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UVEITELE ANTERIOARE

Inflamatia irisului=IRITA iar inflamatia

corpului ciliar = CICLITA. De obicei lele

evolueaza concomitentIRIDOCICLITE.

Simptome subiective:

1. DURERI OCULARE2.FOTOFOBIE, LACRIMARE,

BLEFAROSPASM

3.VEDERE INCETOSATA

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SEMNE OBIECTIVE

1.CONGESTIE CONJUNCTIVALAPERIKERATICA

2.EDEM CORNEEAN ENDOTELIAL

3.MIOZA sau IREGULARITATE

PUPILARA

4.PRECIPITATELE RETROCORNEENE-celule inflamatorii localizate pe fata

posterioara a corneei.

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5.EXUDATE IN CAMERA ANT cu

aspect de fulgi de nea.

PurulenteHemoragice

Fibrinoase

6.TULBURAREA UMORII

APOASE

in functie de tipul exudatelorprezente.

7.ALTERAREA RELIEFULUI SI

CULORII IRIENE

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DIAGNOSTIC DIFERENTIAL

-CONJUNCTIVITE

-GLAUCOM ACUT

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ETIOPATOGENIE

Uveitele anterioare endogene apar

in cadrul unei boli manifeste sau latentece afecteaza organismul respectiv

1. Boli infectioase cronice (tbc.lues)

2. Infectii de focar

3. Boli de colagen (les,pr)

4. Boli SN5. Boli de piele (acnee rozacee,eritem

nodos)

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6. Boli reumatismale degenerative

7. Sarcoidoza

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FORME CLINICE

-d.p.d.v evolutiv *acute

*subacute

*cronice-d.p.d.v anatomo-patolgic:

*difuze-negranulomatoase

*nodulare-granulomatoase

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COMPLICATII-propagarea lor in intreaga uvee

-panuveite/ panoftalmie

-sinechiile iriene

-glaucomul secundar

- cataracta complicata-atrofia progresiva a G.O.

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TRATAMENT

Local- midriatice

- antibioticeinstilatii sau inj.subconjunctivale sau parabulbare

- cortizoninstilatii sau inj.subconjunctivale sau parabulbare

General - Antiinflamator

- Antibiotic

- Acetazolamida in

uveitele hipertensive

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Iridociclita acuta

http://images.google.ro/imgres?imgurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/toxoplasma_chorioretinitis.jpg&imgrefurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/clinical_symptoms.htm&h=158&w=193&sz=7&hl=ro&start=10&tbnid=cDl8wCIr-XnWqM:&tbnh=84&tbnw=103&prev=

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Uveita anterioara cu sinechii

cronice posterioare

http://images.google.ro/imgres?imgurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/Chorioretinitis.jpg&imgrefurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/uveitis.htm&h=178&w=248&sz=62&hl=ro&start=4&tbnid=WMibR3O7B-e20M:&tbnh=80&tbnw=111&prev=

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Precipitate

http://images.google.ro/imgres?imgurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/toxobilat.jpg&imgrefurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/uveitis.htm&h=198&w=482&sz=130&hl=ro&start=34&tbnid=HgDSgVcPWXjD9M:&tbnh=53&tbnw=129&prev=

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UVEITELE POSTERIOAREcand procesul inflamator afecteaza

coroida vorbim despre uveita posterioara

sau coroidita.

COROIDITELE EXOGENEse datoreaza patrunderii agentului

patogen in interiorul ochiului printr-o

plaga perforanta accidentala sauchirurgicala.

- stafilococ, streptococ,

pseudomonas, pneumococ, escherichia

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Tablou clinic

SEMNE SUBIECTIVE

- durere ocularaaccentuata la palpare sila miscarile globului ocular

SEMNE FUNCTIONALE

- scaderea acuitatii vizualeSEMNE OBIECTIVE

- edem si spasm palpebral

-congestie ciliara accentuata-plaga (daca exista) cu buze infiltrate

-hipopion

-sinechii posterioare, exudat pupilar

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Evolutie:

a) spre vindecare sub tratament

b) subacut complicandu-se cu secluzie- ocluzie

pupilara

c) spre panoftalmie dureri vii

chemozis ce herniaza

printre pleoapecornee tulbure

hipopion abundent

exudat galbui in pupilavitros cu reflex galbui, nu

se vizualizeaza fundul de ochi

glob ocular dur, exoftalm

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Tratament:

Local: -antibioatice cu spectru larg-midriatice

General: -antibiotice in doze mari

-antalgice, sedative, AINS

Chirurgical in cazul panoftalmiei in care

ochiul e pierdut functional si dezorganizat

anatomic. Se recomanda evisceratia.

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COROIDITELE ENDOGENE

I. COROIDITE EXOGENE

NESUPURATIVE

Etiopatogenia:

apar prin mecanism autoimun, alergic.

Cea mai frecventa cauza-TOXOPLASMOZA

Tablou clinic:

- senzatia de muste zburatoare

- metamorfopsii

- scaderea AV

- scotoame

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- Ochiul este alb fara congestie

conjunctivala- flocoane in vitros = exudate inflamatorii

FO: noduli albi galbui cu contur sterszone alb galbui marginite sau

presarate cu pigment negru peste care

vasele retiniene trec nemodificate. Acestaspect indica o leziune cicatricealasi se

datoreaza atrofiei coroidiene

http://images.google.ro/imgres?imgurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/toxoplasma_chorioretinitis.jpg&imgrefurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/clinical_symptoms.htm&h=158&w=193&sz=7&hl=ro&start=10&tbnid=cDl8wCIr-XnWqM:&tbnh=84&tbnw=103&prev=http://images.google.ro/imgres?imgurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/Chorioretinitis.jpg&imgrefurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/uveitis.htm&h=178&w=248&sz=62&hl=ro&start=4&tbnid=WMibR3O7B-e20M:&tbnh=80&tbnw=111&prev=

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http://images.google.ro/imgres?imgurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/toxobilat.jpg&imgrefurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/uveitis.htm&h=198&w=482&sz=130&hl=ro&start=34&tbnid=HgDSgVcPWXjD9M:&tbnh=53&tbnw=129&prev=http://images.google.ro/imgres?imgurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/toxoplasma_chorioretinitis.jpg&imgrefurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/clinical_symptoms.htm&h=158&w=193&sz=7&hl=ro&start=10&tbnid=cDl8wCIr-XnWqM:&tbnh=84&tbnw=103&prev=http://images.google.ro/imgres?imgurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/Chorioretinitis.jpg&imgrefurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/uveitis.htm&h=178&w=248&sz=62&hl=ro&start=4&tbnid=WMibR3O7B-e20M:&tbnh=80&tbnw=111&prev=

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Tratament:

- antiinfectios local si general- antiiflamator

- antialergic

Complicatii:

- cataracta complicata subcapsulara

posterioara- pierderea nervului optic realizan o

neurocorioretinita

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