In case of cyclitis there is an exudate from the ciliary body into
the posterior chamber. This may cause a total adherence of the iris
to the crystalline lens. With the ophthalmoscope, opacities in the
vitreous may be noticed. These are exudates. The tension of the eye is
liable to increase a little at first but as the exudates absorb there
is more or less softening. Vision is low. Also in cyclitis there is
ciliary injection, photophobia, lacrymation and pain, similar to that
of iritis. Pressure on the eye ball will reveal a very tender condition
around the sclerocorneal junction or over the area of ciliary injection.
The causes of iritis, cyclitis or iridocyclitis frequently are systemic
conditions and infection such as syphilis, rheumatism, gonorrhea,
tuberculosis, infectious diseases and metabolic changes, it may be of
traumatic origin or sympathetic. Fuchs says “There are many cases of
iritis for which no cause can be discovered and therefore which cannot
be placed under these causes.” We agree with him and advance the theory
of cervical and upper dorsal lesions or trouble in the sinuses, nose,
nasopharynx or throat. No doubt osteopathy can throw some important
light on the causes of diseases of the iris and ciliary body. The nose
and throat should be examined in all these cases.
=Treatment.=—Atropine must be used in the sore eye to put the iris
and ciliary body at rest and dilate the pupil to draw it back from
the lens so that adhesions may not form. Warm compresses will give
much comfort. Sweating should be brought about. All fluid should be
reduced to a minimum. Diet should be very moderate and the bowels kept
unusually free. The eye should be protected by dark goggles. Thorough
treatment of the neck and upper dorsal region with attention to the
nose and throat should be given. Constitutional treatment should be
given according to the indications mentioned under causes. If annular
synechia or total posterior synechia form or there is atrophy of the
eyeball operative work may be needed. Also for injuries, tumors,
anomalies and so forth of the iris see the latest medical works on this
subject.
Diseases of the Choroid
The =choroid= is the vascular tunic of the eye. With the iris and
ciliary body it forms the =uvea=. The iris and ciliary body are rich
in nerve terminals and when inflamed; pain is a prominent symptom. The
choroid has no sensory nerve terminals. When it is involved alone; pain
is not present however severe the pathology. Embryologically Descemet’s
membrane is a part of the uvea. When the uveal tract is diseased we
frequently note symptoms of a descemetitis as a turbidity of the
anterior chamber and spots on Descemet’s membrane. When one part of the
uvea is inflamed the tendency is to pass to the other parts because of
the intimate blood supply.
Choroiditis
There are many forms of choroiditis given by writers according to the
clinical picture and the pathology.
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