Eye inflammation. Inflamed eyes

Eye inflammation describes a relatively wide range of complaints associated with inflammatory processes around the eye. Depending on which parts of the eye are affected by the inflammation, extremely different impairments may show up. In the worst case, behind the symptoms hides a disease that leads to complete blindness, which is why in case of evidence of ophthalmia urgent visit to the ophthalmologist is required.

contents

definition
symptoms
Causes of inflamed eyes
diagnosis
treatment
Naturopathy with eye inflammations

definition

Eye inflammations are to be understood in the broadest sense of all inflammatory diseases of the eye, and these can be further differentiated depending on the specific localization in conjunctivitis (conjunctivitis), keratitis (corneal inflammation), uveitis (inflammation of the middle eye skin), retinitis (retinal inflammation), Iridocyclitis (inflammation of the iris) and scleritis (inflammation of the outer skin of the eyeball), endophthalmitis (infection in the eye), panophthalmitis (infection of the entire eye). Inflammations of the lacrimal sac (dacryocystitis) and the eyelids (blepharitis) are - as well as the classic barley grain (hordeolum) - in the broadest sense attributed to the eye inflammations. The same applies to inflammation of the optic nerve.

Eye inflammation occurs in extremely different forms, which may also affect the eyelids. (Image: geargodz / fotolia.com)

symptoms

Symptoms of ophthalmia may vary significantly depending on the area of ​​the affected area, with symptoms ranging from mild itching and tearing of the eyes to massive pain and increased vision loss. A more detailed description of each symptom follows in the context of the discussion of the various forms of ophthalmia.

Causes of inflamed eyes

As already mentioned, the eye inflammations can be subdivided into many different manifestations, whose symptoms as well as their causes can clearly differ from each other.

Conjunctivitis / conjunctivitis
Conjunctivitis is the most well-known form of inflammation in the eye area and is relatively common. They may be due to allergies, mechanical irritation (eg due to false eyelashes), as well as bacterial, viral, mycogenic or parasitic infections. Typical symptoms include redness of the eyes, itching, burning and tearing, eyelid swelling and gluing of the eyelids. For those affected, conjunctivitis is usually extremely annoying, but with no serious health restrictions. In the event of an infection, however, it can at worst expand and spread to the cornea, resulting in significantly more extensive symptoms and possibly even impaired vision.

Corneal inflammation / keratitis
Corneal inflammation, similar to conjunctivitis, can be traced back to a number of different causes, including mechanical and chemical irritation and an excess of UV light. Furthermore, infections with bacteria (for example special staphylococci and streptococci), viruses (for example herpesviruses, adenoviruses), fungi (for example special yeasts) and amoebae can cause keratitis. In rare cases, damage to the trigeminal nerve also causes inflammation of the cornea. The persons affected by keratitis show marked changes in the corneal structure, which, in addition to cloudiness, may also include the formation of ulcers on the cornea. Furthermore, uncontrolled neovascularization of the cornea and concomitant inflammation of the iris are not uncommon.

Symptoms of corneal inflammation include redness of the eye, a foreign body sensation in the eye, increased photosensitivity, corneal opacity, visual acuity, and severe eye pain. Since the cornea is increasingly damaged in the course of the disease, the person threatened a permanent impairment of eyesight. An increased discharge of secretions, as occurs in conjunctivitis, is not recorded in keratitis.

Uveitis / inflammation of the middle eye skin
The middle eye skin is made up of the iris, the choroid (Choroidea) and the ray body (also ciliary body or corpus ciliare). An inflammation of the middle eye skin (medical term: uveitis) can therefore manifest itself in different places in the eye. The accompanying complaints are correspondingly different. If, for example, the iris and the area of ​​the anterior vitreous are affected (iridocyclitis), the symptoms are similar to those of conjunctivitis. However, patients with inflammation of the choroid more often suffer from impaired visual acuity, but otherwise often show no further conspicuous symptoms. If the entire middle eye skin is inflamed, those affected suffer from redness, eye pain, itching, photosensitivity and CO, as well as significant vision impairment.

The causes of uveitis are primarily viral (for example with herpesviruses or rubella viruses), bacterial, mycogenic and parasitic infections. Besides local infections of the middle eye skin, systemic diseases, such as the tick-borne borreliosis, can lead to uveitis. In addition, an association of uveitis with various autoimmune diseases and numerous other diseases - such as ankylosing spondylitis or Crohn's disease - is discussed. Generally, acute inflammation of the iris is a typical concomitant symptom of inflammatory rheumatic diseases of the spine. The inflammatory processes also affect the middle eye skin and in the worst case permanently damage it. In the long term, the patient is threatened with complete loss of vision due to uveitis, especially if the inflammation in the context of so-called chorioretinitis affects the retina in addition to the choroid and causes an increase in tissue degeneration. If the retina is inflamed alone, this is called retinitis. It too can lead to retinal degeneration and loss of vision.

Inflammation of the lacrimal sac (Dakryozystitis) and the lacrimal gland (Dakryoadenitis)
If the lacrimal sac is inflamed, the tissue around the inner eyelid of the eye is often reddened, swollen and painfully sensitive to pressure. Repeated pus occurs through the so-called lacrimal punctures and under certain circumstances an abscess forms, which can lead to severe further impairment and at worst the development of life-threatening encephalitis (inflammation of the brain). If the pus buildup breaks through to the outside and forms an open connection, this is referred to as a fistula or tear sac fistula. Dacryocystitis is usually due to a drainage disturbance of the tear fluid with subsequent, excessive proliferation of bacteria inside the lacrimal sac. In inflammation of the lacrimal gland, the Augenoberlid is painfully swollen and not infrequently also forms in the Dakryoadenitis an abscess. Again, a pus breakthrough to the outside and the emergence of a fistula is possible.

Inflammation of the eyelids / blepharitis
Eyelid inflammation causes significant redness and swelling of the eyelids, which is often accompanied by a strong itching and sometimes by a painful burning sensation. The eyelashes are sticky and may begin to fail slowly. According to their causes, the inflammations of the eyelid can be differentiated into scaly inflammations of the lungs in the course of general skin disease, allergic inflammations of the lungs (for example in response to incompatible cosmetics) and infectious inflammations of the lungs (usually caused by bacteria or viruses). Not infrequently, the Augenlidentzündung is also observed in connection with conjunctivitis.

A special form of the Augenlidentzündung forms the barley grain. Barley grain is a relatively common condition in which inflammation of the eyelid glands leads to marked redness and painful swelling of the eyelid. It is between a Hordeolum externum, in which the minor glands (sweat glands in the eyelid) or Zeis glands (sebaceous glands in the eyelid) are affected, and the hordeolum internum, in particular the meibomian glands (sebaceous glands on the lid margin ) are differentiated. The accumulation of pus can break outward in the course of a hordeolum externally, in the case of a hordeolum internum, to break inward. The barley grain is caused in most cases by a local bacterial infection with staphylococci (occasionally streptococci). Serious health problems are usually not to be feared with a barley grain. The barley grain usually breaks within a few days and then heals by itself. If the barley grain does not break open, however, the development of a lid abscess is threatened, which is why a surgical opening and removal of pus accumulation is required here. Patients suffering from a barley grain can point to a general weakening of the immune system, for example as a result of diabetes. In addition, the risk of recurrent infections is increased, for example, by the use of cosmetics in the eye area and the wearing of contact lenses.

Endophthalmitis / inflammation in the vitreous body of the eye
Endophthalmitis is an inflammation inside the so-called vitreous body. It is a particularly severe form of eye inflammation and often results in complete loss of vision. In addition to impaired visual acuity, eye pain, acute redness of the eye, and swelling of the conjunctiva are considered typical signs of endophthalmitis. The inflammation of the vitreous body is based on most of a bacterial infection, the pathogens are often introduced in the course of an eye operation or an injury from the outside. Less common is secondary inflammation of the vitreous in the course of a general systemic infectious disease.

Panophthalmitis / inflammation of the entire eye
If the inflammation passes from the vitreous to the entire structure of the eye, this is called panophthalmitis. It is the most severe form of ophthalmia and often causes complete loss of vision and sometimes the entire eye. In the area of ​​the eye in the course of the Panophthalmitis increased accumulations of pus form and the affected tissue begins to die off gradually. Also, the infection can pass to the second eye. The cause is mainly injuries to the eye and the associated penetration of germs. The pathogens can in rare cases (for example, in a blood poisoning) but also pass through the bloodstream to the eye and cause a Panophthalmitis here.

Neuritis optic nerve / inflammation of the optic nerve
In the broadest sense, inflammation of the optic nerve is also attributable to ocular inflammation, with the loss of visual acuity and pain in the area of ​​the eye socket being considered as leading symptoms. The cause of optic nerve inflammation may be diseases of the central nervous system (for example multiple sclerosis), toxic influences (for example due to excessive alcohol consumption) or certain infectious diseases such as typhus, typhus or diphtheria. In addition, an expansion of inflammation of the middle eye skin (uveitis) on the optic nerve is possible. Furthermore, special diseases of the cardiovascular system and extreme hypertension are considered risk factors for neuritis optic nerve.

In the diagnosis of ophthalmic inflammation, various methods are used, ranging from microscopic examination by means of a so-called slit lamp to the measurement of intraocular pressure (tonometry). (Image: jyleken / fotolia.com)

diagnosis

In order to clearly diagnose an eye inflammation or its various manifestations, numerous, sometimes highly specialized, ophthalmological examination methods are available. In most cases, however, the appearance of ophthalmia and symptom description by the patient already provide relatively clear indications of the underlying disease. Subsequent widely used diagnostic methods are, for example, microscopic examinations of the anterior, middle and posterior sections of the eye by means of a so-called slit lamp (slit lamp microscopy) and the reflection of the ocular fundus using an ophthalmoscope (ophthalmoscopy). In addition, a wide range of other diagnostic procedures are available, ranging from retinal resolution (using a retinometer) to chamber angle examination (using a so-called gonioscope or contact lens) and corneal topography (using a keratograph) to measure intraocular pressure (tonometry) is sufficient.

Which ophthalmological examination methods are required in detail depends largely on the form of ophthalmia. If a bacterial, viral, mycogenic or parasitic infection is the cause of inflammation in the eye area, determination of pathogens in the laboratory plays a key role in successful treatment. In addition, blood tests also provide information on existing systemic infectious diseases or general diseases. Also, an allergy test, for example, in repeated conjunctivitis be useful. If an optic nerve inflammation is suspected, the so-called contrast-enhanced magnetic resonance imaging (MRI) serves to secure the diagnosis. Since some forms of ophthalmia can lead to complete loss of vision and, in the worst case, even death of the patient, an ophthalmologist should always be consulted for suspected symptoms. This also applies to supposedly harmless eye inflammations, such as the barley grain, if they do not subside by themselves after a few days.

treatment

The treatment of ophthalmia should always be based on the underlying diseases and may therefore differ significantly from case to case. This applies in a similar way to the treatment of certain clinical pictures, such as conjunctivitis. If this is caused by bacteria, a treatment with antibiotics is provided. In allergic conjunctivitis, the contact with the allergens should be avoided as far as possible and under certain circumstances a so-called hyposensitization be performed. Viral conjunctivitis, however, can be significantly worse or very limited to combat therapeutically. Here, so-called antivirals are used. Generally, patients with conjunctivitis are advised to avoid drafts and irritation of the conjunctiva as much as possible. Also, as with many other forms of ophthalmia, wearing safety goggles may be appropriate.

In the case of corneal inflammation, the possible treatment approaches are comparable variable, as in conjunctivitis. For example, a bacterial keratitis is usually treated with antibiotic-containing eye drops. Moisturizing eyedrops are used against corneal inflammation, which is the result of a dry eye, and antiviral agents can be used in the case of underlying viral infections, although they often have only a limited effect. If ulcers develop on the cornea in the course of keratitis, a so-called amniotic membrane transplatation can also take place in the course of a surgical procedure. The amnion (innermost egg skin in the amniotic sac) is taken as a tissue donation (available with each birth process) and then transplanted as a kind of dressing on the eye or the cornea transplanted. The amniotic membrane shows an anti-inflammatory (anti-inflammatory) and anti-scarring effect. In addition, the contained growth factors have a positive effect on the wound healing of the ocular surface epithelium. After some time, the transplanted tissue dissolves by itself.

If the inflammation of the eye in the form of uveitis is found in addition to a treatment of the causes (for example with antibiotics or antivirals) various other medical measures are required, which among other things serve to avoid consequential damage such as gluing of the iris and lens. For this purpose, eye drops are administered, which cause enlargement of the pupil. Cortisone-containing ointments are also frequently used. In severe cases, cortisone tablets are also prescribed and under certain circumstances a cortisone injection is made directly under the conjunctiva.

If the lacrimal sac is inflamed, this usually goes back to a bacterial infection and the treatment is carried out with appropriate antibiotics. If an abscess has already formed, a surgical opening or removal is required in order to avoid further health impairments. The underlying closure of the lacrimal ducts, which has made possible the pathological propagation of the bacteria in the interior of the lacrimal sac, is supplied therapeutically after the inflammation subsides. As part of a surgical procedure, the lacrimal ducts are restored in their function or there is the creation of an additional artificial drainage path towards the nose. Moisturizing, warm and disinfecting envelopes can help alleviate lacrimation and lacrimal inflammation and promote healing. The lacrimal inflammation, in turn, is also treated with antibiotics, if a bacterial infection is the cause of the discomfort. Otherwise, the patients here rely increasingly on their self-healing powers. However, eye drops that keep the eye moist and pain relievers (especially in severe disease) can provide significant relief to the sufferer.

In the case of inflammation of the eyelids, any stressful factors such as the wearing of contact lenses or the use of eye cosmetics should be stopped urgently. The lid margin here requires a particularly hygienic care. Warm, moist compresses can also help to liquefy the secretion in the eyelid glands or to open the blocked glands, so that in light pressure in the form of a Lidmassage the accumulated secretions can escape. If the blepharitis is based on an infection with bacteria or viruses, a drug therapy based on antibiotics or antivirals is provided. Here as possible should be dispensed with the moist-warm compresses, as a risk of carryover of the pathogens. It is not uncommon to treat allergic eyelid infections with the help of cortisone, but its use is only possible over a very limited period of time.

Although barley grain in most cases does not require any therapeutic treatment, there are various ways to alleviate the symptoms and to positively influence the healing process. Here are mainly disinfectant eye ointments to call. Severe courses, in which the barley grain does not open and heal on its own, require an ophthalmological treatment in which the barley grain is opened by means of a so-called incision (puncture) and the drainage of the pus is made possible. In the case of a barley grain, moist-warm compresses and the attempt to achieve an opening of the barley grain by pressure should be contraindicated and urgently avoided.

An endophthalmitis is usually treated with antibiotics, which can be administered as eye drops, injections in the eye or intravenous infusions. Oral antibiotics help support the therapy. If the inflammation can not be controlled in this way, there remains the possibility of a so-called vitrectomy, in which surgically targeted tissue is removed from the vitreous. In the worst case, the removal of the complete eye may be necessary. The treatment options for panophthalmitis are essentially the same as for endophthalmitis.

With optic nerve inflammation, treatment options are extremely limited in many cases. Although underlying bacterial infections can be successfully treated by antibiotics quite successful. However, if optic nerve inflammation is due, for example, to a disease of the central nervous system, there are only limited possibilities for therapeutic treatment. Not infrequently, so-called corticosteroids, because of their anti-inflammatory effect, used for the treatment of optic nerve inflammation.

Naturopathy with eye inflammations

Naturopathy offers a variety of treatment options that can achieve remarkable healing results, especially in the lighter forms of ophthalmia. From the field of herbal medicine is mainly to mention eyebright (Euphrasia). The extracts of the medicinal plant have been proven especially in the treatment of conjunctivitis and corneal inflammation. They are mostly used in the form of homeopathic eye drops. Other homeopathic remedies used for conjunctivitis include, for example, Aconitum napellus, Arsenicum album, Dulcamara and Hepar sulfuris calcareum. Hepar sulfuris is - in addition to Apis and Silicea - also one of the widely used homeopathic remedies for eye inflammation in the form of a barley grain. In conjunctival and corneal inflammations as well as in barley seeds, naturopathy also uses compresses made from fennel tea, although here caution or strict hygiene is required to prevent carry-over of existing pathogens.

Although numerous naturopathic approaches to treat the different eye inflammations are available, but serious forms such as endophthalmitis can be treated with the help of naturopathy only very limited and require in any case a conventional ophthalmological treatment. (Fp)