Symptoms of uveitis

Symptoms of uveitis may be different, depending on the location of the inflammatory process, the resistance of the organism and the pathogenicity of the microorganism.

Acute anterior uveitis

Acute anterior uveitis is characterized by photophobia, pain, redness, decreased visual acuity and lacrimation. Chronic anterior uveitis can occur asymptomatically or with a slight reddening and a sensation of "floating points" in front of the eyes.

Pericorneal (ciliary) injection with acute anterior uveitis has a violet hue.

Corneal precipitates are cellular deposits on the corneal endothelium. By their nature and distribution, it is possible to establish the prospective type of uveitis. Corneal precipitates are most often located in the middle and lower parts of the cornea due to its shape and movement of fluid in the anterior chamber. However, with uveitis associated with Fuchs syndrome, corneal precipitates are scattered throughout the endothelium.

• endothelial dust caused by a multitude of cells occurs with acute anterior uveitis and with subacute flow of chronic inflammation;
• average corneal precipitates are more common in acute and chronic anterior uveitis;
• large corneal precipitates usually have the form of "droplets of fat" with waxy luster and are characteristic of granulomatous uveitis;
• old corneal precipitates - usually pigmented; the remains of large corneal precipitates can be represented as hyalineized deposits.

Cells determine the activity of the inflammatory process.

• the cells in the moisture of the anterior chamber are distributed in degrees depending on their amount, detected by biomicroscopy with an oblique slot 3 mm long and 1 mm wide, with maximum illumination and magnification;
  • <5 cells - +/- 0
  • 5-10 cells = +1;
  • 11-20 cells = +2;
  • 21-50 cells = +3;
  • > 50 cells = +4.
• cells in the anterior part of the vitreous humor should be compared in quantity with cells located in watery moisture. At irites, the cells but the moisture of the anterior chamber are much larger than their number in the vitreous.

Opalescence of watery moisture is caused by light scattering by proteins (the effect of Tyndall), which penetrate into watery moisture through damaged iris vessels. In the absence of cells, opalescence is not an indicator of the activity of the inflammatory process and does not require treatment. Classify in degrees as well as in the counting of cells in the anterior chamber.

• Weak degree: first detected = +1.
• Moderate degree: the details of the iris are clearly seen = +2.
• Expressed degree: the details of the iris are not clearly visible = +3.
• Intensive degree: the formation of fibrinous exudate - +4.

Nodules on the iris are a characteristic feature of the granulomatous nature of inflammation:

• Knurre nodules are small in size and located along the pupil margin;
• Busacca nodules are less common and are located closer to the periphery of the pupillary margin.

[1], [2], [3], [4], [5], [6], [7], [8]

Rear Sanctuaries

Rear synechiae represent a fusion between the iris and the anterior capsule of the lens. Formed in acute anterior uveitis, as well as with chronic anterior uveitis of moderate and severe degrees. Rear synechiae, located around the pupillary margin at 360 (seclusion pupilae). Lead to a violation of the circulation of aqueous humor from the back chamber to the anterior chamber, thereby causing a bombardment of the iris. This, in turn, helps to close the angle of the anterior chamber with the root of the iris and the appearance of secondary ophthalmic hypertension. After the rupture of the posterior synechia, the traces of the pigment of the iris may remain on the anterior lens capsule.

Other complications of chronic or recurrent uveitis: ribbon-like keratopathy, cataracts, glaucoma, macular edema, the formation of inflammatory membranes and the phthisis of the eyeball.

Posterior uveitis

In patients with localization of inflammatory foci at the periphery, complaints are noted about "floating points" before the eyes and blurring of vision. In acute choroiditis, the pathological process involves the foveal or paramacular region, which is the cause of the loss of central vision. Opacification in the vitreous remains a patient undetected.

Signs of posterior uveitis:

• Vitreit. Characterized by the presence of cells, opacities, opalescence and detachment of the vitreous. Inflammatory precipitates cover the surface of the posterior hyaloid membrane.
• Choroiditis. Appear deep, yellowish or grayish foci with clear boundaries. With an inactive inflammatory process, chorioretinal atrophic foci are white with clear boundaries and pigmented margins.
• Retinitis. The retina acquires a white, cloud-like appearance, the vessels are not clearly visualized. The contour of the inflammatory focus is fuzzy. It is difficult to draw a dividing line between the healthy and affected areas of the retina.
• Vasculitis. The most common are the veins of the retina (periflebit), less often - the arteries (ieriarteritis). The active periphlebitis is characterized by the presence of white accompanying bands along the course of the retinal vessels. The lesion is focal in nature with uneven protrusions of the vascular wall outwards. In some cases of periphlebitis, perivascular accumulation of granulomatous tissue occurs, which causes the appearance of a "dripping wax" pattern.

Macular edema

Include involvement in the inflammatory process of the macula, macular macular edema, macular ischemia, the formation of the epiretinal membrane, retinal vascular occlusion, neovascularization of the choroid, retinal detachment and optical neuropathy.