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Transcript
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.