Sarcoidosis of the eye occurs in the form of bilateral flaccid inflammatory process in the choroid, retina and optic nerve. Signs of ocular sarcoidosis may be the first signs of systemic disease, and can be connected to other forms of sarcoidosis. Therefore, all patients with sarcoidosis necessarily vision checked.

Sarcoidosis of the eye - why it begins

Sarcoidosis of the eye - is a form of systemic disease in which may affect any organ system. Sarcoidosis of vision can occur as an independent disease, but more often it is a manifestation of systemic sarcoidosis.

Properties immune individuals predisposed to the disease, leading to the fact that, in response to some external stimulus (usually well-tolerated by others) have developed specific inflammation.

A feature of sarcoidosis is the formation in the tissues of various organs and tissue concentrations of inflammatory cells - granulomas. In sarcoidosis eye gpanulemy developed primarily in the choroid, retina and optic nerve. Sarcoidosis of the eye is not as common, but in recent years the incidence of this form of sarcoidosis is growing, which is clearly associated with improved detection of it.

The structure of the eye membranes

The human eye has three membranes: the outer, middle (vascular) and internal (the retina). The outer shell is the cornea (the front part - it is transparent, convex, passes and refracts light rays) and sclera (the rest of the non-transparent).

The choroid is the middle and consists of small blood vessels. The front part of the choroid is called the iris, the side - ciliary body, posterior - choroid (choroid). Choroid is connected to the retina and provides it with necessary nutrients.

The retina - is the inner membrane of the eye, it is composed of several layers of nerve cells, it displayed on the objects that we see. Information on them is then transmitted by the optic nerve to the brain.

The outer surface of the eye is covered by the conjunctiva - the thin protective coating consisting of a connective tissue framework, covered with epithelium.

Sarcoidosis of the eye - as it flows

Symptoms of ocular sarcoidosis is very diverse, is affected most often suffers choroid, especially the front office - the iris, ciliary body. Inflammation of the eye is called the choroid uevitom. Uevit can be front - with the inflamed iris (iris and ciliary body - iridocyclitis) and rear - inflamed choroid (choroiditis).

In sarcoidosis eye choroid usually develops bilateral iridocyclitis sluggish or front uevit. The inflammation may also be involved choroid, retina and optic nerve. The defeat of the choroid occurs in the form of granulomatous uveitis.

Another feature of sarcoidosis uveitis is the tendency to form adhesions causing bad pupil is expanded using medication, and this in turn leads to the development of secondary glaucoma Secondary glaucoma - against the backdrop of another disease   - Increased intraocular pressure.

In the long sarcoidosis Sarcoidosis - how to protect themselves?   the eye can lead to the development of cataracts (cataract) and blindness. The disease can also spread to the conjunctiva, oculomotor muscle tissue located behind the eyeball, lacrimal glands, lining of the brain.

Symptoms

Front uevit (iridouiklit) caused by sarcoidosis, begins with watery eyes, redness of eyes, intolerance of bright light. While checking visual acuity revealed its decline. At the same time restore sight How to restore vision - help their own eyes   using the plus or minus glass fails.

On examination also revealed sluggish pupil dilation - fully extend it is not possible even with atropita. When viewed from the eye can see thin spikes Adhesions - how to get rid of them? Which extend from the inner edge of the iris to the lens capsule. With light pressure on the eyeball patient feels pain and discomfort. Discomfort in the eyes of the majority of patients experiencing constant.

Rear uevit (choroiditis), if it is not combined with a front uevitom can manifest itself only by a decrease in visual acuity and visual fields violation. All changes in the choroid can be identified only by means of oftalnoskopii. At the same time the fundus can see signs of focal retinohorioidita - inflammation of the retina and choroid. In areas of inflammation at the same time developing specific granulomas.

Diagnosis and treatment

For the diagnosis of ocular sarcoidosis conduct multilateral ophthalmologic examination of patients. First performed ophthalmoscopy - fundus examination using an ophthalmoscope or a special lens. This allows you to assess the condition of the inner shells of the eye and the optic nerve.

There are also study histological tissue of the conjunctiva and lacrimal gland taken by biopsy.

For suspected ocular sarcoidosis conducted a full examination of the patient to identify sarkoidoznyh granulomas in other organs.

When detection of the disease is carried out using a complex treatment of local and systemic medications (mainly glucocorticoid hormones), symptomatic therapy. To date, the search for new effective treatments.

Galina Romanenko

Than to treat conjunctivitis, can tell a doctor because the symptoms of different types of conjunctivitis may be similar, but they require different treatment. For the treatment of conjunctivitis producing drugs and general topical (eye drops and eye ointment) having different properties.

Antibacterials from conjunctivitis

For the treatment of bacterial conjunctivitis are used antibacterial drugs mainly local action. In severe bacterial conjunctivitis drugs local action is sometimes not enough in such cases, prescribe antibiotics general (systemic) action in the form of tablets. Today, these pills are used by conjunctivitis, antibiotic tetracycline Tetracycline - a natural broad-spectrum antibiotic   doxycycline, azithromycin macrolide antibiotics group (sumamed) and dzhozimitsin (vilprafen), fluoroquinolone antibiotics (ofloxacin) and others. All of them are prescribed by the results of the preliminary examination of the patient.

But more often the treatment is still carried out using topical antimicrobials - eye drops and ointments. The most effective drugs are considered to be topical, which include fluoroquinolones, for example, 0, 3% eye drops and 0, 3% ophthalmic ointment for conjunctivitis ofloksotsin. Assign as tetracycline and erythromycin ophthalmic ointment, 20-30% solution of sodium sulfatsil (sulfacetamide), 0, 25% solution of chloramphenicol.

Antivirals in the conjunctiva

Viral conjunctivitis is today the most widely used, whereas for his treatment there are no safe and effective drugs for the treatment of bacterial conjunctivitis.

One of the old proven techniques is 0, 25% oxolinic ointment, viral conjunctivitis when she had been used extensively, but today found that the antiviral activity of the drug for the most part limited to influenza viruses and herpes simplex Herpes simplex - in fact, not so simple . When the most common adenovirus infection oxolinic ointment is ineffective. Nevertheless, it is prescribed and adenoviral conjunctivitis, laying behind the eyelid 1-3 times a day for 2-8 weeks. The same treatment in herpetic conjunctivitis. Oxolinic ointment is usually well tolerated, but can sometimes cause a slight burning sensation at the site of application. Contraindications for use of oxolinic ointment is a hypersensitivity to the drug.

For the treatment of adenovirus and herpes lesions of the eye is used 0, 05% bonaftonovaya eye ointment from conjunctivitis. It lay behind the eyelid 3-4 times a day for 7-10 days. 0, 5% ointment conjunctivitis florenal laying lids for initially 3 times a day and then 1-2 times per day. The course of treatment for superficial conjunctivitis about two weeks under deep - up to two months. If no effect within 10 days it is recommended to switch to other treatments. 3% ointment for the eyes of conjunctivitis acyclovir Acyclovir - as it is safe?   applied in herpetic eye disease in the form of a strip of 1 cm, which is put into the lower conjunctival sac five times a day until healing and for three days after healing

Antiviral eye drops include, for example, oftalmoferon, having in its composition interferon and diphenhydramine. The drug has an antiviral, immunomodulatory and anti-allergic effect. 1-2 drops administered to each eye 6-8 times per day. Contraindications for the use of drops is only individual intolerance of components.

In viral conjunctivitis beneficial effect on all parts of the immune system and have an eye drop derinat, which includes deoxyribonucleat. Derinata solution for external use was instilled into both eyes of 1-2 drops twice or three times a day for 4-8 weeks.

Eye drops Poludanum possess antiviral and immunomodulatory properties. The drug is used to treat viral diseases of the eye adenovirus and herpes etiology. The drops instilled into the conjunctival sac of the eye of the patient first 1-2 drops 6-8 times a day, and then, as the inflammation subsided - 3-4 times per day.

If eye irritation, including conjunctivitis allergic, eye drops well help vizin, vasoconstrictor and anti-edema properties. Visine eye drops are contraindicated if you are hypersensitive, glaucoma Glaucoma - a perspective possible blindness   and children up to two years.

Time initiated conjunctivitis adequate treatment can prevent the development of complications in the first place, by the cornea, which can end the partial or complete loss of vision.

Galina Romanenko