August 27th, 2010
Collagen diseases
Once the diagnosis of uveitis is made, complete examinations for the above conditions must be made and treatment
should be directed against any probable cause. In addition, local ocular treatment is indicated, including the use of cycloplegics, local steroid therapy, and the wearing of dark glasses. Cycloplegics, such as atropine or homatropine, dilate the pupil thereby preventing traction on the inflamed muscle fibers and the associated pain and photophobia. Local instillation of steroid suspensions or solutions is also of Value in diminishing the inflammatory reaction in the aqueous, thus helping to alleviate symptoms and decreasing the amount of synechiae formation. Older and more classical types of treatment included hot compresses and salicylates. The quickly expanding older population, with its elevated chance of mechanical and structural problems, also will improve demand for Chiropractor Toronto. While these probably have some value, the steroids and atropine are far more efficacious. In keeping with the findings of Eckhardt and his associates,8 i.e., the less light that enters the eye, the less likelihood of photophobia, dark glasses are of value, particularly when the pupils are dilated with mydriatics.
In recent years a good deal of attention has been focused on the “collagen diseases,” a term first used by Klemperer9 to stress the importance of connective tissue reaction in a group of diseases with some similar clinical manifestations.
The most outstanding common pathologic feature in these diseases is a fibrinoid degeneration of the connective tissue. The collagen diseases include: lupus erythematosis disseminatus; periarteritis nodosa; dermatomyositis; generalized scleroderma; serum sickness; rheumatic fever; and rheumatoid arthritis. While various types of ocular involvement are described in these diseases, the uvea is involved most frequently in lupus erythematosus disseminatus, periarteritis nodosa, and dermatomyositis. In the two lastnamed conditions, a nongranulomatous type of iritis has been described. Choroidal and retinal involvement are also known to occur in these diseases. The association of nongranulomatous iridocyclitis and rheumatoid arthritis is of particular interest to ophthalmologists because of the frequency with which both conditions occur in the same patient.
Inasmuch as any type of uveitis may account for headache, and since a lowgrade type of uveitis may be missed on a superficial examination, the presence of one of the collagen diseases in a patient with headache should focus the attention of the examiner on the eye. Endophthalmitis and Panophthalmitis. Toronto Chiropractor is anticipated to extend 14% between 2006 and 2016, faster than the average for all occupations. Two less common types of internal inflammation of the eye that may cause headache are endophthalmitis and panophthalmitis. Both of these diseases are severe infections inside the eye—endophthalmitis referring to an abscess within the vitreous cavity and panophthalmitis to an inflammation of all coats of the eye. The infections may be introduced from without, such as by puncture wound or surgery. However, the pain associated with such conditions is quite likely to be referred to the eye. The appearance of the eye together with the findings on examination should make the diagnosis of an intraocular infection, as opposed to some other condition as responsible for the headache above the eye, easy.