Eyes

Eye inflammation: inflamed eyes


Eye inflammation describe 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 can appear. In the worst case, the complaint is a disease that leads to complete blindness, which is why a visit to the ophthalmologist is urgently required if there is evidence of eye inflammation.

Definition

In the broadest sense, eye inflammation is to be understood as all inflammatory diseases of the eye, whereby these can be further differentiated depending on the specific location into conjunctivitis (conjunctivitis), keratitis (inflammation of the cornea), uveitis (inflammation of the middle eye skin), retinitis (inflammation of the retina), 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). Inflammation of the lacrimal sac (dacryocystitis) and the eyelids (blepharitis) - as well as the classic grain of barley (hordeolum) - can be broadly assigned to eye infections. The same applies to inflammation of the optic nerve.

Eye inflammation symptoms

The symptoms of eye inflammation can vary significantly depending on the areas affected, with symptoms ranging from mild itchy eyes and tears in the eyes to massive pain and an increasing loss of vision. A more detailed description of the respective symptoms then follows in connection with the explanations on the various forms of eye inflammation.

Causes of inflamed eyes

As already shown, the eye infections can be divided into numerous different manifestations, the symptoms and their causes can differ significantly from one another.

Conjunctivitis / conjunctivitis

Conjunctivitis form the most well-known form of inflammation in the eye area and are relatively widespread. They can be due to allergies, mechanical irritation (e.g. from incorrectly grown eyelashes) as well as bacterial, viral, mycogenic or parasitic infections. Typical complaints include reddening of the eyes, itching, burning and tears in the eyes, swelling of the eyelids and sticking of the eyelids. For those affected, conjunctivitis is usually extremely annoying, but there are no serious health restrictions. In the worst case, an infection can spread and spread to the cornea, which in turn leads to significantly more extensive complaints and possibly even impaired vision.

For more information on conjunctivitis, read the article: Conjunctivitis (conjunctivitis).

Corneal inflammation / keratitis

A Corneal inflammation Similar to conjunctivitis, it can be attributed to numerous different triggers, whereby in addition to the mechanical and chemical irritations, an excessive amount of UV light can also be mentioned. Furthermore, infections with bacteria (for example special staphylococci and streptococci), viruses (for example herpes viruses, adenoviruses), fungi (for example special yeasts) and amoebae can cause keratitis. In rare cases, damage to the trigeminal nerve also leads to inflammation of the cornea. Those affected by keratitis show marked changes in the structure of the cornea, which in addition to clouding can also include the formation of ulcers on the cornea. Furthermore, uncontrolled formation of new vessels in the corneal area and accompanying inflammation of the iris are not uncommon.

The symptoms of corneal inflammation include reddening of the eyes, a foreign body sensation in the eye, increased sensitivity to light, clouding of the cornea, impaired visual acuity and severe eye pain. Since the cornea is increasingly damaged in the course of the disease, those affected are at risk of permanent impairment of their eyesight. There is no increased secretion of secretions, such as occurs with conjunctivitis, in keratitis.

For more information on keratitis, read the article: Corneal inflammation of the eyes (keratitis).

Uveitis / inflammation of the middle skin of the eye

The middle eye skin is formed from the iris (iris), the choroid (choroid) and the radiation body (also ciliary body or ciliary body). Inflammation of the middle eye skin (medical term: Uveitis) can therefore manifest itself in various places in the eye. The accompanying complaints are correspondingly different. For example, if the iris and the area of ​​the anterior vitreous are affected (iridocyclitis), the symptoms resemble those of conjunctivitis. However, patients with choroidal inflammation are more likely to suffer from visual impairment, but otherwise often do not initially show any other noticeable symptoms. If the entire middle skin of the eye is inflamed, the sufferers suffer from reddening of the eyes, eye pain, itching in the eyes, sensitivity to light and the like, as well as considerable impairments in vision.

The main causes of uveitis are viral (e.g. with herpes viruses or rubella viruses), bacterial, mycogenic and parasitic infections. In addition to local infections of the middle eye skin, systemic diseases such as tick-borne disease can lead to uveitis. In addition, a connection between uveitis and various autoimmune diseases and numerous other diseases - such as Bechterew's disease or Crohn's disease - is discussed. In general, acute inflammation of the iris is a typical accompanying symptom of inflammatory-rheumatic diseases of the spine. The middle eye skin is also affected by the inflammatory processes and, in the worst case, permanently damaged. In the long term, patients with uveitis are at risk of completely losing their eyesight, especially if the inflammation as part of a so-called chorioretinitis affects not only the choroid, but also the retina and causes increasing tissue degeneration here. 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 (dacryocystitis) and the lacrimal gland (dacryoadenitis)
If the lacrimal sac is inflamed, the tissue around the inner corner of the eyelid of the eye is often clearly red, swollen and painfully sensitive to pressure. Pus repeatedly emerges through the so-called tear dots and an abscess may form, which can lead to serious further impairment and, in the worst case, to the development of life-threatening encephalitis (inflammation of the brain). If the accumulation of pus breaks out and an open connection is formed, this is referred to as a fistula or lacrimal sac fistula. The dacryocystitis is mostly due to a drainage disorder of the lacrimal fluid with subsequent, excessive multiplication of bacteria inside the lacrimal sac. With an inflammation of the lacrimal gland, the upper eyelid is painfully swollen and not infrequently, an abscess also forms in dacryoadenitis. Here too, a pus breakthrough to the outside and the development of a fistula is possible.

Inflammation of the eyelids / blepharitis

Eyelid infections cause marked reddening and swelling of the eyelids, which is often accompanied by severe itching and sometimes by a painful burning sensation. The eyelashes are glued and may start to fall out. According to their causes, the inflammation of the eyelid can be divided into flaky eyelid inflammation due to a general skin disease, allergic eyelid inflammation (for example in response to incompatible cosmetics) and infectious eyelid inflammation (mostly caused by bacteria or viruses). It is not uncommon to see eyelid inflammation in connection with conjunctivitis.

A special form of eyelid inflammation is the barley grain. The grain of barley is a relatively widespread complaint in which inflammation of the eyelid glands leads to marked reddening and painful swelling of the eyelid. It is between an external hordeolum, in which the minor glands (sweat glands in the area of ​​the eyelid) or Zeis glands (sebum glands in the area of ​​the eyelid) are affected, and the internal hordeolum, in particular the meibomian glands (sebum glands on the edge of the lid ) are ignited, differentiated. The accumulation of pus can break out in the course of a hordeolum externum, in the case of a hordeolum internum inwards. In most cases, the grain of barley is caused by a local bacterial infection with staphylococci (occasionally also streptococci). Serious health problems are usually not to be feared with a barley grain. The barley grain usually breaks up within a few days and then heals on its own. If the barley grain does not break open, there is a risk of developing an eyelid abscess, which is why a surgical opening and removal of the pus accumulation is necessary here. If patients repeatedly suffer from a grain of barley, this can indicate a general weakening of the immune system, for example in the course of diabetes. The risk of recurrent infections is also increased, for example, by using cosmetics in the eye area and wearing contact lenses.

For more information on blepharitis, read the article: Blepharitis: inflammation of the eye; Inflammation of the eyelid.

Endophthalmitis / inflammation in the vitreous of the eye

The Endophthalmitis is an inflammation inside the so-called vitreous. It forms a particularly severe form of eye inflammation and often leads to a complete loss of vision. In addition to impaired visual acuity, eye pain, acute reddening of the eye and swelling of the conjunctiva are typical indications of endophthalmitis. The inflammation of the vitreous body is mostly due to a bacterial infection, and the pathogens are often introduced from outside during eye surgery or an injury. Secondary inflammation of the vitreous body due to a general systemic infectious disease is less common.

Panophthalmitis / inflammation of the entire eye

If the inflammation passes from the vitreous body to the entire structure of the eye, this is known as the so-called Panophthalmitis designated. It is the most serious form of eye inflammation and often results in complete loss of vision and sometimes the entire eye. In the area of ​​the eye, accumulation of pus forms in the course of panophthalmitis and the affected tissue gradually begins to die. The infection can also spread to the second eye. The main causes are injuries to the eye and the associated penetration of germs. In rare cases (for example in the case of blood poisoning), the pathogens can also reach the eye via the bloodstream and cause panophthalmitis here.

Optic nerve neuritis / inflammation of the optic nerve

In the broadest sense, inflammation of the optic nerve can also be attributed to eye inflammation, the loss of visual acuity and pain in the area of ​​the eye socket being the main symptoms. Cause of Optic nerve inflammation can be diseases of the central nervous system (e.g. multiple sclerosis), toxic influences (e.g. due to excessive alcohol consumption) or certain infectious diseases such as typhoid, typhus or diphtheria. Inflammation of the middle eye skin (uveitis) to the optic nerve is also possible. Furthermore, special diseases of the cardiovascular system and extreme high blood pressure are considered risk factors for neuritis nervi optici.

Diagnosis

Numerous, sometimes highly specialized, ophthalmological examination methods are available to clearly diagnose eye inflammation and its various manifestations. Most of the time, however, the appearance of the inflammation of the eye and the description of the symptoms by the patient give relatively clear indications of the underlying disease. Subsequent, frequently used diagnostic procedures include, for example, microscopic examinations of the front, middle and rear eye sections using a so-called slit lamp (slit lamp microscopy) and the reflection of the fundus with the help of an ophthalmoscope (ophthalmoscopy). In addition, a wide range of other diagnostic methods is available, ranging from examining the resolution of the retina (using a retinometer) to examining the chamber angle (using a so-called gonioscope or contact glass) and checking the corneal topography (using a keratograph) to measure the intraocular pressure (tonometry) is enough.

Which ophthalmological examination methods are required depends largely on the form of the eye inflammation. If a bacterial, viral, mycogenic or parasitic infection is the cause of inflammation in the eye area, the determination of the pathogen in the laboratory plays a decisive role for the successful treatment. Blood tests also provide information about existing systemic infectious diseases or general diseases. An allergy test, for example in the case of repeated conjunctivitis, can also be useful. If an optic nerve inflammation is suspected, contrast-assisted magnetic resonance imaging (MRI) is used to confirm the diagnosis. Since some forms of eye inflammation can lead to complete loss of vision and, in the worst case, even death to the patient, an ophthalmologist should be consulted in any case if symptoms are suspicious. This also applies to supposedly harmless eye infections, such as the barley grain, if they do not go away on their own after a few days.

Eye inflammation treatment

The treatment of inflammation of the eye should be based on the underlying diseases and can therefore differ significantly from case to case. In a similar form, this also applies to the treatment of certain clinical pictures, such as conjunctivitis. If this is caused by bacteria, treatment with antibiotics is planned. In the case of allergic conjunctivitis, contact with the allergens should be avoided as far as possible and so-called hyposensitization should be carried out under certain circumstances. Viral conjunctivitis, however, can be combated much less or only very therapeutically. So-called antivirals are used here. In general, patients with conjunctivitis are advised to avoid drafts and other irritations of the conjunctiva. As with many other forms of eye inflammation, wearing protective glasses may also be appropriate.

With inflammation of the cornea, the possible treatment approaches are as variable as with conjunctivitis. Against a bacterial one Keratitis For example, eye drops containing antibiotics are usually used. Moisturizing eye drops are used against inflammation of the cornea, which is the result of a dry eye, and antivirals can be used for underlying viral infections, but these often have only a limited effect. If ulcers form on the cornea in the course of keratitis, a so-called amniotic membrane transplantation can also take place in the course of a surgical procedure. The amnion (innermost egg skin in the amniotic sac) is removed as tissue donation (available for every birth process) and then transplanted to the eye or cornea as a kind of dressing. The amniotic membrane shows an anti-inflammatory (anti-inflammatory) and anti-scarring effect. The growth factors it contains also have a positive effect on wound healing of the ocular surface epithelium. After a while, the transplanted tissue dissolves on its own.

The eye inflammation shows up in the form of a Uveitis In addition to treating the causes (for example with antibiotics or antivirals), various other medicinal measures are required, which should serve, among other things, to prevent consequential damage, such as sticking the iris and lens. For this purpose, eye drops are administered, which cause the pupil to dilate. Eye ointments containing cortisone are also often used. If the course is severe, cortisone tablets are also prescribed and, under certain circumstances, a cortisone injection may be given directly under the conjunctiva.

Is the Eye bag inflamed, this is usually due to a bacterial infection and treatment with appropriate antibiotics. If an abscess has already formed, surgical opening or removal is necessary in order to avoid further health problems. The underlying occlusion of the tear ducts, which made the pathological multiplication of the bacteria inside the tear sac possible, is treated therapeutically after the inflammation has subsided. In the course of an operation, the tear ducts are restored in their function or an additional artificial drainage path is created towards the nose. Moist, warm and disinfectant envelopes can help alleviate the lacrimal sac as well as the lacrimal gland and help the healing process. The lacrimal gland inflammation, in turn, is also treated with antibiotics if a bacterial infection is the cause of the symptoms. Otherwise, patients are increasingly dependent on their self-healing powers. However, eye drops that keep the eye moist and pain relievers (especially if the disease is severe) can provide significant relief to those affected.

At a Inflammation of the eyelids any stressful factors, such as wearing contact lenses or using eye cosmetics, should be stopped urgently. Here, the edge of the lid requires particularly hygienic care. Warm, moist compresses can also help to liquefy the secretions in the eyelid glands or to open the blocked glands, so that the accumulated secretions can escape with light pressure in the form of an eyelid massage. If blepharitis is based on an infection with bacteria or viruses, drug therapy based on antibiotics or antivirals is planned. Here, if possible, the warm, moist compresses should also be avoided, as the pathogens may be carried over. Cortisone is often used to treat allergic eyelid infections, but its use is only possible for a very limited period of time.

A Barley grain Although in most cases no therapeutic care is required, there are various ways to alleviate the symptoms and to influence the healing process too positively. Disinfectant eye ointments are particularly worth mentioning here. Severe forms, in which the barley grain does not open and heal on its own, require 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 kernel, warm, moist compresses and the attempt to open the barley kernel by pressure are contraindicated and must be avoided at all costs.

A Endophthalmitis is usually treated with antibiotics, which can be administered as eye drops, injections into the eye or intravenous infusions. Oral antibiotics are used to support therapy. If the inflammation cannot be controlled in this way, there remains the possibility of a so-called vitrectomy, in which targeted tissue is removed from the vitreous by surgical means. In the worst case, the entire eye may also need to be removed. The treatment options for panophthalmitis are essentially the same as for endophthalmitis.

At a Optic nerve inflammation treatment options are extremely limited in many cases. Underlying bacterial infections can be successfully treated with antibiotics. But if the optic nerve inflammation goes back to a disease of the central nervous system, for example, there are only limited possibilities for therapeutic care. So-called corticosteroids are often used to treat optic nerve inflammation due to their anti-inflammatory effects.

Naturopathy for eye infections

Naturopathy offers a variety of treatment options that can achieve remarkable healing successes, especially with the lighter forms of eye inflammation. From the field of herbal medicine, eyebright (Euphrasia) is particularly worth mentioning. The extracts of the medicinal plant have proven particularly useful in the treatment of conjunctivitis and corneal inflammation. Naturopathy also relies on fennel tea compresses for conjunctivitis and corneal inflammation, as well as for a barley grain, although here a certain caution or strict hygiene is required to avoid spreading existing pathogens.

Homeopathy for eye infections

Even if the effectiveness of homeopathy is controversial from a scientific point of view, many people trust homeopathic remedies. In the case of eye infections, they are mostly used in the form of homeopathic eye drops. In addition to eyebright, Apis and Silicea, other homeopathic remedies for conjunctivitis are used, for example Aconitum napellus, Arsenicum album, Dulcamara and Hepar sulfuris calcareum. Hepar sulfuris. Apis and Silicea are also widely used on a barley grain.

Although there are numerous naturopathic approaches for treating different eye infections, serious forms, such as endophthalmitis, can only be treated with the help of naturopathy to a very limited extent and in any case require conventional ophthalmological treatment. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters

Swell:

  • Federal Center for Health Education: Eye infections (accessed: 22.08.2019), infektionsschutz.de
  • Swiss Kneipp Association: Eye Inflammation (accessed: August 22, 2019), kneipp.ch
  • Institute for Quality and Efficiency in Health Care (IQWiG): Conjunctivitis (accessed: August 22, 2019), gesundheitsinformation.de
  • Amir A. Azari, Neal P. Barney: Conjunctivitis A Systematic Review of Diagnosis and Treatment, JAMA, 2013, jamanetwork.com
  • Mayo Clinic: Keratitis (access: 22.08.2019), mayoclinic.org
  • National Eye Institute (NEI): Facts About Uveitis (accessed: 22.08.2019), nei.nih.gov
  • National Health Service UK: Blepharitis (accessed: 22.08.2019), nhs.uk
  • American Academy of Ophthalmology: What is Endophthalmitis? (Accessed: 22.08.2019), aao.org

ICD codes for this disease: H01, H10, H16, H20, H44, H46, among others ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


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