Iridocyclitis Complications, Treatment, and Prevention

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Iridocyclitis is an ophthalmic disease accompanied by inflammation of the iris and ciliary body and is characterize with a chronic recurrent course with the development of complications leading to a  decrease in visual acuity. 

Usually, the red color of the eye can cause this problem. It could be due to some environmental or sometimes due to changing weather condition. 

Usually, the inflammatory process affects the iris, leading to irita, and the ciliary body, provoking cyclist, these diseases occur in parallel. And therefore the condition is called iridocyclitis. Predisposing factors can be acute viral, infectious and bacterial diseases, fungal infection, hypothermia. As well as dental diseases, nasopharynx, and eye trauma.

The clinical picture of iridocyclitis can manifest itself at any age, young people 20-40 years old are more likely to suffer. Symptoms characteristic of this eye disease are inflammation, signs of immune cytolysis, dysfermentosis, and changes in microcirculation.

 In each case, there are painful sensations in the eye and the okolovisochnoy area, photophobia, discoloration and smoothing of the figure of the iris. Narrowing of the pupil, lacrimation, turbidity of the vitreous, lowering of intraocular pressure and a decrease in visual acuity. 

Patients often complain about the presence of a “veil” before the eyes and unbearable pain, and the appearance of photophobia arises from the swelling of the iris, which causes the pupil to contract. When examined, the vessels of the mucosa are markedly enlarged, the color of the iris varies from red to rusty-green

With pressure on the eyeball, there is an increase in pain; there is an accumulation of purulent contents in the anterior chamber of the eye. Iridocyclitis is dangerous with such possible complications as synechia.

Which subsequently provokes constriction, pupillary deformity and even absolute pupillary involvement, which can lead to complete loss of vision and deep amblyopia.

Types of  iridocyclitis depend on the current and can be:

  • sharp;
  • subacute;
  • chronically recurrent.

Also, in the systematization of iridocyclitis infectious, infectious-allergic, post-traumatic and some other variants of manifestation are noted.

Diagnosis of the disease is carried out by patient complaints and microscopy of the anterior chamber of the eye with the detection of a significant amount of purulent exudate in the form of a strip or gray-yellow crescent. Rupture of the vessel, which lead to a change and reddening of the color, up to red. Differential diagnosis is carried out with a sharp attack of glaucoma and conjunctivitis.

For complex treatment, first of all, it is necessary to establish the cause of the disease, for which it is required to consult an ophthalmologist. It is known that the sooner they start therapy, the less the risk of complications. The first emergency aid for acute iridocyclitis is a therapy aimed at dilating the pupil and stopping the severe pain.

What is conjunctivitis Called?

 

Conjunctivitis is a term for inflammation of the mucous membranes of the eye. In addition to simple conjunctivitis, blepharoconjunctivitis, episcleritis, and keratoconjunctivitis are also recognized. The cause of this inflammation can become a variety of viruses, bacteria, fungi, allergens or chemical agents.

 Sometimes the symptoms of conjunctivitis are the first manifestations of the severe disease. It may include rheumatoid arthritis, SLE, diffuse toxic goiter, Kawasaki disease, rubella, Crohn’s disease and ulcerative colitis.

Conjunctivitis caused by viruses or bacteria is very contagious. They are easily transmitted from person to person when coughing, sneezing or through dirty hands. Children with such conjunctivitis should be isolated from children’s collectives until they are completely cured. Allergic and chemical conjunctivitis is not dangerous to others.

How is conjunctivitis manifested?

This disease has several characteristic features, most often one eye suffers, but if the hygiene rules or allergies are not observed, a bilateral defeat is possible.

  • Redness of the eyes – redness is one of 5 classic signs of the inflammatory process;
  • Edema and redness of the eyelids – this symptom is not necessary, but it occurs quite often, especially with bacterial and allergic conjunctivitis;
  • Lachrymation is a protective reaction of the body to damage to the mucous membranes of the eye;
  • Itching or burning in the eyes;
  • Detachable from the eyes – watery discharge is a sign of viral or allergic conjunctivitis, greenish-yellow – characteristic of bacterial
  • Folding eyelids – it is usually difficult for patients with conjunctivitis to open their eyes after sleeping since the eyelashes are glued together
  • Photophobia – this symptom occurs with any conjunctivitis, but severe pain and intense sensitivity to light, may be a sign of infection spread beyond the conjunctiva.
  • The sensation of a foreign body in the eye – with conjunctivitis, you may think that the eye has got villi or sand, which you can not get rid of. This symptom often occurs with conjunctivitis in children.

How is conjunctivitis diagnosed and treated?

Most often the doctor makes a diagnosis after examining and questioning the patient by complaints and a clinical picture; this is done entirely only due to the bright and typical symptoms of the disease.

In some cases, a slit lamp may be required. If conjunctivitis has an atypical course or is not amenable to cure, then sowing of the separated from the eye will help to establish the reason on which the physician can choose an effective therapeutic regimen.

Iridocyclitis
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Although conjunctivitis has unpleasant symptoms, it rarely runs for a long time or causes complications with proper treatment and hygiene measures.

Antibacterial components in eye drops and ointments are useful only in the treatment of bacterial conjunctivitis. In viral infections, specific treatment often does not exist, and only eye treatment and hygiene are required.

Viral conjunctivitis usually lasts 4-7 days. With pollinosis, specific anti-allergic therapy is needed to relieve the symptoms of conjunctivitis. If you have burned the eye with a chemically active substance, you should immediately wash it with water for 5 minutes and immediately consult a doctor.

How to prevent infection?

If someone is sick with conjunctivitis, always wash your hands thoroughly and try not to touch the area around your eyes. Wash your hands before and after applying the medicine to the eyes.

 To avoid the spread of infection, the patient should use disposable towels, healthy ones – individual, and replace them daily. Change bed linen daily if it gets detached from the eyes. Carry out regular disinfection of surfaces: flooring, countertops, and door handle.

 Throw away all the decorative cosmetics for the eyes, if you used it during the illness, to avoid re-infection.

Iridocyclitis: complications, treatment, and prevention

One of the most common inflammatory diseases of the eye is inflammation of the iris and ciliary body. Due to the generality of the blood supply to the iris and the ciliary body, an isolated lesion of only the iris – iris or just the ciliary body (cycle) is rare. More often the inflammatory process captures the entire anterior section of the vascular tract and the iris and the ciliary body – iridocyclitis.

The classification is divided into the following groups:

  • Infectious and infectious-allergic;
  • Allergic non-infectious;
  • With systemic and syndromic diseases;
  • With pathological conditions of the body and metabolic disorders;
  • Post-traumatic.
What is dangerous in iridocyclitis
Complications of iridocyclitis – it is possible to spread the inflammatory process to the cornea, sclera, posterior parts of the vascular tract, retina, and optic nerve.
There is also fusion and infection of the pupil, secondary glaucoma, retinal detachment, eyeball subatrophy after severe (long-lasting) fibrinous-plastic iridocyclitis.
Cure and prevent
IridocyclitisTreatment of iridocyclitis should be comprehensive with the inclusion of funds that affect the etiological factors, the inflammatory process in the iris and ciliary body, as well as the immune mechanisms in the patient’s body. The first help consists in prescribing the dilating pupils, to prevent the development of adhesions and the removal of pain syndrome.
Systemically, they use modern antibacterial agents. In the drops are prescribed antibiotics, anti-inflammatory drugs.
In most cases, drugs are injected subconjunctivally (injections under the mucosa of the eyeball).
Physiotherapeutic treatment in ophthalmology with iridocyclitis is used very efficiently. It uses electrophoresis with antibiotics, enzymes, adrenaline, etc. (up to 15 procedures).
When the process is calmed down, resorption therapy is shown, including electrophoresis with aloe extracts and thermal procedures.
In the development of iridocyclitis, the effect of provoking factors of the external or internal environment, leading to the repeated entry of antigens into the eye tissue from the foci of infection, is of great importance.

The provoking factors are:

  • cooling,
  • injuries,
  • endocrine changes in the body,
  • visual fatigue.

Therefore, the prevention of iridocyclitis is the timely treatment of the underlying disease and the elimination of chronic foci of infection.

The peculiarities of the patient’s behavior with iridocyclitis do not exist. It is necessary to avoid provoking factors, strictly follow the recommendations of an ophthalmologist and in no case to engage in self-medication.
Based on the article “Iridocyclitis.”

Causes and symptoms of iridocyclitis

The objectives of iridocyclitis are diverse. In approximately 60% of cases, iridocyclitis is an isolated, independent disease. In the remaining 40% of cases, the association of iridocyclitis with other conditions: infectious and non-infectious.
Iridocyclitis can be caused by an infection that has come through the blood from various foci, where it can be for a long time in an inactive (latent) state. Iridocyclitis rarely occur, when a direct connection with an acute infectious disease that occurs first, for example, leptospirosis, toxocariasis, Lyme disease, etc., is revealed.

Most often, iridocyclitis is associate with infections:

  • virus;
  • toxoplasmosis
  • tuberculosis
  • chlamydia
  • syphilis and others

And also with non-infectious diseases:

  • sarcoidosis
  • rheumatoid arthritis
  • Reiter’s illness
  • Bechterev’s disease
  • Behcet’s disease, etc.

How To Recognize Iridocyclitis?

For inflammation in the anterior segment of the choroid, it is characteristic:

  • redness of the eye;
  • pain in the eye;
  • change the shape of the pupil;
  • decreased vision;
  • The appearance of products of inflammation in the eye.

Iridocyclitis

The onset of iridocyclitis is most often acute, inflammation during the day can lead to a change in the shape of the pupil – it becomes narrow, non-circular, rigid (does not respond to light), does not expand. There is a clumping of the pupil’s edge with the lens. If the pupil sticks to the lens completely (round), watery moisture begins to accumulate in the back chamber and bulges the iris – there is a “bombardment of the iris” and an increase in intraocular pressure – hypertension.

One of the characteristic features of iridocyclitis is the appearance of products of inflammation in the eye. These are grayish lumps of various sizes that settle on the posterior surface of the cornea. Sometimes precipitates are the only visible signs of the onset or ongoing iridocyclitis. In chronic forms of iridocyclitis, they can be present in the eye for many months.

The diagnosis of iridocyclitis is based on a complex clinical and laboratory examination of the patient. In some cases, it is necessary to consult the related specialists – doctors of different profiles. Based on the article “Iridocyclitis.”

Acute and Chronic Iridocyclitis

The term “iridocyclitis” means inflammation of the iris and ciliary body. Anatomically, the iris and ciliary body are the parts of the choroid of the eye; therefore, in the overwhelming majority of cases, both structures are involved in the inflammatory process. However, with isolated lesions of the iris and ciliary body, respectively, talk about irity and cyclite.

The cause of inflammation of the anterior parts of the choroid is most often unknown but can cause some common inflammatory diseases of the body, infection, eye surgery or trauma.
Iridocyclitis can affect both one and both eyes. There are two forms of iridocyclitis – acute and chronic.
Acute Iridocyclitis
Iridocyclitis

The following symptoms characterize acute iridocyclitis: 

  • severe pain in the eye;
  • photophobia
  • lacrimation
  • a headache.

Characterized by the widespread reddening of the thick membrane of the eye around the cornea with a lilac shade, a discoloration and streakiness of the iris pattern, constriction and deformation of the pupil, reduced reaction to light.

In severe cases, turbidity in the vitreous humor is determined. The disease is long, with relapses.
Influenza iridocyclitis occurs and proceeds acutely; the pain syndrome is expressed slightly. The development of disturbances manifests itself in a sharp inflammatory reaction, the appearance of serous fluid, the deposition of inflammatory substances in the form of small dots on the back surface of the cornea.
Rapidly appear splices of the pupillary margin of the iris with the anterior capsule of the lens in the form of separate pigment points.
Over time, as a result of increased vascular permeability of the ciliary body in the vitreous body, delicate turbidity develops. The outcome of the process is favorable, but relapses are possible. One eye is often affected.
Rheumatic iridocyclitis begins acutely and violently leaks. There is a hemorrhage in the anterior chamber, as well as under the conjunctiva; there is a sharply mixed injection of the eyeball. Exudation has a gelatinous character, insignificant, but there are numerous pigmented points.
The vitreous humor is rarely involved in the pathological process. Both eyes are affected. The disease occurs in autumn and spring, coincides with relapses of rheumatism.
Iridocyclitis with collagen diseases. The most studied is iridocyclitis in infectious nonspecific polyarthritis. The defeat of the eye arises suddenly; its flow is sluggish.
The earliest signs are small deposits of inflammatory substances on the back surface of the cornea at the inner and outer corners. Subsequently, ribbon-like and multiple dry deposits appear on the posterior surface of the cornea, as well as tender band-like opacities in the thick layers of the cornea near the inner and outer limbs.
Subsequently, on the cornea, the ribbon-like and multiple opacities become gross, capture the cornea throughout the entire glottis. Infection of the pupil and turbidity of the vitreous can be observed. The secondary cataract develops. Most often affected by both eyes.
Chronic iridocyclitis
A sluggish recurrent course characterizes chronic iridocyclitis; there is a slight pain, some redness, often coarse adhesions of the iris with the lens, deposition of fluid in the vitreous, atrophy of the eyeball.

A significant role in the development of chronic iridocyclitis is played by:

  • herpes simplex virus;
  • tuberculosis
  • penetrating wounds of the eye.

Tuberculosis iridocyclitis has a lingering flow, appears gradually, characterized by the appearance in the iris of new vessels that sometimes fit and surround single or multiple tuberculous tubercles. One eye is often affected.

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Iritis and iridocyclitis

 

Iridocyclitis formally known as the iris is ciliary body of the eye. It arises by common diseases of the body (tuberculosis, rheumatism, tonsillitis, flu, polyarthritis, chronic typhoid, gout, diabetes, syphilis, gonorrhea, etc.), dental diseases, adnexal sinuses when there is drift with the bloodstream of pathogens or their toxins in iris and ciliary body.
Inflammation can begin in the iris (iritis), then spread to the ciliary body (cyclilite) or the process simultaneously covers both membranes – iridocyclitis develops.
Iritis is accompanied with photophobia, lacrimation, pain in the eye, hyperemia of the conjunctiva of the eyeball.
The color and the iris pattern changes, the pupil narrows, the moisture in the anterior chamber of the eye often becomes turbid; there are adhesions between the pupillary margin of the iris and the lens bag (can be easily detected with the dilatation of the pupil).
In iridocyclitis, the symptoms of the iris are joined by the signs of a cyclitis: pain in the eye is increased, visual acuity is reduced, grayish dotted deposits appear on the posterior surface of the cornea, and vitreous opacification develops.
Intraocular pressure is usually normal or slightly decreased. When palpating the eyeball, there is a sharp pain.
Iridocyclitis, with proper treatment, usually ends in recovery with the recovery of vision. In some forms of iridocyclitis, for example, in rheumatic iridocyclitis, relapses of inflammation can occur, which often lead to persistent loss of vision.
With severe current iridocyclitis, complications can occur in the form of pupillary invasion, the increment of the pupillary margin to the lens bag, resulting in secondary glaucoma.
This complication threatens with blindness. That is why in this case it is essential not to miss the moment and to make a timely surgical intervention.
Diagnosis and principles of treatment of iridocyclitis
Iridocyclitis is detected by examining the eye with a slit lamp. In addition to the symptoms listed above, the doctor discovers the inflammatory cells in the anterior chamber of the eye as a light suspension.
 With a large number of cells, they settle on the bottom of the anterior chamber in the form of a drop of pus. Spiny deposits of protein are found on the back of the cornea.
Also, the doctor will necessarily check the posterior parts of the eye to exclude their involvement in the inflammatory process.

For the treatment of iridocyclitis, anti-inflammatory preparations of the steroid and non-steroidal series are prescribed, both topically in drops and ointments, and in injections and tablets. Also, droplets dilating the pupil are used to avoid soldering the pupil with the lens, narrowing the dilated vessels, reducing inflammation.

Iridocyclitis and its types

So, iridotsiklity are:

There is also granulomatous and non-granulomatous iridocyclitis. Granulomatous iridocyclitis develops mainly in certain infections and is characterized by the formation of granulomas in the iris and ciliary body, consisting of lymphoid, epithelioid, giant cells and foci of necrosis.
Non-granulomatous iridocyclitis is characteristic of infectious-allergic and autoimmune processes. They are characterized by edema, fibrinous exudation of the iris and ciliary body.

Iridocyclitis has a diverse clinical picture, which depends on the factors that caused iridocyclitis. Common symptoms of the disease are pain that spreads along the trigeminal nerve, pain in palpation of the eye and the appearance of a ciliary (deep) violet-pink injection of the eyeball.

The iris is always swollen, hyperemic may be greenish or rusty, its pattern is indistinct, the pupil is narrowed, and there are often spikes between the pupillary margin of the iris and the anterior lens bag. Toxico-allergic iridocyclitis in certain diseases of the body has a very characteristic clinical picture.

Rheumatic iridocyclitis is manifested by moderate swelling and iris of the iris, especially in the area of its sphincter. The course of rheumatic iridocyclitis is relatively favorable. The process can recur. More often one eye is affected.
Gouty iridocyclitis occurs in the elderly as a result of the toxic effect of uric acid and its salts on the eye tissue. It usually starts suddenly, like a gout attack. At an early stage, the thick layers of the iris and ciliary body are affected. The current is resistant to relapses. The opacity of the vitreous can complicate the process.
Diabetic iridocyclitis is usually bilateral, arises unnoticeably and proceeds sluggishly with a minor inflammatory reaction.
Gonorrheal iridocyclitis develops more often as a toxic-allergic process and less often as a metastatic one.
Toxico-allergic iridocyclitis, which does not have specific features, can arise due to the effect on the vascular tract of toxic products of decay of the intraocular tumor, in patients with retinal detachment.
Metastatic iridocyclitis includes tubercular, syphilitic, brucellosis, etc. Tuberculosis iridocyclitis often occurs in diffuse form and, less frequently, in granulomatous. Syphilitic iridocyclitis develops more often during secondary syphilis. Brucellosis iridocyclitis is usually unilateral, proceeds in acute or chronic form. In the outcome of the disease, cataract and secondary glaucoma may develop.
For acute purulent iridocyclitis, sharply expressed phenomena of inflammation and pain in the eye are characteristic.
Traumatic iridocyclitis occurs after penetrating wounds of the eye.
Purulent iridocyclitis usually develops in the 2-3 days after the injury of the eye, it is difficult. Spreading the process to the posterior part of the eyeball leads to endophthalmitis and panophthalmitis.
The main thing is to eliminate the cause
If you suspect that iridocyclitis should immediately consult a doctor. Treatment should be directed against the purpose of iridocyclitis and is performed at the direction of the ophthalmologist.
Prevention of iridocyclitis – treatment of the underlying disease, elimination of foci of infection (sanction of the mouth, treatment of tonsillitis, inflammatory diseases of the paranasal sinuses).
Iridocyclitis in his treatment usually ends with recovery with the recovery of vision. In some forms of iridocyclitis, for example, with rheumatic fever, relapses of inflammation can occur, which often lead to a persistent decrease in vision.
With severely current iridocyclitis, complications can occur in the form of pupil infestation by organized exudate (fluid), the increment of the pupillary margin all the way to the lens bag, resulting in secondary glaucoma. Usually, if you do not resort to surgery promptly, this complication leads to blindness.

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