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"lead": "Нарушение здоровья, относящееся к группе болезни склеры, роговицы, радужной оболочки и цилиарного тела",
"description": " \r\n\r\nИридоциклитом называют сочетанное поражение воспалительным процессом радужной оболочки и цилиарного тела глаза. Кровоснабжение радужки и цилиарного тела является общим, и воспалительный процесс в одном из них (циклит или ирит) быстро распространяется на другой участок глаза.",
"etiology": "<p>Причины иридоциклита весьма многообразны. К ним относятся: </p>\r\n<ul>\r\n<li>Травмы зрительного анализатора — проникающие ранения, ушибы, инородные тела, последствия хирургического лечения, </li>\r\n<li>Воспаление роговицы или склеры, </li>\r\n<li>Вирусная инфекция — гриппозная, коревая, герпетическая, цитомегаловирусная, </li>\r\n<li>Патогенные и условно-патогенные бактерии — стафилококки, стрептококки, палочка Коха, гонококки, бледная трепонема, хламидии, токсоплазмы, </li>\r\n<li>Патогенные грибки — кандиды, актиномицеты, </li>\r\n<li>Различные гельминтозы и паразитозы, </li>\r\n<li>ЛОР-заболевания — отиты, синуситы, тонзиллиты, </li>\r\n<li>Стоматологические заболевания — кариес, стоматит, прикорневые кисты, </li>\r\n<li>Аутоиммунные заболевания — ревматоидный артрит, склеродермия, саркоидоз, спондилоартроз, </li>\r\n<li>Аллергия на продукты питания, лекарственные препараты, </li>\r\n<li>Эндокринопатии — сахарный диабет, гиперфункция щитовидной железы. </li>\r\n</ul>",
"pathogenesis": "<p>Воздействие этиологических факторов ведёт к образованию и проникновению в кровоток циркулирующих антигенов, поступающих из внеглазных очагов инфекции или других источников сенсибилизации. </p>\r\n<p>Воздействие эндогенных (хронические инфекции, длительный стресс) или экзогенных (травма, переохлаждение, острые инфекции) причин ведёт к нарушению проницаемости гематоофтальмического барьера и способствует осаждению иммунных комплексов в тканях увеального тракта глаза, частью которого являются радужная оболочка глаза и ресничное тело. Иммунологическое повреждение структур глаза происходит при участии медиаторов воспаления — гистамина, серотонина, ацетилхолина, лимфокинов, простагландинов и комплемента. Образование комплексов «антиген—антитело» сопровождается симптоматикой иридоциклита: воспалением, васкулопатиями, явлениями иммунного цитолиза, дисферментоза, нарушениями микроциркуляции с исходом в рубцевание и дистрофию тканей. Выраженность клинических проявлений зависит от природы и продолжительности воздействия антигена, степени нарушения гематоофтальмического барьера, состояния иммунитета и обусловлена генотипом организма. </p>",
"diagnostics": "<p>Диагноз иридоциклита устанавливают по результатам комплексного обследования: офтальмологического, лабораторно-диагностического, рентгенологического, консультирования больного узкими специалистами. </p>\r\n<p>Первоначально врачом-офтальмологом проводится наружный осмотр глазного яблока, пальпация, сбор анамнестических данных. Для уточнения диагноза иридоциклита выполняют проверку остроты зрения, измерение внутриглазного давления методом контактной или бесконтактной тонометрии, биомикроскопию глаза, выявляющую поражение глазных структур, УЗИ глаза с одномерным или двухмерным изображением глазного яблока. Процедура офтальмоскопии при иридоциклите часто затруднена из-за воспалительно измененных передних отделов глаза. </p>\r\n<p>Для выяснения этиологии иридоциклита назначают общий и биохимический анализы крови и мочи, коагулограмму, ревмопробы для выявления системных заболеваний, аллергопробы (местные и общие реакции на введение аллергенов стрептококка, стафилококка, специфических антигенов: туберкулина, токсоплазмина и др.), ПЦР и ИФА-диагностику возбудителя воспаления (в т. ч. сифилиса, туберкулеза, герпеса, хламидиоза и т. д.). </p>\r\n<p>Для оценки иммунного статуса выполняют исследование уровня сывороточных иммуноглобулинов в крови IgM, IgG, IgA , а также их содержание в слезной жидкости. </p>\r\n<p> </p>",
"treatment": "<p>Плановое лечение иридоциклита проводится в условиях стационара, его основу составляет местная и общая антисептическая, антибактериальная или противовирусная терапия, введение противовоспалительных нестероидных и гормональных препаратов (в виде глазных капель, парабульбарных, субконьюнктивальных, внутримышечных или внутривенных инъекций. Кортикостероиды широко используются в лечении иридоциклита токсико-аллергического и аутоиммунного генеза. </p>\r\n<p>При иридоциклите проводится дезинтоксикационная терапия (при выраженном воспалении - плазмаферез, гемосорбция), инстилляции растворов мидриатиков, предотвращающих сращение радужки с хрусталиком. Назначают антигистаминные средства, поливитамины, иммуностимуляторы или иммуносупрессоры (в зависимости от основного заболевания), местно-протеолитические ферменты для рассасывания экссудата, преципитатов и спаек.</p>\r\n<p>Часто при иридоциклите применяются физиотерапевтические процедуры: электрофорез, магнитотерапия, лазерная терапия. </p>\r\n<p>Хирургические лечение иридоциклита проводится при необходимости разделения спаек или (рассечение передних и задних синехий радужки), в случае развития вторичной глаукомы. В случае тяжелого осложнения гнойного иридоциклита с лизисом оболочек и содержимого глаза показано хирургическое удаление последнего (энуклеация, эвисцерация глаза). </p>\r\n<p> </p>",
"prevention": "<p>Профилактика иридоциклита заключается в следующих мероприятиях: </p>\r\n<ul>\r\n<li>своевременной санации хронических очагов инфекции; </li>\r\n<li>своевременном выявлении и адекватном постоянном лечении системных заболеваний; </li>\r\n<li>укреплении иммунитета; </li>\r\n<li>безотлагательном обращении к врачу при первых признаках воспаления глаза. </li>\r\n</ul>",
"clinical_picture": "<p>Классические симптомы острого проявления иридоциклита: </p>\r\n<ul>\r\n<li>боль и дискомфорт; </li>\r\n<li>покраснение глаза; </li>\r\n<li>слезотечение; </li>\r\n<li>непереносимость яркого света; </li>\r\n<li>появление тумана перед глазами; </li>\r\n<li>снижение остроты зрения; </li>\r\n<li>появление в передней камере желтого или красного выпота; </li>\r\n<li>изменение цвета радужной оболочки; </li>\r\n<li>головная боль. </li>\r\n</ul>\r\n<p>Снижение остроты зрения при иридоциклите обусловлено отеком роговой оболочки и оседанием на ее внутренней поверхности преципитатов. Помимо этого, во внутриглазной жидкости могут появляться клеточные элементы, вызывающие ее опалесценцию (симптом Тиндаля). </p>\r\n<p>Все это приводит к нарушению прозрачности оптических сред глаза и появлению тумана перед глазами </p>\r\n<p>Хронический иридоциклит глаза проявляется аналогичными симптомами, но менее выраженными и плохо поддающимися лечению. Хроническое воспаление приводит к атрофическим изменениям в глазу. Радиально идущие сосуды переполняются кровью, становятся прямыми и длинными. Это приводит к сужению зрачка и ограничению его подвижности. </p>",
"image": null,
"image_alt": null,
"standard_type": 3,
"danger": 1,
"published": 2,
"parent": null,
"block_rubric": 77,
"standards": []
}
]
}
