaucoma has developed, surgical intervention may be necessary. In this case, the affected tissues are divided in case of fusion or removed if necessary. If large amounts of pus accumulate, surgical incision may be necessary to remove the exudate.

In addition to drug therapy, physiotherapeutic procedures are used. An ophthalmologist may prescribe laser therapy, magnetic therapy or electrophoresis.

Traditional medicine recommends using heat to eliminate illness. It is useful to be in the sun (but only with your eyes closed and following all the rules to avoid sunburn or heat stroke).

Dry warm compresses are also used. To do this, heat salt, sand or cereal, place it in a fabric bag and apply it to the affected eye.

The temperature of the compress should not exceed 40 degrees, and the duration of the procedure should not exceed 10 minutes.

To speed up recovery, you can take a decoction of aspen bark, a mixture of lemon juice and garlic, as well as a composition of aloe juice, St. John's wort infusion, white wine and honey. Such therapeutic measures can have a beneficial effect on the patient’s body and help eliminate the disease, but such methods can only complement drug therapy and not replace it. Otherwise, the untreated disease will become chronic and complications will arise.