Keratitis Tashkent Medical Academy Department of Ophthalmology

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 Light Pupil Lens Sclera Retina n.opticus

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.