Uveitis
Introduction
Introduction Uveitis refers to inflammation of the iris, ciliary body, and choroid. The blood supply of the iris and ciliary body is the same as the iris ring. Therefore, the two are often inflamed at the same time, and they are collectively called iridocyclitis. If the choroid is also inflamed at the same time, it is called uveitis. Uveitis is an eye disease that occurs mostly in young adults. It has a wide variety of causes and complex causes. Improper treatment can lead to blindness. It plays an important role in blinding eye diseases and has attracted worldwide attention. Because the mechanism of its onset and recurrence is not completely clear, its prevention is impossible, and the treatment effect is also not ideal. Therefore, the search for reasonable and effective treatment drugs has become an urgent problem in the field of ophthalmology.
Cause
Cause
The etiology and pathogenesis of uveitis is mainly due to the invasion of external evils or internal heat; it is related to the dysfunction of liver, kidney and spleen. The liver is more spleen and bloody, the liver is vented, the liver is open to the eye, the liver is heated by the wind or the liver is stagnation, the heat is disturbed, the eye is burned, or the fat is sweet and fragrant, resulting in spleen and stomach dampness. Heat evil on the eyes, smoked and burned glutinous rice, or yin deficiency, long-term yin, liver and kidney yin deficiency, virtual fire on the inflammation, eye damage, or the adjacent tissue lesions in the eye and the intraocular veins cause blood Hoarding. Blood circulation disorder causes disease.
The causes and mechanisms of uveitis are quite complex, involving multiple factors such as traumatic infection and autoimmunity. Mainly divided into two categories of infectious and non-infective.
1. Infectivity: caused by bacterial, viral, fungal, rickettsia, parasitic and other pathogens.
2, non-infective: divided into exogenous and endogenous:
(1) External causes: It is caused by external factors. 1 Infectivity: such as bacteria, fungi, etc. through the trauma or surgical wound directly into the eye, easy to cause suppurative inflammation. 2 non-infectious: such as mechanical, chemical and thermal burns can cause uveitis, often accompanied by other changes in the eye.
(2) Secondary causes: uveal inflammation of the eye caused by other diseases. 1 The spread of inflammation in adjacent ocular tissues, such as severe keratitis or scleritis, can cause iridocyclitis. 2 eye endotoxin or irritant reactions, such as blind atrophy and degeneration of the eyeball, long-term retinal detachment, repeated intraocular hemorrhage and malignant tumor necrosis can cause uveitis.
(3) Intrinsic causes: 1 Infectivity: Pathogens or their products are spread through the bloodstream and enter the eye from other parts of the body, such as the metastasis of obvious infections or the disease process in which the source of infection is clear. Bacterial infections such as tuberculosis, syphilis, leptospirosis, or protozoal infections such as herpes simplex, herpes zoster, or toxoplasmosis, as well as parasitic infections such as aphids and cysticercosis may cause uveitis. 2 non-infectious: many endogenous uveitis can not detect pathogens, often have immune abnormalities. Such as crystal-derived uveitis, sympathetic ophthalmia, Fuchs iris heterochromic iridocyclitis, intermediate uveitis, or anterior uveitis with systemic diseases such as rheumatoid arthritis, Vogt-Koyanagi - Harada disease, Behcet's disease, systemic lupus erythematosus, sarcoidosis, etc.
Examine
an examination
Related inspection
Ultrasound examination of eyeballs and eyelids by ophthalmoscopy
1. If you find redness, pain, photophobia, tearing, decreased vision or no redness or pain, but there are black shadows floating in front of you, blurred vision or visual distortion, people with flashing sensation and decreased vision may have uveitis. Go to the relevant specialist for a detailed examination to confirm the diagnosis.
2, once the diagnosis of uveitis, should be actively treated, dilated sputum is a necessary measure to treat anterior uveitis, can prevent pupillary adhesions, to avoid the production of secondary glaucoma and complicated cataract; hormone is the treatment of uveitis Commonly used drugs, but with side effects, whether systemic or topical, must be used under the guidance of a doctor, should not be abused.
3, uveitis patients should be reviewed regularly to prevent recurrence, such as conscious symptoms of recurrence, should be diagnosed early.
4, active exercise, enhance physical fitness, prevent colds, eat less irritating food, pay attention to work and rest, maintain physical and mental health, is also important to prevent uveitis.
Diagnosis
Differential diagnosis
Differential diagnosis:
(a) anterior uveitis:
1. Eye pain, photophobia, tearing, and decreased vision.
2, ciliary congestion or mixed congestion.
3, turbid aqueous humor, there are sediments behind the cornea, and even anterior chamber fibers exudation or anterior chamber empyema.
4, the iris is swollen, the texture is unclear, and the adhesion after the pupil.
5, accompanied by systemic manifestations.
(B) after uveitis (choroiditis):
1. The visual acuity is seriously degraded, and the degree of vision loss depends on the degree of opacity of the lesion and the vitreous. If it occurs in the macula, it will seriously affect vision.
2, the sense of flash, the symptoms of retinal irritation caused by inflammation.
3, vision deformation, caused by edema or exudation caused by disordered arrangement of retina and visual cells.
4, fundus examination: visible multiple exudation, omental edema and fundus hemorrhage; late patients can see fundus pigmentation, sunset-like fundus, scar, proliferative changes, and subretinal neovascularization.
(three) total uveitis:
When the iris, ciliary body and choroid are accompanied by inflammation at the same time or in succession, it is called total uveitis.
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