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Tashkent Medical Academy Department of Ophthalmology Keratitis • The purpose of the training session: Doctors of any specialties need to know about such ocular pathology as diseases of the vascular tunic and cataracts. Often it is a local manifestation of many common diseases of the body: rheumatism, diabetes, tuberculosis, chronic and acute infectious disease, thyroid disease, etc. Doctors should be able to diagnose and treat patients with this pathology. It is also necessary to be able to carry out prevention of possible complications arising at these diseases. • Pedagogical objectives: • Deepen knowledge on the clinical course of iridocyclitis and chorioretinitis and cataracts. • Develop the ability to select the correct algorithm of actions at iridocyclitis and cataracts. • Criteria for the diagnosis of complications of iridocyclitis and cataracts. • Tactics of GPs in acute iridocyclitis • Modern methods of treatment of cataract • The student should be able to: • Identify risk factors at iridocyclitis and cataracts • Conduct clinical examination with laboratory and instrumental methods. • Disclose the criteria for diagnosis • • Make his/her own decisions and determine admission criteria in RMC (rural medical center). • Learning outcomes: The student should know: • Clinical features of iridocyclitis, chorioretinitis and cataracts • Develop the ability to select the correct algorithm of actions at iridotsiklitah and cataract • diagnostic criteria for complications of iridocyclitis, chorioretinitis, and cataracts. • GPs tactics in acute iridocyclitis • Modern methods of cataract treatment Scheme of eye bulb Cornea n.opticus Light Pupil Lens Sclera Retina Structure of cornea Anomalies of cornea • Microcornea • Megalocornea • Keratoconus • Keratoglobus • Congenital dimness of cornea Megalocornea Congenital dimness of cornea Keratoconus Sharp keratoconus with edema of cornea Classification (A.I Volokonenko) • Exogenous keratitis. 1. Erosion of cornea. 2. Traumatic keratitis. 3. Bacterial keratitis. 4. Keratitis which caused by disease of conjunctivas and palpebra. 5. Fungous keratitis. Classification • Endogenous keratitis 1. Infectious keratitis. а. tubercular б. syphilitic в. herpetic 2. Neuroparalitic keratitis. 3. Avitaminous keratitis. Corneal syndrome • • • • • Photophobia. Lacrimation. Blepharospasm. Feelness of foreign body in the eye Pericorneal injection. Creeping ulcer of cornea •Creeping ulcer •Iridocyclitis. •Hypopyon. Bacterial ulcer of cornea Creeping ulcer of cornea Marginal keratitis Fungous keratitis Tubercular keratitis • Tubercular-allergic keratits • Hematogenic tubercular keratitis. 1. Deep diffuse keratitis. 2. Deep infiltrate of cornea. 3. Sclerosing keratitis. Tubercular-allergic keratits Miliary flicktens Tubercular-allergic keratoconjunctivitis Deep diffuse keratitis Deep infiltrate of cornea Sclerosing keratitis Parenchymatous syphilitic keratits • Congenital syphilitic keratitis Triad of symptoms: 1. Getchenson’s teeth 2. Saddle-like nose 3. Acinaciform cruses • Acquired syphilitic keratitis Meet seldom Three periods of syphilitic keratitis: • Infiltration (duration: 3-4 weeks). • Vascularization (duration: 6-8 weeks). • Resolution (duration: 1-2 years). Infiltration period Vascularization period Resolution period Herpetic keratitis (classification of A.B Kancelson) • Primary herpetic keratitis 1. Epithelial keratitis. 2. Keratoconjunctivitis with ulceration and vascularization • Postoperative herpetic keratitis: 1. Superficial keratitis. а. Epithelial keratitis. б. Sub epithelial dotted keratitis в. Arborescent keratitis. 2. Profound forms of keratitis : а. Methaherpetic keratitis. б. Discal keratitis. в. Profound diffuse keratitis. г. Keratoiridocyclitis. Epithelial keratitis Arborescent keratitis Methaherpetic keratitis Discal keratitis Profound diffuse keratitis Neuroparalitic keratitis Avitaminosis keratitis The results of cornea’s diseases • Cloudlet • Spot • Walleye CLOUDLET SPOT MARGINAL DIMNESS WALLEYE • Questions • 1.Uvea, structure, blood supply, innervation, function. 2. The iris, the structure, blood supply, innervation, function. 3. Iridocyclitis, classification, clinical features, diagnosis, treatment, complications. 4. Post-traumatic iridocyclitis, clinic, diagnosis, treatment, complications. 5. Choroiditis, clinic, diagnosis, treatment, complications. 6. The structure of the lens, the disease of the lens. 7. Types of cataracts by localization, etiology. 8. Age-related cataracts. Methods of examination of patients. 9. Conservative and surgical treatment of cataract. 10. Swelling cataract, cataract with common diseases. 11. Complicated cataract, cataract correction methods.