What Is a Black Eye?

Black eye is a phrase used to describe bruising around the eye due to an injury to the face or the head. Blood and other fluids collect in the space around the eye, causing swelling and dark bruising in the tissue.

When there is trauma or injury to the face, the skin around the eye — which is very loose — is one of the first places to swell as fluid builds up. Although the name “black eye” would indicate otherwise, the eye itself is usually not injured. Many black eyes heal on their own in a few days.

A black eye can be a sign of a more serious injury, such as a hyphema (bleeding in the eye).

However, a black eye can be a sign of a more serious injury. For instance, if there is bleeding within the eye that is called a hyphema and should be looked for any time you see a black eye. It can affect your cornea and your vision. In some cases of face or eye trauma, increased pressure inside the eyeball can occur, resulting in damage to the eye and eyesight if not treated. If both eyes are black after a head injury, it could signify a skull fracture or other serious injury.

What Are Symptoms of a Black Eye?

After an injury to the eye, it is important to distinguish between symptoms of black eye and those that might indicate a more serious head injury.

Black eye symptoms may include:

• pain around the eye
• swelling around the eye, which can be mild at first, then increasing later. Swelling may make it difficult to open the eye
• discoloration (like a bruise) around the eye. The skin around the eye may be red at first, then grows darker, progressing to purple, yellow, green or black
• blurred vision

Signs of a more serious head injury require medical attention, and may include the following:

• double vision
• vision loss
• blood on the eyeball surface
• inability to move the eye
• severe or ongoing headache
• fainting/loss of consciousness
• blood or fluid coming from the ears or nose

What Causes a Black Eye?

A black eye is most commonly caused by something hitting the eye or nose. Either one or both eyes may be blackened depending on where you get hit. If you suffer a blow to the nose, both eyes may swell; the swelling is due to the buildup of fluid in the loose skin beneath the eyes. Other types of trauma to the head can cause black eyes, including skull fractures.

Facial surgery can also cause black and swollen eyes, including facelifts, nose surgery or surgery on the jaw. Other conditions, such as allergies and infections, can lead to swelling around the eye, but not the bruising discoloration of a black eye.

Black Eye Diagnosis

In general, your doctor can simply do a physical exam to diagnose a black eye. He or she will check your vision and test the motion of your eye by moving his or her finger in front of your face and asking you to follow the movement with your eyes. The doctor will shine a light into your eyes to assess if your pupil is dilating normally and to look at the inside of your eye for any problems.

The doctor will also examine the bones in your face and around your eye. If he or she suspects you may have fractured any bones or that there might be something inside the eye, you may have an X-ray or CT scan.

Black Eye Treatment

A typical black eye that does not involve more serious symptoms is generally treated with self-care at home. To reduce swelling and ease pain the first day, an ice pack can be applied to the eye for 15-20 minutes at a time, once every hour. If an ice pack is not available, a bag of frozen vegetables can be used, or ice cubes wrapped in cloth (to avoid freezing the skin). Despite what you see in movies or on television, you should never put a raw steak or other raw meat on a black eye. The bacteria on raw meat poses a high risk of infection, and this method of treating a black eye has no scientific basis.

Finally, be sure to keep the affected eye(s) well-protected from further injury. Avoid sports or other similar activities where the eye can be hit until the eye has healed.

If pain or swelling from a black eye do not improve after a few days, or if you are experiencing vision changes or problems, call your ophthalmologist.

Why Do My Eyes Hurt? 11 Possible Causes of Eye Pain and Soreness

Nearly everyone has had sore eyes at some point. Sometimes they get better on their own, but they can also be a sign of something more serious.

Your eye doctor can figure out what’s going on and find the right treatment for you.

Where Does It Hurt?

Sometimes discomfort or pain results from a problem in your eye or the parts around it, such as:

• Cornea: The clear window in the front of your eye that focuses light
• Sclera: The whites of your eyes
• Conjunctiva: The ultra-thin covering of your sclera and the inside of your eyelid
• Iris: The colored part of your eye, with the pupil in the middle
• Orbit: A bony cave (eye socket) in your skull where the eye and its muscles are located.
• Extraocular muscles: They rotate your eye.
• Nerves: They carry visual information from your eyes to your brain.
• Eyelids: Outside coverings that protect and spread moisture over your eyes.

Common Eye Problems

Blepharitis: An inflammation or infection of the eyelid which typically is not painful

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Conjunctivitis (pinkeye): This is inflammation of the conjunctiva. It can be from allergies or infections (viral or bacterial). Blood vessels in the conjunctiva swell. This makes the part of your eye that’s usually white look red. Your eye could also get itchy and gunky. This condition is typically not painful.

Corneal abrasions: That’s the official name for a scratch on this part of your eye. It sounds minor, but it can hurt. It’s easy to do, too. You can scratch your eye while rubbing it. Your doctor will give you antibiotic drops. It should get better in a couple of days without further problems.

Corneal infections (keratitis): An inflamed or infected cornea is sometimes caused by a bacterial or viral infection. You may be more likely to get it if you leave your contacts in overnight or wear dirty lenses.

Foreign bodies: Something in your eye, like a bit of dirt, can irritate it. Try to rinse it out with artificial tears or water. If you don’t get it out, it can scratch your eye.

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Glaucoma: This family of conditions causes fluid to build up in your eye. That puts pressure on your optic nerve. If you don’t treat it, you could lose your sight. Most of the time there are no early symptoms. But a type called acute angle-closure glaucoma causes pressure inside your eye to rise suddenly. Symptoms include severe eye pain, nausea and vomiting, headache, and worsening vision. This is an emergency. You need treatment ASAP to prevent blindness.

Iritis or uveitis: An inflammation inside your eye from trauma, infections, or problems with your immune system. Symptoms include pain, red eye, and, often, worse vision.

Optic neuritis: An inflammation of the nerve that travels from the back of the eyeball into your brain. Multiple sclerosis and other conditions or infections are often to blame. Symptoms include loss of vision and sometimes deep discomfort when you look from side to side.

Sinusitis: An infection in one of your sinuses. When pressure builds up behind your eyes, it can cause pain on one or both sides.

Stye: This is a tender bump on the edge of your eyelid. It happens when an oil gland, eyelash, or hair follicle gets infected or inflamed. You may hear your doctor call it a chalazion or hordeolum.

Other Symptoms

Eye pain can happen on its own or with other symptoms, like:

• Less vision
• Discharge: It can be clear or thick and colored
• Foreign body sensation — the feeling that something is in the eye, whether real or imagined
• Headache
• Light sensitivity
• Nausea or vomiting
• Red eye or pinkeye
• Tearing
• Your eye is crusted shut with discharge when you wake up.

Other symptoms along with sore eyes can be a clue to what is causing the pain.

Tests to Diagnose Eye Pain

See your eye doctor if you have eye pain, especially if you have less vision, headache, or nausea and vomiting.

Eye doctors use a variety of tools to diagnose eye pain:

• A slit-lamp exam uses bright light to look at all the structures of your eye.
• Dilating drops expand your pupil to let the doctor see deep into your eye.
• A tonometer is a tool that measures eye pressure. The doctor uses it to diagnose glaucoma.

Treatments

Just as causes can vary, so do treatments. They target the specific cause of eye pain.

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Conjunctivitis: Antibacterial eyedrops can cure bacterial conjunctivitis. Antihistamines in the form of eyedrops, a pill, or a syrup can improve conjunctivitis from allergies.

Corneal abrasions: These heal on their own with time. Your doctor might prescribe an antibiotic ointment or drops.

Glaucoma: You’ll get eyedrops and maybe pills to reduce pressure. If they don’t work, you may need surgery.

Infected cornea: You may need antiviral or antibacterial eyedrops.

Iritis: The doctor will treat this with steroid, antibiotic, or antiviral eyedrops.

Optic neuritis: It’s treated with corticosteroids.

Styes: Use warm compresses at home for a few days.

The only way to sort out the causes of eye pain and to get the right treatment is to see a doctor. Your vision is precious. Protect it by taking eye pain seriously.

Symptoms, Causes, Tests, Diagnosis, Treatment

When you have optic neuritis, the nerve that sends messages from your eye to your brain, called the optic nerve, is inflamed.

It can happen all of a sudden. Your vision gets dim or blurry. You can’t see colors. Your eyes hurt when you move them. It’s a common problem for people living with multiple sclerosis (MS). The symptoms can seem scary, but most people recover fully, often without treatment.

What Is Optic Neuritis?

We don’t know why, but sometimes your immune system attacks the fatty coating called myelin that covers and protects your optic nerve. When the myelin is damaged or missing, your optic nerve can’t send the right signals to your brain. This can lead to changes in your vision.

Optic neuritis is one of the most common symptoms of the relapsing-remitting form of MS. But it can also happen when you take certain medications or if you have diabetes. It’s also linked to neuromyelitis optica (NMO), or Devic’s disease. This autoimmune disorder causes immune system cells and antibodies to attack your optic nerves, spinal cord, and, sometimes, your brain.

Symptoms of Optic Neuritis

This condition usually comes on quickly, over a few hours or days. You may notice some of these symptoms:

• Pain when you move your eyes
• Blurred vision
• Loss of color vision
• Trouble seeing to the side
• A hole in the center of your vision
• Blindness in rare cases
• Headache — a dull ache behind your eyes

Adults usually get optic neuritis in only one eye, but children may have it in both.

Some people get better in a few weeks, even without treatment. For others, it can take up to a year. And a few people never fully regain their sight. Even when other symptoms clear up, they may still have trouble with night vision or seeing colors.

If you have MS, heat can make optic neuritis symptoms flare up again, too — usually after a hot shower, exercise, fever, or a bout of the flu. Once you cool off, the problems usually go away.

Causes of Optic Neuritis

We don’t know exactly what the cause is. Doctors think it happens when something goes awry in your immune system and it attacks the myelin that covers and protects your optic nerve. The myelin gets inflamed and causes pain. Once it’s damaged, it can’t carry messages from your eyes to your brain.

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Optic neuritis has close links to multiple sclerosis. About half the people who have MS will get it. It’s also an early sign of the disease.

Other causes include:

What Are Optic Neuritis Risk Factors?

You may be more likely to get optic neuritis if you:

• Have MS
• Live at a high altitude
• Are white
• Are female
• Are 20-40
• Have certain genes that raise your odds

Optic Neuritis Complications

Even though optic neuritis symptoms go away, you will probably have:

• Some optic nerve damage: It may or may not cause symptoms.
• Vision changes: Your sight should be as sharp as it was before the optic neuritis, but you may not see colors as well.
• Medication side effects: The steroids most often used to treat optic neuritis put a damper on your immune system. You may get infections more easily. These drugs can also cause mood changes and weight gain.

Tests for Diagnosing Optic Neuritis

If your doctor thinks you have optic neuritis, they’ll refer you to a doctor who treats eye diseases, called an ophthalmologist. You’ll likely have a routine eye exam to check:

• Your color vision
• The smallest letters you can read on a chart
• Your side, or peripheral, vision

They’ll also use a test called magnetic resonance imaging (MRI). It creates a detailed picture of your brain and helps your doctor look for damaged areas called lesions. They may inject dye into a vein in your arm. It will make your optic nerve and brain easier to see.

Other tests your doctor might use include:

Pupillary reaction test: The doctor will shine a bright light in front of your eyes to see how they respond.

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Ophthalmoscopy: It checks your optic nerve to see if it’s swollen.

Blood tests: They can find proteins in your blood that show you might be likely to get, or already have, neuromyelitis optica.

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Lumbar puncture: If both eyes are affected, if you’re under 15, or if your doctor thinks you have an infection, they might use this test to check the fluid that surrounds your brain and spinal cord. You might hear them call it a spinal tap.

Optical coherence tomography (OCT): It measures the fiber layer in your retinal nerve. If you have optic neuritis, it’ll be thinner than in people who don’t.

Visual evoked response. The doctor attaches wires to your head with small patches. The wires record your brain’s responses as you watch a screen that displays an alternating checkerboard pattern. The test measures the speed at which your optic nerve sends signals to your brain. If it’s damaged, they’ll move more slowly.

Expect to go to back to the doctor in 2 to 4 weeks to confirm the diagnosis.

Treatment for Optic Neuritis

The condition often goes away on its own. To help you heal faster, your doctor will probably give you high-dose steroid drugs through an IV. This treatment may also lower your risk of other MS problems or delay its start if it’s the cause. But while these drugs help the swelling go down, they won’t make a difference in your vision.

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In special cases, your doctor may suggest other treatments, such as:

• Intravenous immune globulin (IVIG): You may also hear it called plasma exchange. This is a medication made from blood. You get it through a vein in your arm. It’s costly, and doctors aren’t completely sure that it works. But it may be an option if you have severe symptoms and can’t use steroids or they haven’t helped you. You can get this treatment long-term if you have optic neuritis and your brain MRI shows you have lesions.
• Vitamin B12 shots. It’s rare, but optic neuritis can happen when the body has too little of this nutrient. In these cases, doctors can prescribe extra vitamin B12.

If your optic neuritis results from a disease, your doctor will treat that condition.

What’s the Outlook?

Once your vision is back to normal, you can get optic neuritis again, especially if you have MS. If your symptoms return, be sure to tell your doctor. Report any new symptoms or those that get worse, too.

Photophobia: Light Sensitivity and Migraines

Photophobia literally means “fear of light.” If you have photophobia, you’re not actually afraid of light, but you are very sensitive to it. The sun or bright indoor light can be uncomfortable, even painful.

Photophobia isn’t a condition — it’s a symptom of another problem. Migraine headaches, dry eyes, and swelling inside your eye are commonly linked to light sensitivity.

It can cause pain whenever you’re in bright sunlight or indoor light. You might want to blink or close your eyes. Some people also get headaches.

Causes

Photophobia is linked to the connection between cells in your eyes that detect light and a nerve that goes to your head.

Migraines are the most common cause of light sensitivity. Up to 80% of people who get them have photophobia along with their headaches. Many of those people are light sensitive even when they don’t have a headache.

Other types of headaches can cause photophobia, too. People who get tension and cluster headaches also say they’re uncomfortable around bright light.

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A few brain conditions can cause photophobia, including:

• Meningitis (swelling of the protective coverings of your brain and spinal cord)
• Serious brain injury
• Supranuclear palsy (a brain disorder that causes problems with balance, walking, and eye movement)
• Tumors in your pituitary gland

Some eye diseases cause this symptom, including:

• Dry eye
• Uveitis (swelling of the inside of your eye)
• Keratitis (swelling of your cornea, the clear layer that covers the colored part of your eye)
• Iritis (swelling of the colored ring around your pupil)
• Cataracts (cloudy coverings over the lenses of your eyes)
• Corneal abrasion (a scratch on your cornea)
• Conjunctivitis (inflammation of the conjunctiva, the clear tissue that sits over the white part of your eye)
• Damage to your retina, the light-sensitive layer in the back of your eye
• Blepharospasm (a condition that makes your eyelids close uncontrollably)

Photophobia may also affect some people who have these mental health conditions:

• Agoraphobia (a fear of being in public places)
• Anxiety
• Bipolar disorder
• Depression
• Panic disorder

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You can also get photophobia after you have LASIK or other surgery to fix vision problems.

Certain wavelengths of light — like the blue light your computer and smartphone give off — cause the most sensitivity.

Some medicines can also cause photophobia, including:

Diagnosis

If you think you have photophobia, see your eye doctor. They’ll ask about your symptoms and any medical conditions you have. Then they’ll check the health of your eyes and possibly your brain.

Tests your doctor might use include:

• Slit-lamp eye exam. They’ll use a special microscope with a light to examine your eyes.
• MRI, or magnetic resonance imaging.This uses powerful magnets and radio waves to make detailed pictures of your eyes.
• Exam of the tear film. This checks the amount of tears you make to see if you have dry eyes.

Treatment

The best way to ease photophobia is to treat the condition or stop taking the medicine that’s causing it.

If you’re still affected by it, tinted glasses may help. Some people have found relief from rose-colored lenses called FL-41.

But tinted lenses aren’t for everyone. They can make some people even more sensitive to light, so talk with your doctor about what’s best for you.

Causes, Symptoms, Tests and Treatment

What Is Iritis?

Iritis is inflammation of your iris, the colored part of your eye. It’s also called anterior uveitis.

Your iris is made up of muscular fibers that control how much light enters your pupil, the opening in the center, so you can see clearly. It makes your pupil smaller in bright light and larger in dim light.

Iritis can cause serious problems, including vision loss. See your doctor as soon as possible if you have eye pain, redness, or blurry vision.

Iritis Symptoms

Iritis usually comes on quickly and most often affects only one eye. Signs and symptoms may include:

• Pain in your eye or brow area
• Severe eye pain in bright light
• Redness, especially around your iris
• An unusually small or strangely shaped pupil
• Blurry vision or vision loss
• Headache

When to get medical care

Call your eye doctor as soon as possible if you have symptoms of iritis. If you can’t reach them, go to an emergency room.

Iritis Causes and Risk Factors

In most cases, doctors don’t know what causes iritis. Sometimes, it’s tied to eye trauma or other health conditions. Causes of iritis may include:

• Injury from burns, punctures, or strikes with a blunt object
• Conditions such as ankylosing spondylitis, Reiter syndrome, sarcoidosis, inflammatory bowel disease, Behcet’s disease, juvenile rheumatoid arthritis, and psoriasis
• Infections from bacteria and viruses, including Lyme disease, tuberculosis, toxoplasmosis, syphilis, herpes simplex, and herpes zoster
• Infections with parasites, such as toxoplasmosis
• Infections from a fungus, such as histoplasmosis
• Reactions to medications

You might be more likely to get iritis if you smoke tobacco or if you have certain genetic disorders.

Iritis Exams and Diagnosis

Your doctor will ask about your symptoms and your medical history, including whether you have a condition that can cause iritis. They’ll also do exams including:

• A visual acuity test. You might read an eye chart to check your vision.
• Pressure readings. Your doctor will measure the pressure inside your eye with a special device.
• Penlight and slit lamp exams. A small beam of light can give your doctor a good look at your eye. A slit lamp uses a magnifying lens to show more detail. You might get drops to dilate (widen) your pupil first.

If your doctor suspects that another health problem is causing your iritis, they might order blood tests, imaging tests, or tests of the fluid inside your eye.

Iritis Treatment

It’s crucial to start treatment for iritis right away. You’ll probably get medicine and have follow-up visits with your doctor.

Medical treatment of Iritis

Your doctor will prescribe medication to help your eye heal and make you feel better. You might have surgery if your case is severe or if you have complications.

Drugs to treat iritis

Your doctor may prescribe one or more of these medications:

• Eye drops to dilate your pupil and prevent muscle spasms
• Steroids to lessen inflammation. You’ll probably use eye drops first. If your eye isn’t better after a week, your doctor might give you pills or shots around your eye.
• Antibiotics or antivirals to fight infection
• Anticholinergic drugs to block nerve signals for pain and light sensitivity
• Medicines to slow your immune system, if the cause of your iritis is autoimmune.

Iritis treatment at home

Take these steps while you recover:

• Follow the directions on your prescription medications.
• Wear dark glasses if light makes your eye pain worse.
• Take over-the-counter painkillers such as acetaminophen or ibuprofen if necessary.

Follow-up care for iritis

Your doctor might want to check your eye a few days after you start treatment and then see you over the next few weeks to be sure it’s healing the way it should.

Iritis Complications

Without treatment, iritis may cause complications that can lead to permanent vision loss or blindness. These include:

• Clouded lens (cataract)
• High pressure in your eye (glaucoma)
• Scar tissue causing your iris to stick to your lens or cornea (synechiae)
• Inflammation of the vitreous gel inside your eye (vitritis) or of your retina (retinitis)
• Swelling in the back of your eye (macular edema)
• Optic nerve damage
• Calcium buildup on your cornea (band keratopathy)

Outlook for Iritis

Iritis that’s caused by an injury usually goes away within 1 or 2 weeks. Other cases may take weeks or months to clear up. If a bacteria or virus causes your iritis, it will go away after you treat the infection.

Iritis might last a long time or come back if it’s linked to a disease such as sarcoidosis or ankylosing spondylitis. Your eye doctor might tell you to keep steroid eye drops on hand so you can use them at the first sign of inflammation.

Causes, Treatment, and When to See a Doctor

Eye pain is a common symptom, and there are many potential causes, ranging from serious ones, like acute angle-closure glaucoma and optic neuritis, to less serious ones, like conjunctivitis, styes, or dry eye. Certain characteristics, such as the quality of your pain (burning, sharp, aching, etc.) or associated symptoms (sensitivity to light, headache, etc.) can help your doctor narrow down the differential rapidly and efficiently.

Your primary care doctor may be able to treat your eye pain on their own, often by recommending or prescribing an eye drop and/or a self-care strategy. At other times, your provider will refer you (usually that same day) to an ophthalmologist for a more detailed examination.

Verywell / Alexandra Gordon

Causes of Eye Pain

Your eye, which sits in a bony socket called the orbit, is a complex organ consisting of several unique structures such as the sclera (the white part), iris (the colored part of your eye), pupil (black spot in the middle), and cornea (the clear outer layer of the eye).

Diseases that affect any eye structure or structure connected to your eye (for example, the optic nerve) may lead to pain.

Common Causes

Eye pain can be distracting and debilitating. The upside is that most of the common causes can be cured or managed well. Below are some of the more common eye pain diagnoses, which are generally considered not to be serious:

Stye

A stye, or a hordeolum, is a red, tender bump resembling a pimple located on the outside or inside of the eyelid. Often developing over a few days, styes generally result from an inflamed or infected eyelid oil gland. In addition to pain, a stye may cause tearing and eyelid swelling.

Corneal Abrasion

A corneal abrasion is a scratch on the surface of the cornea, which is the clear, dome-like structure on the front part of the eye. Corneal abrasions may occur on their own or as a result of an injury or trauma (e.g., from a torn contact lens or the presence of a foreign body).

The eye pain from a corneal abrasion can be quite severe, making it virtually impossible to read, drive, go to work, or even sleep. Besides pain, people often report a sensitivity to light.

Dry Eye Syndrome

The cornea of your eye is filled with nerves that give the eye and brain feedback. So when the surface of the eye dries out—due to decreased tear production and/or increased tear evaporation—eye irritation, often described as a gritty, burning, or sharp sensation, can develop. In addition to eye discomfort, a person with dry eye syndrome may notice red eyes and a sensitivity to light.

Conjunctivitis (Pink Eye)

Conjunctivitis is an irritation or inflammation of the conjunctiva—a thin membrane that lines the outside of your eyeball and the inside of your eyelid. Allergies or an infection with a virus or bacteria are the most common culprits.

Besides burning pain or soreness in the eye, conjunctivitis is often associated with a watery discharge (viral or allergic conjunctivitis) or a sticky, pus-filled discharge (bacterial conjunctivitis). Allergic conjunctivitis also causes itchy eyes and puffy eyelids.

Blepharitis

Blepharitis is inflammation of the eyelash follicles that is generally caused by an excess of bacteria at the base of the eyelashes. Common symptoms of blepharitis include swollen, itchy, and irritated eyelids. It can also cause eyelash issues, light sensitivity, dandruff-like flakes on the eyelids or eyelashes, or a foreign-body sensation in the eye. Symptoms tend to be most pronounced in the morning after waking up.

Dacryocystitis (Tear Duct Infection)

Dacryocystitis is an infection in the tear drainage system that can occur when bacteria clog up the tear duct. The infection is typically characterized by pain, redness, and inflammation that affects the inner corner of the eye. Symptoms may also include excessive tearing as well as pus or discharge from the eye. In more severe cases, a person with dacryocystitis may develop a fever.

Sinus Headache

A sinus headache results from inflammation or infection within one or more of your sinuses, which are cavities located behind your nose, between your eyes, and within your cheekbones and lower forehead. Besides pain or pressure felt behind the eyeballs, a person may experience a fever, nasal discharge, ear discomfort, and/or tooth pain.

Less Common Causes

These eye pain diagnoses occur less commonly; however, some of them require urgent or emergent ophthalmologic evaluation and treatment.

Acute Angle-Closure Glaucoma

Most cases of glaucoma create no symptoms at all. However, with acute angle-closure glaucoma, the iris suddenly blocks the drainage angle—the area where the cornea and iris meet to allow fluid to drain out of the eye. If the drainage angle is blocked, pressure builds up rapidly within the eye, causing sudden and intense eye pain and swelling.

In addition to pain, people with this condition often complain of eye redness and may see halos and rainbows around lights due to swelling. This condition is very serious and requires emergent treatment to prevent loss of vision.

Keratitis

Keratitis, also known as a corneal ulcer, refers to swelling of your cornea. In addition to eye pain, redness and blurry vision may occur. While infections (e.g., bacterial, viral, fungal, or parasitic) may cause keratitis, it may also develop from a fingernail scratch or from wearing contact lenses too long. If not treated right away, blindness may result.

Scleritis

Scleritis simply translates to inflammation of the sclera. Often associated with an underlying autoimmune disease, the pain of scleritis is severe and felt deep within the eye. In addition to pain, swelling and redness of the sclera are also common. Blurry vision (and possibly a partial or complete loss of vision), tearing, and an extreme sensitivity to light may occur.

Hyphema

Often occurring from an eye injury, a hyphema is when blood collects between the cornea and the iris at the front of the eye. The blood will cover all or part of the iris and pupil. Besides eye pain and bleeding in the eye, blurry vision and light sensitivity may also be present.

It’s important to not confuse a hyphema with a subconjunctival hemorrhage—a benign condition that results from a broken blood vessel. With a subconjunctival hemorrhage, blood will appear in the white of the eye (sclera) but will not be painful.

Optic Neuritis

Optic neuritis refers to swelling of the optic nerve, a cable-like structure that connects the eye to the brain. Although optic neuritis can occur from several causes, it is most commonly linked to multiple sclerosis. Besides pain upon moving the eye, blurry vision, loss of color vision (dyschromatopsia), and a “blind spot” (scotoma) may occur.

Interestingly, patients complain of a decrease in vision but also pain upon eye movement. Pain occurs with eye movement because the optic nerve is like a cable that connects the eye to the brain. As the eye moves back and forth, the nerve gets moved back and forth, and when inflamed, pain can occur.

Anterior Uveitis

Anterior uveitis is an inflammation of the anterior chamber—a fluid-filled compartment at the front part of the eye. The inflammation occurs as a result of an infection, autoimmune disease, or eye injury. Anterior uveitis causes an aching eye pain, along with intense light sensitivity and blurry vision.

Orbital Cellulitis

Orbital cellulitis is a serious infection of the muscles and fat that surround the eye. This condition causes pain with eyeball movement, along with eyelid swelling and drooping and sometimes a fever.

Orbital cellulitis is more common in children and often develops from a bacterial sinus infection. Prompt treatment is required to prevent vision loss and spread of the infection to the brain.

Cluster Headache

A cluster headache is a rare, extremely painful headache disorder that is more common in men. The sharp, burning, or piercing pain of a cluster headache usually occurs around or above one eye and/or in the temple area. In addition to severe pain, a person experiences one or more autonomic symptoms, such as eyelid swelling or drooping and redness or tearing of the eye.

When to See a Doctor

As described above, sometimes eye pain can originate from something very simple, while other times, it can be quite serious. This is why it’s important to see your doctor if your eye pain continues for more than a couple of hours.

If you are experiencing eye pain with vision loss or as a result of a trauma to the eye, do not wait—seek emergent medical attention.

Diagnosis

The diagnosis of eye conditions requires a medical history and eye examination. For more serious diagnoses, imaging and blood tests may be required.

Medical History

A medical history is the first step in evaluating your eye pain. Although not exhaustive, here is a list of potential questions your doctor may ask you:

• Are you experiencing any vision loss? If yes, you will need an urgent ophthalmology referral.
• Have you experienced any trauma to your eye? If yes, you will need an urgent ophthalmology referral.
• Are you experiencing associated symptoms like a headache, sensitivity to light, fever, or nasal or eye discharge?
• Do you wear contact lenses? If so, your doctor may inquire about your wearing schedule, overnight wear habits, and hygiene regimen.
• Do you feel like there is a foreign body in your eye?
• Do you have any other health conditions?

Eye Examination

In addition to a medical history, your doctor will perform an eye exam. Many different tests can be part of the exam, and your doctor may perform one or all of them, depending on which conditions they suspect are the cause of your pain. Some examples of eye tests include:

Imaging

Imaging tests are indicated to confirm a few eye pain diagnoses. For example, a computed tomography (CT) scan is done for suspected orbital cellulitis, while a magnetic resonance imaging (MRI) is done for suspected optic neuritis.

Certain imaging tests may also be ordered if your doctor thinks you may have an underlying medical condition, especially with a new diagnosis of anterior uveitis or scleritis.

Blood Tests

Blood tests are not often used for the diagnosis of eye pain unless an underlying systemic illness is suspected. However, blood cultures and a complete blood count (CBC) will be ordered when evaluating orbital cellulitis.

Treatment

Treatment of eye pain centers around what exactly is causing the eye pain. In some cases, it can be remedied in a short office visit with your primary care physician. In other cases, you may need to see an ophthalmologist.

Self-Care Strategies

Sometimes you can’t get to the doctor’s office right away. Trying the following self-care strategies can help soothe your pain until your appointment. These same remedies may also be recommended by your doctor once serious eye conditions are ruled out.

For a Stye

Applying a warm, wet compress to the affected eye for 10 minutes, three to four times a day can ease your discomfort and coax the stye into draining on its own. Be sure to not squeeze or pop the stye, though, as this can spread the infection.

For Dry Eyes

You may consider one or more of these strategies:

• Try not to blink a lot, especially when performing visually demanding tasks like reading or using the computer.
• Place a humidifier in your bedroom or home office.
• Minimize exposure to air conditioning or heating.
• Consider glasses that have protective shields on the sides to protect your eyes from dry air and wind.

For a Foreign Body

You may consider placing an eye patch or taping the eyelid shut with medical tape until you see your doctor. By reducing the ability to blink, you will minimize the likelihood of more scratches occurring. Be sure, though, not to tape the eye shut for more than a few hours, as bacteria can flourish in dark, warm environments.

For Viral or Allergic Conjunctivitis

Place a cool, wet compress on your eye to ease the discomfort.

For Blepharitis

Focusing on eyelid hygiene can help minimize flares and manage symptoms. To keep eyelids clean and loosen crusts, try applying a warm compress over your eyes for 10 minutes two to four times a day.

Medications

Your doctor may prescribe different types of medications to both alleviate your pain and treat the underlying problem, if present.

Non-steroidal anti-inflammatory (NSAID) eye drops may be prescribed to soothe your eye pain. While these work quite well, they should not be prescribed for the long term due to a potential for cornea problems.

Allergy eye drops, available both over-the-counter and by prescription, can relieve the redness, itchiness, and puffiness of allergic conjunctivitis.

While not a cure, artificial tears are used to manage dry eyes. Artificial tears come in different formulations (e.g., liquid, gel, ointment) and are available over the counter. When “chilled” or placed in the refrigerator for an hour, they can often be extra-soothing.

For people with severe or persistent dry eyes, an ophthalmologist may consider prescribing medication, like topical cyclosporine or lifitegrast.

Antibiotic eye drops are usually prescribed to treat bacterial conjunctivitis and bacterial keratitis. They are sometimes prescribed for blepharitis as well.

Glaucoma eye drops—of which there are several kinds—work to lower the pressure in your eye. For acute angle-closure glaucoma, eye drops along with an oral or intravenous medication (called acetazolamide) will be given to reduce the pressure immediately.

Oral antibiotics may be used to treat a few different eye pain diagnoses, such as:

• A stye that does not resolve on its own or becomes infected
• A bacterial sinus infection
• Blepharitis that does not respond to antibiotic eyedrops or ointments

Intravenous antibiotics, which are antibiotics given through your vein, are indicated for the treatment of orbital cellulitis.

Steroid eye drops (or pills) are used to treat more serious eye pain diagnoses, like anterior uveitis.

High-dose corticosteroids, administered orally or intravenously, are indicated to treat optic neuritis.

Surgery

Sometimes surgery is required to treat your eye pain diagnosis. For instance, in the case of acute angle-closure glaucoma, once the initial eye pressure is reduced, laser therapy or less commonly, surgery, is needed to drain the fluid from the eye.

For severe keratitis, if the cornea is severely scarred or thinned, a corneal transplant may be needed. Dacryocystitis may also require surgery to widen the tear duct pathway and clear any blockage so that infection does not recur.

Prevention

While not all eye pain diagnoses can be prevented, some can. Here are a few examples of eye preventive care strategies:

To prevent styes and conjunctivitis, it’s important to wash your hands often, especially before applying eye makeup or putting in contact lenses. It’s also a good idea to remove your eye makeup every night using a fresh, clean towel.

Never share eye drops with anyone or touch the tip of a dropper to your eye, as this can transfer bacteria.

To prevent corneal abrasions, it’s important to wear protective eyewear if you are engaging in an activity that risks eye injury (e.g., cutting wood or metal). Be sure to also clean your contact lenses well and not use them for longer periods of time than advised.

A Word From Verywell

Getting to the bottom of your eye pain may be a straightforward process, or it may be more complicated, especially if a serious diagnosis is suspected. Be sure to seek a doctor’s advice if you are experiencing eye pain (even if it’s after hours or on the weekend). Your condition could be severe and require immediate treatment.

Sinus Headache in Adults: Condition, Treatments, and Pictures – Overview

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Images of Sinus Headache

Overview

Sinus headache involves head pain in the setting of irritation of the sinuses (air-filled chambers present in several bones of the face). This irritation can be secondary to infection of the sinuses by viruses, bacteria, fungi, or other organisms or may be secondary to allergies.

Immediately seek medical attention if you or someone you are caring for experiences any of the following:

• Stiff neck and a high fever associated with headache
• Sudden onset of a severe headache
• Loss of motor function, the ability to think clearly, or convulsions associated with headache
• Head injury
• Increased intensity and/or frequency of headaches

Who’s at risk?

Sinus headaches are a common response to allergies to substances in the environment such as dust, pollen, ragweed, and grass, which, in those affected by the particular allergy, cause production of secretions that drain into the sinuses and congest them. People with chronic or severe allergies may develop headaches in specific settings that they can easily identify (eg, seasonal allergies, being around pets).

Infection of the sinuses is possible in anyone, but it is potentially more common or serious in people who have weakened or malfunctioning immune systems (those with AIDS, cancer, or poorly controlled blood sugar; with chronic steroid use; old age, etc). Certain conditions may also make a person prone to sinus infections (eg, those with Sjögren’s syndrome), due to abnormal tissue lining of the sinuses. Injury to nasal passages and sinuses may also predispose a person to sinus infections and headaches.

Signs and Symptoms

Sinus headaches involve pressure or pain in the forehead, brow, below or behind the eye, behind the ear, and, occasionally, sensitivity in the upper gums. This pain is typically constant and on one side, but it may be on both sides of the head. Congestion with difficulty breathing through the nose may be present, due to secretions that can be thick and yellow or green in color. Blowing of the nose, moving quickly, lying down, and bending forward often intensify the pain. The area around the eyes and cheek may be swollen, to the extent that the eye may appear narrowed on the affected side when open. The forehead, brow, and cheek may be tender to the touch. Cough, runny nose, and itchy eyes and ears (if due to allergies) are additional possible symptoms.

If a fever is present along with sinus headache, then infection is more likely, but many sinus infections causing headache do not involve a fever. Sore throat, muscle aches, and fatigue may be present if the sinus infection is caused by a virus.

Self-Care Guidelines

Humidified air from a humidifier, basin of hot water, or shower can relieve symptoms, as can over-the-counter pain medications such as ibuprofen or acetaminophen. Over-the-counter decongestant sprays (oxymetazoline, phenylephrine) and tablets (pseudoephedrine) are often helpful. If allergies are responsible for the sinus headache, antihistamines (diphenhydramine, loratadine) or saline nasal sprays are effective and available at pharmacies.

Avoiding the causes of allergies or treating the allergic problem before exposure is also important. Avoiding flying or sudden changes in air pressure when having a sinus headache is helpful as well.

When to Seek Medical Care

For people with known allergic triggers to sinus headaches, management is often possible without routine medical care simply by relieving symptoms with over-the-counter medications and, when possible, avoiding what causes the allergies.

Call your doctor if:

• You have head pain over your sinus and develop a fever, or you have a problem with your immune system.
• You symptoms are worsening in ways not experienced before.
• You develop new symptoms not typical of prior headache.
• A particularly severe headache occurs.
• Alteration or loss of consciousness occurs.
• Headache persists longer than 5–6 days, particularly with symptoms that are worsening.
• Current therapies/treatments are not working.
• Fever and neck pain or stiffness are present.
• Headache symptoms interfere with activities of daily living (eating, bathing, working, etc).
• You suspect an infection.

Treatments Your Physician May Prescribe

If appropriate, your doctor may prescribe over-the-counter medications described above. Decongestants can be particularly helpful in sinus headache.

For more difficult allergies, medications that decrease secretion formation may be prescribed. Steroid nasal sprays can also be used effectively. For severe allergies, your doctor may refer you to an allergy specialist for other desensitizing therapies.

Your doctor may order a CT or MRI scan of the sinuses to determine the extent of a bacterial infection, if present. If your doctor suspects a bacterial infection, he/she may prescribe antibiotics. Many sinus infections are caused by viruses that the body can effectively eliminate with time, which do not require antibiotics. Different agents designed to kill fungus or other organisms may be prescribed depending on your medical history. Additionally, some of the fluids draining from you sinus may be taken to identify the infection.

Other headache syndromes, such as migraine or cluster headache, can mimic sinus headache. Your doctor will discuss these possibilities and advise you accordingly.

90,000 Periostitis of the eye orbit: description of the disease, causes, symptoms, cost of treatment in Moscow

Periostitis is a process that is inflammatory in nature, occurring in the periosteum (connective tissue located on all surfaces outside the bone). Inflammation most often begins in the outer or inner layers of this tissue, then the process penetrates into the rest of its layers. Due to the fact that the periosteum and bone are practically one whole, the inflammatory process begins in the bone tissue, it is called osteoperiostitis.

The disease can develop quickly enough within two to three days or gradually over a couple of weeks. The inflammation is gradually absorbed and replaced by connective tissue. The catarrhal process can turn into a purulent one, while a subperiosteal abscess develops, threatening with a transition to the phlegmon of the orbit.

The form of the disease called posterior periostitis is rather difficult to diagnose. The patient with it is worried about pain in the orbit, decreased visual acuity, decreased sensitivity of the skin on the eyelids, limited movement of the eyeballs and chemosis of the conjunctiva.

If periostitis has developed as a result of tuberculosis or syphilis, then it is characterized by an anterior location. The tuberculous type of the disease manifests itself in the lower outer part of the orbit, it is painless. The syphilitic form of the disease is accompanied by severe pain at night.

Classification

By localization, the anterior and posterior periostitis of the eye orbit differs, by the nature of the process, there is a simple and purulent type of disease.

Simple develops more often against the background of infectious diseases (for example, measles, syphilis, rubella, tuberculosis, etc.). The increase in symptoms with it is slow, characterized by edema, pain in the eyelids and the edges of the orbit, hyperemia. With the right therapy, a complete cure is possible with a slight thickening in the area of ​​inflammation.

The purulent form of the disease begins rapidly, accompanied by malaise, headaches, high fever, local symptoms appear much stronger than with simple periostitis.The patient needs hospitalization.

With anterior periostitis, inflammation is localized along the edge of the orbit, an infiltration is formed, and a fistula may appear on the skin. This form of the disease is treated surgically.

With posterior periostitis, the infiltrate accumulates in the area of ​​the ethmoid bone, the main sinus. May be complicated by optic neuritis with decreased function.

Also, periostitis can have an acute and chronic form.The first is accompanied by purulent inflammatory processes, arises from the penetration of pathogenic microorganisms into the periosteum. The development of the disease can be suspected by the appearance of swelling in the periosteum and swelling of soft tissues. Further, the swelling transforms into purulent inflammation, the patient’s body temperature rises to 38-39 degrees.

The chronic form of the disease is accompanied by the appearance of thickening on the bone, it does not cause pain. This form of the disease is revealed during X-ray examination, the lesion has a clear outline.With it, pathological changes in bone tissue of moderate severity, severe hyperplasia in the periosteum are observed. The chronic form develops if the acute one has not been cured. In some cases, the periostitis of the eye orbit does not go through the acute stage, but immediately begins with a sluggish, chronic one.

The reasons for the development of the disease

The following reasons can cause periostitis:

1. The introduction of pathogenic microbes into the body (Koch’s bacillus, spirochete, streptococcus, staphylococcus).

2. Angina.

3. Sinusitis.

4. Scarlet fever.

5. Furunculosis.

6. Injuries to the eyes and face resulting in wounds.

7. Dacryocystitis.

8. Purulent inflammation of the conjunctiva or cornea.

9. Influenza.

10. Caries or periodontal disease.

11. Sinusitis.

Pathogenesis of the disease

The mechanism of the appearance and course of the disease is divided into types:

1. Traumatic. The disease occurs as a consequence of trauma that affects the periosteum. There is an aseptic inflammatory process. The disease can manifest itself in an acute form, but if left untreated, it becomes chronic. It is treated with physiotherapy, applications, magnets to reduce the amount of exudate.Next, laser therapy is applied to reduce the thickening on the periosteum.

2. Toxic. It occurs due to the effect on the periosteum in the area of ​​the eye orbit of various toxins that get there with blood or lymph from other affected areas. This type often develops against the background of general diseases of the body.

3. Inflammatory. The disease develops due to inflammation of nearby tissues.

4. Allergic. It occurs due to an allergic reaction of the body to any irritating factors.

5. Specific. Develops against the background of certain diseases.

Diagnostics

Periostitis of the orbit requires careful diagnosis. The patient should consult an ophthalmologist and otorhinolaryngologist. Most often, doctors prescribe the following diagnostic methods:

1. General and biochemical blood test.

2. Radiography of the orbit.

3. Examination of the sinuses of the nose.

4. Immunoassay for the detection of antibodies of pyogenic bacteria.

5. Computer or magnetic resonance imaging.

Differential diagnosis

These diagnostic methods are used if a person has symptoms of several diseases that are similar in the course of the disease. They help to make an accurate diagnosis. For example, to distinguish acute and purulent periostitis from abscess, phlegmon, lymphadenitis and other ailments.Chronic, aseptic and specific periostitis is detected with the help of X-ray examination, they can reveal thickenings, growths on bones, necrotic tissue changes, etc.

If an X-ray does not allow an accurate diagnosis, then doctors resort to biopsy.

Periostitis in children

By the nature of the course, periostitis in children can have acute and chronic forms. Although the first type of ailment is more common.The disease can occur against the background of the postponed injury and due to the penetration of infection into the periosteum.

Treatment methods

Drug therapy

Periostitis of the orbit is treated comprehensively. The doctor may prescribe the following antibacterial medicines to treat a simple, non-suppurative type of disease:

• Nitrofural;

• Tobrex;

• Cyloxane;

• Floxal;

• Erythromycin;

• Uniflox;

• Tetracycline.

Antiseptic medicines are also prescribed:

Drugs that have a reparative effect:

• Korneregel;

• Methyluracil.

The purulent form of the disease is treated in a hospital, since it is necessary to open the infiltrate. Posterior periostitis is also treated in the hospital, since the treatment must be systemic and include antibiotic therapy, vitamin preparations, sulfa, detoxification, antihistamines, decongestants.If adjacent sinuses are involved in the inflammatory process, then an autopsy is also necessary.

Periostitis of the orbit, accompanied by complications of a purulent or septic nature, is always treated with antibiotics. It is worth noting that the drug should be prescribed by a doctor after all tests have been performed, since some bacteria such as staphylococcus and streptococcus have mutated over time and acquired resistance to some types of antibacterial drugs. Staphylococci are not sensitive to penicillin antibiotics, and streptococci still die from them.The disease can be caused not by one specific bacterium, but by their association, for example, staphylococcus + streptococcus, staphylococcus + pseudomonas aeruginosa + proteus, etc.

Not so long ago, the periostitis of the eye orbit was treated with shock doses of an antibiotic, but today this method of treating the disease is a thing of the past. A large amount of an antibacterial drug can cause intoxication of the body, provoke the development of allergic reactions, candidiasis or dysbiosis.

To cure the purulent form of periostitis, the doctor prescribes antibiotics that have a tropism to bone tissue.Suitable for these purposes:

Antibacterial drugs must be taken for at least 7 days. If the disease requires a longer antibiotic treatment, then the doctor prescribes new ones every 7-10 days so that harmful microorganisms cannot develop resistance to them. Also, the medication is changed if the patient has complications of the disease. With long-term treatment with drugs of this type, the patient needs to donate blood for analysis weekly.

The purulent form of periostitis of the eye orbit is treated in a complex manner, therefore, antibiotics are often combined with antifungal medication.Which include:

If the doctor believes that the disease is caused by anaerobic microbes, then he prescribes the following drugs to the patient:

Antibiotics belonging to the cephalosporin group cope best with anaerobic infections:

Also, for the treatment of periostitis caused by these types of pathogenic microorganisms, drugs such as Biseptol and Dioxidin can be prescribed.

Physiotherapy

After the patient undergoes drug therapy to eliminate inflammation, he is prescribed physiotherapy:

one.Laser treatment.

2. Magnetotherapy.

3. Ultrasound.

4. Infrared irradiation.

5. UHF therapy.

6. Inductothermy.

7. Exposure to ultraviolet light.

Physiotherapy is needed in order to eliminate pain, accelerate tissue regeneration and metabolic processes in them, improve local immunity, normalize blood circulation and lymph drainage, relieve edema, and have anti-inflammatory and bactericidal effects.

Treatment of periostitis in children

In childhood, the disease can be both endogenous and post-traumatic in nature. In children, due to their anatomical features of the body, the disease develops rapidly, begins with local signs of inflammation, an increase in body temperature. Other signs of the disease are manifested in the form of asymmetric edema from the affected area, soft tissue edema, and enlarged lymph nodes. If the child is not shown to the doctor in time and adequate treatment is not started, then the ailment can become chronic.

In children, the treatment of periostitis of the eye orbit begins with the removal of the focus of infection. Further, the doctor prescribes antibiotics, for example, Amosiklav, Metronidazole, drugs such as Nurofen and Diphenhydramine. In addition, during complex treatment, vitamins are prescribed, for example, “Multitabs”. With a purulent form of the disease, surgery is required, washing the affected area with antiseptic agents and drainage.

Disease treatment at home

Only a doctor can decide whether it is possible to treat periostitis of the orbit at home.At home, you can only carry out those procedures that reduce pain. It is better not to postpone the visit to the hospital. In some cases, a non-purulent or simple type of disease can be treated at home, but exactly following all the requirements and prescriptions of the attending physician. As a rule, such therapy consists in anesthetizing the affected area, taking non-steroidal anti-inflammatory drugs, the doctor also prescribes a scheme for their use. It is not recommended to apply compresses and drink herbal tinctures on your own.

Periostitis forecast

The prognosis of a cure for a disease largely depends on its form and the timeliness of the treatment begun. If therapy began to be carried out on time, and the disease, for example, developed as a result of an injury, then, as a rule, it is treated quite successfully.

Purulent advanced forms of periostitis of the orbit may indicate an unfavorable prognosis of the course of the disease. Here complications can arise, inflammation can spread to neighboring tissues, and sepsis can occur.

Periostitis caused by any disease often becomes chronic. The success of their cure depends on how successfully the underlying ailment is cured.

Doctors note that periostitis is a rather insidious disease that leads to serious consequences for the human body and its skeletal system. At the slightest suspicion of its development, you must go to the hospital.

Right or left eye hurts – what is the danger?

Eye pain is a term that includes discomfort in, around and behind the eye.The pain can affect both eyes, and only one. Let’s analyze the last option in more detail.

There is no evidence from studies showing that the right or left eye hurts more often. In each case it is individual.

The most common causes of acute pain in one eye are:

Eye trauma with damage to the cornea, acute attack of glaucoma, iridocyclitis, phlegmon of the orbit, neuralgic syndromes, headaches and temporal arteritis.

1) Injuries to the eye with damage to the cornea. When the anterior transparent membrane of the eye – the cornea – is damaged, a whole complex of symptoms arises, which is combined into the corneal syndrome. In this case, the patient experiences acute cutting pain, photophobia, blepharospasm (the eye cannot fully open). This is due to damage to the nerve fibers of the cornea, which are abundant on its surface. A characteristic diagnostic sign is an improvement in the condition with the use of anesthetic drops, since the sensitivity of the nerve endings decreases.

2) Acute attack of glaucoma. It develops with a sharp increase in intraocular pressure. In this case, the pain spreads to the temple, vision deteriorates, becomes cloudy, the eye acquires a red-violet tint, the eyeball becomes hard, palpation is painless. This situation is urgent and requires immediate medical attention! With prolonged exposure to high pressure, the optic nerve begins to suffer, its tissue is destroyed and the previous visual acuity may not be restored.

Also, glaucoma can proceed without acute attacks. A gradual increase in intraocular pressure does not give acute manifestations, which is often the reason for a late visit to an ophthalmologist. The disease reaches the terminal stage, visual function is lost and hypertensive pain syndrome occurs. The pain comes on gradually and decreases slowly.

3) Iridocyclitis is an inflammation of the anterior part of the choroid (iris and ciliary body).

In this case, the patient experiences acute pain that intensifies at night, the pupil narrows and loses its ability to expand. The eye is soft, but tenderness occurs on palpation.

4) Orbital phlegmon is a purulent inflammation of the orbital tissues. In this case, the pain is localized in the area of ​​the eyeball and next to it. It occurs acutely, the patient’s general condition worsens, the temperature rises, chills and headache appear. The eyelids swell, and when touched, the pain increases sharply.This condition is life-threatening and requires urgent medical attention.

5) Neuralgic syndromes. One-sided eye pain is characteristic of nerve damage. Depending on the affected nerve, the exact location of the pain and its nature differ. With the defeat of the trigeminal nerve (its first branch), severe paroxysmal pains in the area of ​​the eye, brow and upper eyelid are characteristic. Palpation at the exit point of the optic nerve is very painful.

Nasal nerve neuralgia – characterized by severe pain in the eye area, at the inner corner of the eye and the back of the nose.

Pterygopalatine syndrome – pain in the frontal region and in the area of ​​the eyeball. May be accompanied by upper eyelid edema and photophobia.

6) Headaches.

Migraine is accompanied by severe one-sided pain in the fronto-orbital-temporal region of the head. In this case, the pain can spread to the entire half of the head, and vision can deteriorate (in most cases this is manifested by the appearance of a flickering spot in the field of view).

Also known are cluster pains – this is a throbbing headache that captures the eye area, lasting 1.5 hours. It occurs mainly at night at the same time.

7) Temporal arteritis. It occurs exclusively in the elderly, with rare exceptions. Women are more susceptible. This is an inflammation of the arteries that supply blood to the head, eyes and optic nerve. During an attack, there is severe pain in the temple, eye area, temporary deterioration of vision.The danger of this disease is that, with a prolonged course, it can cause irreversible loss of vision.

As you can see, the list of possible causes of pain in one eye is extensive. For an accurate diagnosis, dynamic observation is necessary, in some cases specific examinations. Among these pathologies there are conditions, the delay in which is life-threatening.

Treatment.

• In case of eye injuries, it is necessary to make sure that there are no foreign bodies, if necessary, remove them, treat the wounds with antiseptics, antibacterial drugs and healing gels.
• In glaucoma, it is necessary to normalize intraocular pressure, neuroprotective drugs that protect nerve tissues from high pressure.
• For iridocyclitis – anti-inflammatory and antibacterial therapy is used, as well as the treatment of a systemic disease that provoked iridocyclitis.
• Neuralgic syndromes are caused by inflammation of the nervous tissue, therefore, anti-inflammatory therapy is mainly required. Headaches, like neuralgia, require joint supervision by neurologists.
• Temporal arteritis is treated with a therapist. Prescribe a course of steroid drugs that relieve inflammation of the arteries well.
• All treatment requires an individual approach and comprehensive monitoring. If you notice pain arising in one eye, especially recurring pain, do not hesitate. Sign up for a consultation! After all, only timely medical care will give the fastest way to get rid of the painful condition.

Take care of your eyes and be healthy!

90,000 Retinoblastoma (Brief information)

Retinoblastoma is an eye cancer.In our text, you will receive important information about what kind of disease it is, how often it occurs, why a child can get it, what the symptoms are, how the diagnosis is made, how children are treated and what are their chances of being cured of this form of cancer.

author: Maria Yiallouros, erstellt am: 2016/04/04,
editor: Dr. Natalie Kharina-Welke, Permission to print: Dr. med. Christine Jurklies; Dr. med. Petra Temming, Translator: Dr. Maria Schneider, last modified: 2021/01/26
doi: 10.1591 / poh.retino-patinfo.kurz.1.20120611

What is retinoblastoma?

Retinoblastoma is a rare type of eye cancer. The tumor grows in the retina of the eye (the medical term for retina is retina) and it is almost always found only in children. This disease has a hereditary and non-hereditary form. If retinoblastoma is hereditary, then family members have a predisposition to the fact that one of them may get sick. If retinoblastoma is not hereditary, then eye cancer occurs spontaneously, that is, the cells of the retina of the eye begin to change by themselves.

Retinoblastoma can affect one eye, or both eyes. Most often, it grows in only one eye (experts call this unilateral retinoblastoma, or unilateral tumor). In about one third of children, the tumor begins to grow simultaneously in both eyes (experts call it bilateral retinoblastoma, or bilateral tumor). If cancer appears in both eyes at once, then this almost always indicates hereditary retinoblastoma. Unilateral retinoblastomas are usually not hereditary.The tumor can grow in one area of ​​the eye (in this case, doctors call it unifocal), or simultaneously in several areas (then doctors speak of a multifocal tumor).

Retinoblastomas usually grow quickly. They can appear inside the eyeball. From there, they grow into the eye socket and travel along the optic nerve [optic nerve] to the brain, and cancer cells enter the central nervous system [CNS]. If the disease is at an advanced stage, then cancer cells through the blood and / or lymphatic pathways enter other organs.If left untreated, the disease is almost always fatal. Only in extremely rare cases (in 1-2% of children) the tumor spontaneously disappears by itself. In this case, experts talk about spontaneous regression.

How common is retinoblastoma in children?

Of all types of intraocular cancer, retinoblastoma is the most common cancer in children. In Germany, about 40 children and adolescents under the age of 15 fall ill with retinoblastoma every year. In other words, annually out of 18.000 newborns, one child develops retinoblastoma. But in general, this type of cancer is rare. According to the Children’s Cancer Register (Mainz), retinoblastoma accounts for about 2% of all cancers in children and adolescents.

As a rule, retinoblastoma occurs in infants and young children, that is, almost always – under the age of 5 years. Almost 80% of cases are children under the age of four. Retinoblastoma is extremely rare in children over six years of age.

Why do children get retinoblastoma?

Retinoblastomas appear when two genetic [genetic] changes (two mutations) occur in the progenitor cells of the retina, the so-called retinoblasts. These changes (mutations) can spontaneously appear in the cells of the retina themselves. But mutations can also be found already in the germ cells [germ cells], and therefore in all the cells of the body; then such mutations are inherited, that is, they are congenital.

In the majority of patients – about 60% of all children – retinoblastomas are not hereditary. This means that changes appeared only in a sick child (experts call such mutations the term “sporadic”), and the mutation is isolated only in tumor cells. But 40% of retinoblastomas are congenital. In about a quarter of these cases (that is, from 10 to 15% of all patients), retinoblastoma in the family was already known. When it is known that someone in the family has already suffered from this type of cancer, experts talk about familial retinoblastoma.Other congenital retinoblastomas appear for the first time in children.

Regardless of whether retinoblastoma is hereditary or not, specialists always find genetic changes in the so-called retinoblastoma gene [retinoblastoma gene], which is located on chromosome 13 [chromosome]. Since in humans each cell contains a double set of chromosomes, this means that the retinoblastoma gene is also duplicated (each cell has two so-called alleles [allele] of the retinoblastoma gene).The tumor begins to grow only when there are changes in both alleles.

For more information on the genetic classification of retinoblastomas, how often they appear and how they occur, see the section “The genetics of retinoblastoma / How is the disease inherited?”

What are the symptoms of the disease?

While retinoblastoma is very small, children usually do not complain about anything. For a long time, the disease does not manifest itself in any way, children do not have any symptoms.The first complaints appear when the tumor becomes larger, or it begins to grow into other parts of the eye. The child begins to lose sight, sometimes to the point of complete blindness. The visual acuity of both eyes becomes different and therefore strabismus may appear in children (occurs in about 25 to 30% of patients).

The most common first symptom, according to which about one third of children is diagnosed with retinoblastoma, is a white glow of the pupil under certain lighting (in the language of specialists, this symptom is called leukocoria).For example, in bright light from a camera flash, the healthy pupil becomes red or black, and the diseased pupil develops a white reflex. Such a white pupil is called a “cat’s eye”, and the very effect of a “cat’s eye” suggests that the tumor has already grown behind the lens. Less commonly, it happens that a child’s eye hurts, turns red or swells when intraocular pressure rises.

Anxiety symptoms in children are:

• When the pupil (or both pupils) turns whitish-yellow (leukocoria) 90 100
• the child starts to squint or vision deteriorates / visual acuity 90 100
• redness or swelling of the eyes, eyes start to hurt 90 100 90 125 90 200
  If a child develops one or several of the listed symptoms at once, this does not mean that he has contracted retinoblastoma, or some other type of cancer.Some of these symptoms appear for completely harmless reasons and have nothing to do with cancer. However, we recommend that you see your doctor as soon as possible and find out the exact cause. If it really is retinoblastoma (or some other malignant disease), then a timely diagnosis is the best condition for a good treatment result.

  Children from families with an increased risk of hereditary disease should have regular eye examinations, even if they have no symptoms or complain about anything.Only then can a specialist diagnose retinoblastoma at an early stage and the child will be treated on time.

  How is retinoblastoma diagnosed?

  If the pediatrician (or other specialist) suspects retinoblastoma from the child’s medical history (history) and according to the results of external examination [external examination], the doctor will refer the child to a clinic that specializes in this form of oncology (ophthalmological or children’s cancer center).

  If retinoblastoma is suspected, different tests should be performed. First, the diagnosis must be confirmed. Secondly, it is necessary to find out what specific form of retinoblastoma the child fell ill with (hereditary or non-hereditary), and how much the disease had time to disperse throughout the body.

  Ophthalmoscopy is the most important test to confirm the diagnosis. If retinoblastoma is indeed confirmed, then more research is needed to understand exactly how much.the disease has spread throughout the body. Such important tests are ultrasound (ultrasound) and MRI (magnetic resonance imaging). Additionally, the child is examined by a pediatrician.

  In rare cases, for example, when a child has a pronounced late stage of the disease and / or is about to start chemotherapy, specialists may perform other additional tests, for example, chest X-ray, analysis of cerebrospinal fluid (lumbar puncture), bone brain (bone marrow puncture) and / or examination of the child’s bones (scintigraphy of the bones of the skeleton).

  All diagnostics are performed not only for a sick child. Since the patient may have a congenital form of retinoblastoma, the ophthalmologist checks his brothers, sisters and parents. Also, the whole family undergoes a molecular genetic blood test (genetic diagnosis) to assess the hereditary situation.

  When all the necessary studies and analyzes have been done, a team of specialists together with you decides which treatment tactics will be most effective for your child.

  How is retinoblastoma treated?

  Treatments for children with retinoblastoma include surgery, radiation (brachytherapy or percutaneous radiation therapy), cryotherapy, laser therapy, and chemotherapy.

  What specific method of treatment specialists will stop at depends on whether the tumor has grown in one eye, or in both, how much the disease has spread throughout the body at the time of diagnosis (stage of the disease), and whether it can be expected that after therapy, vision can still be preserved in one eye, or both.Also, when drawing up a treatment plan, the age of the child is taken into account.

  The goal of any treatment is to completely kill, or more accurately remove, the tumor, which means complete recovery from cancer. Therefore, the basic principle is that keeping a child alive is more important than preserving vision.

  In principle, two treatment tactics are possible:

  • Surgical removal of the tumor together with the eye (in the language of specialists, this is called enucleation) 90 100
  • Treatments with radiation therapy, laser therapy, cryotherapy and / or chemotherapy that save the eye.

  It is possible to cure a child and save an eye at the same time only if the diagnosis of retinoblastoma was made in a timely manner, that is, at an early stage of the disease. The goal of such treatment is to completely neutralize the tumor and at the same time preserve vision without risking life. If the disease is at a later stage, then, as a rule, removal of the eye is inevitable. If metastases were found, then in addition to the operation, chemotherapy and / or radiation therapy should also be carried out.

  How children with unilateral retinoblastoma are treated

  If the child has unilateral retinoblastoma, then removal of the diseased eye (enucleation) is the most reliable and most justified method of treatment. Because the child has a second fully working eye and it is possible to refuse other types of treatment that have certain risks. If retinoblastoma is not hereditary, then the treatment ends and the child recovers completely.

  If the tumor is small, then in some cases a treatment is possible, which will preserve the eyeball (first of all, this is a local treatment, the so-called brachytherapy). But this type of treatment is justified only if it is possible not only to cope with the tumor, but after its completion, vision can still be preserved. It is not yet known how long the effectiveness of this method of treatment will be (that is, whether the survival rates of patients will worsen in the future).

  But it must be said that unilateral retinoblastomas, as a rule, are found very late, that is, already at advanced stages. By this time, the diseased eye is usually already blind. Therefore, when it is removed, it does not mean that the child will become worse in seeing or worse to orientate.

  If the tumor can be completely removed by surgery, then no additional treatment is needed after the operation. If the analysis of the tumor tissue (histological analysis) from the removed eye shows that the retinoblastoma was very extensive, or it has already gone beyond the eye, then after removal (enucleation) the child receives chemotherapy courses.Chemotherapy is needed to kill tumor cells, possibly remaining in the body, or destroy the smallest metastases. In extremely rare cases, additional percutaneous radiation therapy is performed.

  How children with bilateral retinoblastoma are treated

  If your child has bilateral retinoblastoma, doctors will try to find an individual combination of the available treatments. Their goal is not only to completely control the tumor, but also to simultaneously preserve vision in at least one eye.

  Therefore, treatment starts with local therapy . Isolated small retinoblastomas can be reliably destroyed with local treatments such as laser coagulation, cryotherapy, or brachytherapy. But it must be said that often these types of treatments need to be performed several times.

  If the tumor is too large for these methods, then in some cases courses of chemotherapy are first prescribed to reduce the size / volume of the tumor .After that, they move on to local therapy (that is, to laser therapy, cryotherapy or brachytherapy).

  It often happens that in one of the eyes the retinoblastoma has grown so extensively that there is no point in trying to save the eyeball. Therefore, specialists completely remove the eyeball ( enucleation ).

  Sometimes – in cases where chemotherapy is required to treat a less diseased eye – enucleation of the more affected eyeball may be delayed.As a result of chemotherapy, the tumor can go away and shrink so much (in the language of specialists, this is called tumor regression) that it will still be possible to save the eyeball. But if the worst eye is already blind, or the tumor has grown into the anterior part of the eye (doctors talk about tumor infiltration), or the tumor has grown into the optic nerve, then only enucleation remains. There is no other alternative.

  If in the second eye (initially less affected by the disease) the tumor continues to grow (that is, the tumor began to grow into the optic nerve or the choroid; there are tumor screenings in the vitreous body), then the only treatment that can save the eyeball is percutaneous irradiation .But it is done only if the function of vision has not yet been lost. If this is not the case, then it is necessary to remove the second eye, so as not to endanger the life of the child.

  Since the risks of complications after courses of modern chemotherapy are lower than after irradiation, today doctors are trying to, whenever possible, refuse percutaneous radiation therapy [percutaneous radiation therapy], especially in children of the first year of life. But I must say that the effectiveness of percutaneous irradiation remains indisputable, since retinoblastomas are very sensitive to irradiation.

  What are the new approaches to the treatment of retinoblastoma?

  To avoid the need to remove the eyeball or conduct radiation therapy, as well as, if possible, reduce or even avoid complications after intravenous chemotherapy (and it acts systemically, that is, on the entire body of the child), recently specialists have been developing and testing new methods of treatment.

  One of the most promising treatments is the so-called intra-arterial chemotherapy (you can also find another term intra-arterial chemotherapy ).This means that the cytostatic agent and (for example, melphalan) are deliberately injected into the eye through the ophthalmic artery. To do this, a catheter is inserted through the groin into the femoral artery, moves towards the heart and is brought to the right place, that is, to the ophthalmic artery of the diseased eye. Through a catheter, the drug is injected directly into the ophthalmic artery and from there diverges through the vascular system that supply blood to the eyes, including through the vessels of the tumor, that is, retinoblastoma.

  This type of treatment is still experimental.They work with him in several clinics and only with a certain group of patients, for example, if the disease does not respond to standard treatment. In some cases, it is performed as an initial treatment (primary therapy). So far, the results have been good. But it is not known exactly how long the effect will be, that is, how long this local treatment allows the tumor to be controlled. Also, all potential late complications and consequences have not yet been fully explored.

  What protocols and registries are used to treat children?

  In order to choose the most optimal treatment method for each specific case, which is recommended for each risk group (in the language of specialists – risk-adapted treatment), there must be a base that is based on reliable statistical data.But retinoblastoma is an extremely rare disease (about 4 children fall ill every year in Germany and Austria). Therefore, to date, little data has been accumulated on this disease.

  Therefore, unlike other forms of cancer that occur in children and adolescents, there is no single standard protocol for the treatment of retinoblastoma, which in Germany is called therapy optimization studies. (German protocols, or therapy optimization studies, are clinical studies and are strictly controlled.They are used to treat children and at the same time investigate a specific form of cancer).

  It is for this reason that clinical register RB-Registry was opened in 2013. This registry will collect data on the epidemiology [epidemiology] of retinoblastoma and how the disease progresses for several years. The goal is to gather more information about this form of cancer and how different types of therapies respond to treatment.

  This registry accepts all children and adolescents from Germany and Austria under 18 years of age who first develop retinoblastoma and / or have found a germline mutation in the RB1 gene (germline mutation [germline]) and have not yet received any treatment.The central research office is located at the Essen University Hospital. Head – Ph.D. Petra Temming.

  In addition, patients with hereditary retinoblastoma have the opportunity to be included in the European research protocol, which investigates the causes of secondary tumors after retinoblastoma has been successfully treated (research protocol “Screening of secondary tumors in children with hereditary retinoblastoma” ). As part of this screening study, children undergo an MRI of the head once a year.The conditions under which children are taken into this protocol: hereditary form of retinoblastoma, children during treatment received radiation therapy, the child’s age is between 8 and 18 years.

  A research protocol on the effectiveness of chemotherapy is currently being planned. But he will be able to start only when funding is received.

  What are the chances of recovering from retinoblastoma?

  Today, thanks to modern approaches in diagnosis and treatment, more than 95% of children with retinoblastoma are cured.Children with unilateral retinoblastoma are left with one healthy eye without visual impairment and can lead a normal life. Most children with bilateral retinoblastoma also have at least one eye that can see enough.

  For each individual child, the prognosis depends mainly on the stage of the disease at which the diagnosis of retinoblastoma was made, and whether the retinoblastoma is congenital (hereditary retinoblastoma).

  If at the time of diagnosis the tumor has not spread beyond the eye, or beyond the two eyes (experts in this case speak of intraocular retinoblastoma), then the disease responds better to treatment than advanced retinoblastomas.Therefore, in principle, they have a more favorable prognosis.

  Children with hereditary retinoblastoma generally have a worse prognosis than children with non-hereditary retinoblastoma. This is due to the fact that regardless of treatment, congenital forms of the disease have a genetic [genetic] predisposition to the fact that in the future the child will develop another cancer (secondary malignant tumor). This can be, for example, osteosarcoma, or soft tissue sarcomas.This risk is further increased if, during the treatment of retinoblastoma, the child was given radiation to the eyeball.

  In about 5% of children with congenital retinoblastoma, which was initially unilateral, retinoblastoma also grows in the other eye within a year and a half after the first illness.

  References:

  1. Kaatsch P, Spix C: German Childhood Cancer Registry – Jahresbericht / Annual Report 2013/14 (1980-2013). Institut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitätsmedizin der Johannes Gutenberg-Universität Mainz 2014 [URI: http: // www.kinderkrebsregister.de/ dkkr / veroeffentlichungen / jahresbericht / jahresbericht-201314.html]

     KAA2014

  2. Houston SK, Murray TG, Wolfe SQ, Fernandes CE: Current update on retinoblastoma. International ophthalmology clinics 2011, 51: 77 [PMID: 21139478]

     HOU2011

  3. Shields CL, Shields JA: Intra-arterial chemotherapy for retinoblastoma: the beginning of a long journey. Clinical & experimental ophthalmology 2010, 38: 638 [PMID: 20584015]

     SHI2010a

  4. Shields CL, Shields JA: Retinoblastoma management: advances in enucleation, intravenous chemoreduction, and intra-arterial chemotherapy.Current opinion in ophthalmology 2010, 21: 203 [PMID: 20224400]

     SHI2010

  5. Lohmann D: Die Genetik des Retinoblastoms. WIR Informationsschrift der Aktion für krebskranke Kinder e.V. (Bonn) 2007, 1:31 [URI: http://www.kinderkrebsstiftung.de/ fileadmin / KKS / files / zeitschriftWIR / 2007_1 / WIR_01_07_S31-33.pdf]

     LOh3007

  6. Jurklies C: Das Retinoblastom – Diagnose und Therapie. WIR Informationsschrift der Aktion für krebskranke Kinder e.V. (Bonn) 2007, 1:26 [URI: http: //www.kinderkrebsstiftung.de / fileadmin / KKS / files / zeitschriftWIR / 2007_1 / WIR_01_07_S26-31.pdf]

     JUR2007

  7. Wieland R, Havers W: Retinoblastome, in: Gadner H, Gaedicke G, Niemeyer CH, Ritter J: Pädiatrische Hämatologie und Onkologie. Springer Medizin Verlag 2006, 823 [ISBN: 3540037020]

     WIE2006

  8. Gutjahr P: Retinoblastome, in: Gutjahr P (Hrsg.): Krebs bei Kindern und Jugendlichen. Deutscher Ärzte-Verlag Köln 5. Aufl. 2004, 499 [ISBN: 376

     85]

     GUT2004b

  9. Abramson DH, Frank CM: Second nonocular tumors in survivors of bilateral retinoblastoma: a possible age effect on radiation-related risk.Ophthalmology 1998,105: 573-9; discussion 579 [PMID: 9544627]

     ABR1998

  10. Wong FL, Boice JD Jr, Abramson DH, Tarone RE, Kleinerman RA, Stovall M, Goldman MB, Seddon JM, Tarbell N, Fraumeni JF Jr, Li FP: Cancer incidence after retinoblastoma. Radiation dose and sarcoma risk. JAMA: the journal of the American Medical Association 1997, 278: 1262 [PMID: 9333268]

      WON1997

  11. Imhof SM, Moll AC, Hofman P, Mourits MP, Schipper J, Tan KE: Second primary tumors in hereditary- and nonhereditary retinoblastoma patients treated with megavoltage external beam irradiation.Documenta ophthalmologica. Advances in ophthalmology 1997, 93: 337 [PMID: 9665291]

      IMh2997

  12. Eng C, Li FP, Abramson DH, Ellsworth RM, Wong FL, Goldman MB, Seddon J, Tarbell N, Boice JD Jr: Mortality from second tumors among long-term survivors of retinoblastoma. Journal of the National Cancer Institute 1993, 85: 1121 [PMID: 8320741]

      ENG1993

  13. Draper GJ, Sanders BM, Kingston JE: Second primary neoplasms in patients with retinoblastoma. British journal of cancer 1986, 53: 661 [PMID: 3718823]

      DRA1986

  Retinoblastoma (summary) – Retinoblastom (PDF-Datei)

  16.04.2016

  A short guide to rheumatism – Venäjän kielinen reuma-aapinen

  A short guide to rheumatism

  in Russian

  reuma-aapinen / reumataudit /

  1. FIBROMYALGIA, 2. PADAGRA, 3. CHILD RHEUMATISM, 4. LYMBORELLIOSIS, 5. SYSTEMIC CONNECTIVE TISSUE DISEASE, 6.JOINT PSORIASIS, 7. JOINT RHEUMATISM, 8. JOINT RHEUMATISM II, 9. JOINT HYPERMOBILITY, 10. OSTEOPOROSIS, 11. RHEUMATIC POLYMIALGIA, 12. POLYMYOSITIS, 13. REACTIVE ARTHRITIS AND REITER’S SYNDROME, 14. SPINE RHEUMATISM AND BEKHTEREV’S DISEASE 15. HEREDITAL DISEASE OF CONNECTIVE TISSUE 16. SEGRIN’S SYNDROME 17. SIGENESTERIC LESYSTEMIS.ERRESTERIOS 18. SCALENGUESTHESTERNATIVE ERROR

  1. FIBROMYALGIA (MUSCLE RHEUMATISM)

  Fibro means connective tissue, and myalgia means muscle pain.Fibromyalgia causes pain in muscles, connective and extra-articular soft tissues. In addition to pain in the musculoskeletal system, patients suffer from various sleep disorders: shallow sleep, frequent awakenings at night, a feeling of weakness and physical exhaustion in the morning. In addition, they have different types of mental and neurological symptoms, which can be very varied.

  More often middle-aged and elderly women suffer from the disease. Fibromyalgia is estimated to occur in 2 to 5% of the population, and is rare in children and young people.

  Causes

  The causes of fibromyalgia are still not entirely clear. The onset of symptoms is influenced by many factors, due to which the disease develops in the form of various changes on the part of the central nervous system (CNS). In many patients, symptoms occur in conjunction with infection, trauma, or other painful situations. Sometimes local pains turn into general pain sensitivity. Some patients suffer from joint hypermobility; in others, social or mental problems are added to the symptoms.Other comorbidities are common in patients with fibromyalgia.

  One of the causes of fibromyalgia is long-term stress, which causes bad mood and feelings of depression. Stress can be caused by repetitive and prolonged external stimuli: work, feelings of dissatisfaction, rush, movement, noise, human relations, money problems, or unemployment. Fibromyalgia patients show the same hormonal changes as people suffering from long-term stress.It remains to be seen whether stress or depression and anxiety is the cause of fibromyalgia, rather than the cause of fibromyalgia.

  Another cause of illness is lack of sleep or poor quality of sleep. During deep sleep, the pituitary gland produces growth hormone, which has an anabolic (tissue-strengthening) effect. If there is a lack of deep sleep, no growth hormone is released. In patients, a decrease in the release of growth hormone was confirmed. At the same time, symptoms similar to fibromyalgia were identified in laboratory conditions, when normal sleep was simply disturbed in the studied people.

  Stress, sleep disturbances and other causes that affect hormone secretion disorders can affect the central nervous system in such a way that pain increases. Patients often experience personal and social pressure that manifests itself in the form of physical symptoms, often in the form of pain.

  Symptoms

  The most important symptom of fibromyalgia is prolonged pain in different parts of the body, the nature of which is influenced by various external stimuli. Patients describe pains: pinching, burning, cutting, aching, deep, exhausting, monotonous.The pain is exacerbated by cold, moisture, drafts and mental stress. In the sauna, the pain decreases, but after the sauna it intensifies again.

  For patients with fibromyalgia, fatigue, fatigue, weakness, edema and a feeling of stiffness are also characteristic. In addition to pain in the musculoskeletal system, headaches, abdominal pain, pain during menstruation and urination may occur. Many patients experience joint swelling, although the doctor does not diagnose this. Patients get tired quickly with exertion. And almost all patients complain of sleep deprivation.

  Diagnosis

  Diagnosis of fibromyalgia is based on patient complaints and medical clinical research. To confirm the disease, a large group of other diseases are taken into account, which also cause pain symptoms. Other diseases do not rule out the possibility of fibromyalgia.

  When talking with a patient, the doctor pays special attention to both the nature of pain in different situations and the quality of sleep. During a medical examination, a painful reaction is noted in known sensitive points on the body.Some parts of the body are very painful. For fibromyalgia, there are no changes in blood tests.

  If necessary, more research is done to rule out other illnesses that cause fatigue and pain, such as anemia, thyroid dysfunction, muscle aches, or menopause symptoms. Joint hypermobility also requires examination.

  Fibromyalgia patients often have comorbidities, which may include, for example, inflammation of the intestines, bladder, endometriosis, headaches, signs of fatigue and depression.Especially in the elderly, fibromyalgia can occur concurrently with coronary artery disease, diabetes, joint damage, and articular rheumatism. This is called secondary fibromyalgia.

  Treatment

  Fibromyalgia does not have a one-size-fits-all treatment that is suitable for everyone. the causes of the disease are different. The patient’s own opinion on the results of treatment is very important.

  Planning, implementation and monitoring of treatment outcomes is a basic prerequisite for close and trusting collaboration between patient and doctor.It is important to stop further unnecessary additional research, which in the worst case leads to unnecessary surgery. The best way to treat a patient with fibromyalgia is a polyclinic doctor who is well aware of his problems.

  Learning about fibromyalgia is the foundation of treatment. If possible, at an early stage, the patient should undergo a rehabilitation course designed for patients with fibromyalgia. Usually it is possible to combine it with work. Group training gives good results.The courses help to reduce the fatigue associated with the disease, support self-medication and training. Avoiding stress and improving mood with warm baths, massage and other physical therapy, as well as group discussion and psychological support, are the only treatment lines. For some, hardening of the body (swimming in an ice hole, cold chambers) and a gradual increase in physical activity are suitable.

  Physical education should be administered with caution. Suitable sports: walking, pole walking, aqua aerobics, cycling, dancing and skiing.Physical activity is aimed at activating the body’s own defense mechanisms that relieve pain.

  There is no specific drug for the treatment of fibromyalgia yet. Medications that improve sleep and mood, such as amitriptyline, can be tried as drug treatments. Treatment should be started in small doses to reduce side effects. The benefits of such treatment are observed only after a few weeks. There is little effect from conventional painkillers, sometimes paracetamol helps.The benefits of medication should outweigh the side effects. For some patients, medications that affect the central nervous system are suitable for relieving pain of nervous origin. If fibromyalgia is associated with prolonged insomnia, depression, or other psychiatric symptoms, the patient needs psychiatric help.

  Prognosis

  Prognosis is favorable, although there is no improving treatment. The symptoms of fibromyalgia persist for years and decades, but damage to organs or tissues of the body does not occur and the disease is quite compatible with life.Many retire early for other reasons. At present, officials dealing with pension issues do not consider fibromyalgia to be a cause of disability and retirement.

  2. PADAGRA (Greek podos – leg, Greek agra – seizure, literally “foot in a trap”)

  Padagra is more common among middle-aged men. In Finland, padagroy affects about 30,000 people. The onset of the disease may be due to a change in life habits and an increase in alcohol consumption, small doses of aspirin and diuretics.

  Padagra is a disease caused by impaired purine metabolism, leading to an increase in the level of uric acid (urates) in the blood and their deposition in tissues, articular cartilage, epiphyses of bones, periarticular tissues, kidneys and other organs. An increase in uric acid levels (hyperurecaemia) can cause kidney failure.

  Against the background of padagra, there may be disorders in the activity of enzymes, which are inherited. The cause of the disease can be malnutrition, overeating, alcohol consumption, especially beer, obesity, diabetes mellitus, high levels of blood fats and arterial hypertension.Padagra can also develop as a side disease with diuretics and aspirin. Sometimes padagra manifests itself together with renal failure or blood disorders.

  Symptoms

  The first symptom of padagra is acute inflammation in the joint of the big toe. Later, other joints become inflamed – the knees, the cervical spine and the joints of the fingers. Padagra causes permanent joint changes and crystallization of uric acid in soft tissues (tophus), kidney diseases can join them.Nowadays, padagra very rarely leads to disability.

  Symptoms appear more often with stress on the inflamed joint or with alcohol and purine-containing foods. The joint becomes hot, red and very painful. The picture of the disease is not always typical. Within a week, the inflammation goes away on its own, but with treatment – faster.

  Diagnosis

  When diagnosing a padagra, the doctor identifies typical symptoms and changes in the patient’s diet. The diagnosis is confirmed by examining the joint fluid, in which urate crystals are visible under a microscope.In patients with padagra, uric acid levels are usually high. On the other hand, they can be high in healthy people. Low rates also do not exclude the possibility of contracting padagra. When researching, it is important to check the functioning of the kidneys in order to exclude disruption of their activity.

  Treatment

  As a treatment for an acute attack of padagra, cold, pain relievers and anti-inflammatory drugs, and rest are used. Intensive treatment for an acute attack of padagra is intra-articular administration of cortisone.

  The most important element of treatment is the balance of medication intake, lifestyle and especially the patient’s diet. When planning treatment, it is also necessary to consult a dietitian. Moderate weight loss can be maintained if necessary with proper nutrition.

  The diet should be followed after the first attack of padagra. The diet prohibits foods that produce uric acid and can significantly reduce the intake of essential drugs.

  But sometimes diet alone is not enough to cure.Then, after the third attack of padagra, drug treatment is started, which reduces the synthesis of uric acid in the blood. In such cases, allopurinol is effective. Treatment with allopurinol should only be started after confirmation of the diagnosis of padagra. Its side effect can be liver dysfunction and changes in the blood picture, so treatment is carried out under the supervision of blood tests. If there have been no seizures during the year against the background of treatment, you can stop taking the drug.

  Prognosis

  With proper treatment, the prognosis for padagr is good, but if for some reason it is impossible to use allopurinol, problems may arise.Failure to follow the diet can also be the reason for the failure of treatment.

  Diet

  Padagra sufferers need to have a list of various foods that contain purine. It can be found in pharmacies and on the internet. Below is a summary of the most important foods.

  Products containing quite a lot of purine are completely prohibited:

  fish

  meat

  peas, beans, soybeans, mushrooms, asparagus

  Other harmful substances:

  all alcoholic beverages (prevent the excretion of uric acid), especially beer

  aspirin-containing antipyretic drugs

  Permitted foods containing a small amount of purine:

  cereals

  dairy products

  eggs, fats, sugar

  fruits, almost all vegetables, potatoes

  coffee, tea, cocoa, spices

  sturgeon caviar fish

  3.CHILD RHEUMATISM

  Children’s rheumatism is an inflammation of the joints that occurs for unknown reasons in children under 16 years of age, and which lasts more than six weeks. The definition of the disease is conditional, because the causes of its occurrence are unknown, the same symptoms of the disease can occur after 16 years. Children who become ill later retain their original diagnosis.

  Children’s rheumatism is currently divided into seven subtypes. For all types, the name is used for childhood rheumatism or juvenile idiopathic arthritis.Every year in Finland, 100-150 children fall ill, half of whom are under 5 years old.

  Causes

  The cause is unknown. Perhaps there are several of them, and hereditary factors increase the risk of getting some form of rheumatism. Children’s rheumatism is not directly inherited, and does not behave like an infectious disease. Children’s rheumatism includes childhood diseases (oligoarthritis) or forms similar to diseases of adults (articular rheumatism, articular psoriasis, spinal rheumatism).

  Symptoms

  Usually the first symptom of childhood rheumatism is morning joint stiffness, which is immediately noticed by parents. Inflexibility can manifest itself either in all or only in diseased joints. Children limp or protect their joints due to pain. They may also have trouble sleeping. However, young children may not always be able to describe pain in words. Often, pain is manifested by a bad mood and the protection of a sore joint. Sometimes the knee or other joint swells so much that it is easy to notice.Fever and slight skin inflammation on the body are the initial symptoms of childhood rheumatism.

  The course of the disease

  The complexity of childhood rheumatism in its variability. The disease drags on and eats away at the cartilage of the joints, bones and ligaments of the joints. As a result, the joints swell and their work is limited. Currently, complete ossification of the joints does not occur. Inflammation of the eyes can go unnoticed, up to complete loss of vision.

  In patients with childhood rheumatism, developmental delays may also appear.Growth can be slowed down by severe illness or high-dose cortisone treatment. Overgrowth of bones begins in a swollen joint, such as in the lower jaw, legs, ankles, wrists, and toes. Especially in the knees, this can be manifested by an asymmetrical limb length or its incorrect position. If left untreated, childhood rheumatism can cause life-threatening heart inflammation and kidney disease.

  Diagnostics

  The main symptom of childhood rheumatism is swelling of one or more joints that lasts more than six weeks.The child feels tired, cries, he may have a skin rash and fever. Blood inflammation and CRP levels may be elevated. When making a diagnosis, rheumatic factor and the presence of antibodies in the blood are also examined. If the blood test for antibodies is positive, then with a high probability we are talking about childhood rheumatism or systemic connective tissue disease. Since heredity is an important factor, it is necessary to find out from the parents whether there were joint diseases or psoriasis in the family.

  Treatment

  Pediatric rheumatism is diagnosed and monitored in university hospitals and the Heinola rheumatology hospital by a specialist doctor. Treatment and rehabilitation of patients is carried out in the children’s department of the rheumatological hospital.

  The goal of treatment is to reduce symptoms and normalize the parameters of inflammation in the blood (ESR, CRP), which are achieved through the selection of individual drug treatment and exercise therapy in everyday life. In difficult cases, more serious treatment is required.

  Usually, an integrated approach is used in the treatment of childhood rheumatism. Thanks to the use of strong medicines, the results are faster and the treatment time can be shortened.

  Pediatric rheumatism is treated with the same medicines as adults. With long-term treatment, methotrexate is used – a drug that affects cell growth. Currently, childhood rheumatism can be treated with biological TNF – alpha drugs. Supportive therapy – cortisone drugs.

  Treatment of childhood rheumatism is aimed at ensuring the normal growth of the child. Correct positioning of the limbs can be assisted by applying splints and splints. In young patients, the growth of the lower jaw and teeth is monitored and the eyes are examined regularly. The physiotherapist develops individual programs to maintain joint mobility and strengthen muscles. The rehabilitation program includes providing conditions for the child to receive primary education.

  Forecast

  Modern methods of treatment significantly improve the prognosis of childhood rheumatism.Lifetime disability and premature mortality are rare. Amyloidosis (a violation of the body’s protein metabolism) no longer occurs. The majority of patients are able to lead a normal working life with the help of treatment.

  Classification of childhood rheumatism

  Normal childhood rheumatism

  Ø fever, skin inflammation, inflammation of the lymph nodes, symptoms of internal diseases

  Oligoarthritis (inflammation of rare joints)

  Ø from 1 to 4 diseased joints

  Seronegative polyarthritis

  Ø in the blood there is no rheumatic factor, joint pain 5 or more

  Adult articular rheumatism

  Ø “seropositive polyarthritis”

  Ø rheumatic factor is present in the blood, joint pains 5 or more

  Articular psoriasis

  Ø cutaneous psoriasis and inflammation of the joints

  Ø pronounced psoriatic changes in the nails without skin symptoms, sausage-like inflammation of the fingers and toes, psoriasis in the closest relatives

  Rheumatism of the spine

  Ø “arthritis joining enthesitis”

  Ø inflammation of the joints and enthesitis (damage to the ligamentous apparatus).If only one of these symptoms is present, then there should also be two more of the following: pain in the sacrum and lower back, positive HLA-B27 antigen, rheumatism of the spine in one of the close relatives, eye inflammation, boy over 8 years old.

  Other forms of the disease

  Ø childhood rheumatism, which is not included in other groups

  4. LYMBORELLIOSIS (Lyme disease or tick-borne borreliosis)

  Lyme disease is an infectious disease transmitted through a tick bite.The causative agent Borrelia burgdorferi is a bacterium belonging to the class of spirochetes. Lyme disease has no connection with childhood rheumatism or rheumatic diseases.

  In Finland, natural foci of Lyme disease are found mainly on islands and coastlines, although ticks also live throughout the country, including Lapland. But not all ticks carry the Borrelia bacteria. On average, the bite of only one tick in 50-100 cases causes disease. Every year in Finland, about 3000 people get sick from tick bites, and 10-20% of them – Lyme disease.The disease can manifest itself as a rapidly passing skin inflammation.

  Prevention

  Lyme disease can be prevented by avoiding tick bites. Ticks settle in humid places where children often play, so their skin should be examined in the evenings. This also applies to adults living in natural foci. Ticks are removed from the skin, for example, with tick-borne tweezers purchased from a pharmacy. The best way to remove it is to grab the tick as close to the skin as possible and gently pull it out in a circular motion.

  Symptoms

  Most tick bites are asymptomatic. If a person is bitten by a tick, it must be quickly removed from the skin, because it can carry the Borrelia bacterium. In this case, reddening of the skin appears around the bite after a few days, which spreads in a circle from the site of the bite (erythema annulus). Bacteria that enter the body can cause a cold-like illness, which is combined with fever, fatigue and muscle pain. This is the initial stage of Lyme disease, and antibiotics are used to treat it.

  Course of the disease

  If untreated, the disease can manifest itself in different parts of the body months or even years after infection. These can be symptoms of damage to the musculoskeletal system (muscle pain and stiffness), edema of one or more joints, in severe cases – symptoms of CNS damage: facial paralysis and paralysis of various nerves, meningitis, neurological pain symptoms. Prolonged muscle pain resembles complex fibromyalgia. In disease caused by a Borrelia bacterium, chronic inflammation of the skin, eyes and heart muscle can be observed.

  Diagnosis

  The initial phase of Lyme disease is confirmed by inflammation of the skin around the site of the tick bite, which does not appear in later stages. The only symptom may be, for example, swelling of the knee joints. At this stage, the doctor tries to rule out other illnesses and confirm borelliasis with blood tests. The study of the results of laboratory tests sometimes requires an examination in the infectious diseases department of the district hospital. In the diagnosis, information about previous tick bites, for example, a month ago, is very helpful.

  Treatment

  A simple tick bite does not require any treatment. If inflammation spreads around the bite, see a doctor immediately. After an obvious bite, antibiotics are prescribed for two weeks to treat borrellia cutaneous inflammation. The infection responds well to treatment and late symptoms do not appear. If the initial phase is left untreated, and the patient develops true Lyme disease, then long-term and debilitating antibiotic treatment is required, which is most often carried out in a hospital setting.

  Prognosis

  As a rule, patients are cured of Lyme disease. In this disease, the inflammation of the joints is benign and does not lead to their destruction, but the pain can last a long time. In young children, the disease is more severe. For years, persistent symptoms of CNS inflammation are rare. They may mimic the symptoms of fibromyalgia.

  5. SYSTEMIC CONNECTIVE TISSUE DISEASE

  In patients with systemic connective tissue disease, symptoms of many rheumatic diseases are observed.They may resemble systemic sclerosis, an autoimmune disease, or polymyositis and joint inflammation. Many diseases can begin with symptoms similar to systemic connective tissue disease, which need to be clarified later. Most of the patients are women over 40 years of age.

  Causes

  The causes are unknown, but heredity affects the onset of the disease.

  Symptoms

  The disease usually begins with general symptoms such as fatigue, fever, muscle and joint pain.Almost all patients have Raynaud’s symptom (blanching of the fingers). The hands may swell so that the fingers take on the shape of sausages. The skin of the hands becomes denser and later atrophies. The patient may have skin inflammation and swelling in the joints, similar to articular rheumatism.

  Course of the disease

  The disease usually either disappears or turns into some clearly expressed disease – articular rheumatism, systemic sclerosis, immune disease or polymyositis. The disease causes changes in internal organs such as the lungs, heart and kidneys.

  Diagnostics

  Diagnostics is carried out on the basis of the patient’s history and blood tests.

  Treatment

  Treatment is prescribed individually according to the patient’s symptoms. As a treatment, cortisone drugs and antirheumatic drugs methotrexate, hydroxyclorokine are used. If the patient has pale fingers, a vasoconstrictor such as nifedepine is recommended, but it is best to keep the hands warm.

  Forecast

  Symptoms of the manifestation of the disease can last for years.The prognosis depends on the direction of the development of the disease. If the disease does not affect the internal organs, the prognosis is favorable.

  6. PSORIASIS OF JOINTS (psoriatic arthritis)

  Psoriasis (squamous lichen) is a chronic dermatosis characterized by scaly skin rashes. Approximately 2% of the Finnish population suffers from psoriasis. Of these, only 10% have joint inflammation. Half of those with complex cutaneous psoriasis also have joint psoriasis. It occurs in both women and men.Sometimes the picture of the disease is similar to joint psoriasis and is diagnosed in patients who do not have skin inflammation. The disease is inherited.

  Causes

  The causes of psoriasis are unknown, and it has not been investigated why patients with skin diseases often exhibit joint symptoms. In psoriasis, the regulation of the body’s immunological defenses is disrupted, and skin inflammations appear, for example, after infection, with skin lesions or after burns.

  Psoriasis is a hereditary disease.If both parents have psoriasis, the child’s risk of developing the disease is about 50%. If only one – the risk of developing the disease is reduced to 20%. Joint psoriasis is much less common.

  Symptoms

  There are 4 different forms of joint psoriasis. The most common form is inflammation of several joints with symptoms of sharpening of the first phalanges of the fingers of the extremities, which can also manifest themselves. Another form of the disease is less common, usually inflammation of a large joint.It can only be inflammation of one knee without other joint symptoms. A disease resembling spinal rheumatism is rare.

  With articular psoriasis, the heel or the Achilles tendon swell, sometimes the finger or toe swells in the form of a sausage (dactylitis, sausage-like toe). Symptoms of sharpening of the phalangeal joints of the fingers are manifested in conjunction with psoriatic changes in the nails.

  Course of the disease

  A patient with psoriasis develops joint disease over time.Often cutaneous psoriasis is only confirmed if a person seeks a doctor for joint symptoms or nail changes. Usually, joint symptoms appear at the age of 30-50, although the skin inflammation in this case has already lasted for many years. Articular psoriasis also occurs in children, but it is quite rare.

  Diagnosis

  Psoriasis of the joints can be suspected if the patient has cutaneous psoriasis and inflammation of one or more joints. The skin inflammation can be quite extensive or limited to the nails only.Sometimes it appears on the scalp as scaly patches.

  In psoriasis of the joints in blood tests there are no increased indicators of inflammation (ESR, CRP) and rheumatic factor, as in articular rheumatism.

  On the X-ray in the joints, the same erosive changes were noted as in articular rheumatism. In patients, the pointed phalanges of the joints of the fingers are eaten away. Mutilating, disfiguring arthritis caused by destruction of the bone tissue of the phalanges of the fingers is quite rare.

  Treatment

  Timely treatment of skin manifestations and sunlight also relieve joint symptoms. Strengthening the physical condition of joints and muscles is suitable as an initial treatment. For more help, you can contact the hospital’s rehabilitation department.

  Paracetamol or anti-inflammatory and pain relievers are used to relieve pain symptoms. If the inflammation of the joints is prolonged or if the X-ray shows changes in the joints, the same medications are used as treatment as in the initial treatment of articular rheumatism.Methotrexate is effective for inflammation of the skin and is better suited for treating articular psoriasis than for treating articular rheumatism. A similar new generation drug is leflunomide. For mild articular psoriasis, sulfasalicylates should be tried first to eliminate joint symptoms. Cyclosporine is suitable for the treatment of both complex skin inflammations and for the treatment of joint inflammation. Cortisone injections are used to treat swollen joints. With mutating, disfiguring arthritis, arthroplasty or endoprosthetics are performed.

  Complex articular and cutaneous psoriasis can also be treated with biological rheumatic drugs. Currently, TNFα inhibitors (blockers) are used in Finland: infliximab, adalimumab, etanercept. They quickly relieve inflammation. The patient can inject adalimumab and etanercept himself. Infliximab is administered to the patient by intravenous drip in a hospital.

  Forecast

  On average, joint psoriasis is a milder disease than joint rheumatism. The long-term prognosis is often very good.Treatment of complex diseases that cause changes in the joints should be carried out as soon as possible. Medical therapy in the initial stage of the disease is more effective. If left untreated, psoriasis of the joints can lead to disability, destruction of joints, or stiffness of the spine.

  7. JOINT RHEUMATISM

  Joint rheumatism (rheumatoid arthritis, arthritis rheumatoides) is a common inflammatory disease of the joints. Every year 1,700 Finns fall ill with it, usually women 60-70 years old, less often young men.There are approximately 35,000 people with articular rheumatism in Finland.

  Causes

  The causes of articular rheumatism are unknown, but it is part of the so-called autoimmune diseases, in which the body’s immunological defense is directed against its own tissues. Articular rheumatism is not a hereditary disease, and susceptibility to it is poorly inherited. Smoking, the postpartum period, all kinds of infections, mental factors and joint injuries contribute to the occurrence of articular rheumatism.There are no clear links between nutrition and the onset of the disease, but during treatment, attention should be paid to a healthy diet.

  At first, changes in the body can begin not in the joints, but in other places. With inflammation, the articular membrane thickens, new blood vessels grow in it, and inflammatory cells circulate in the tissues. Active inflammatory cells release immune complexes (interleukins, prostaglandins, Tnf-alpha) into the environment that cause inflammation in the body: fatigue, fever, increased blood counts and CRP.

  Inflamed tissue grows and expands over the surface of the articular cartilage and bones. It gradually eats away at healthy cartilage, bones and joint ligaments. In this regard, the structure of the joint is destroyed, and its work is disrupted.

  Symptoms

  Articular rheumatism begins with mild joint pain that manifests itself in the morning as soreness and stiffness in the fingers or toes. A visible symptom is joint edema, which occurs with an increase in the amount of articular fluid and a thickening of the articular membrane.With severe inflammation, the joint turns red and becomes hot. The swelling begins most often in the fingers and wrists. Articular rheumatism is usually a symmetrical disease of the joints of the toes and hands, but it can spread to all joints of the limbs, as well as to the jaw joints and the cervical spine. It usually does not appear in the first phalanges of the fingers and the lower back. In the initial stage, the disease causes a deterioration in the general condition, a feeling of malaise, fatigue and joint stiffness in the morning.

  The course of the disease

  If the body’s resistance overcomes the disease, the symptoms of articular rheumatism disappear at all or do not appear for a long time.Most often, articular rheumatism is a disease that lasts for decades. Cartilage erosion begins within a few months from the onset of the disease. Over the years, erosion expands and captures more joints.

  Most of all, patients suffer from damage to the large joints of the extremities (hip, knee, shoulder joint) and the cervical spine. The movement of the joints becomes difficult, but patients suffer much more pain. The pain is manifested by increased sensitivity of the joints, however, in the initial stage it is not very significant.

  With prolonged articular rheumatism, symptoms also appear in other organs. Prolonged inflammation dries out tissues: the skin becomes thinner, muscles die off, bones break, and blood hemoglobin decreases. Dryness of the mucous membranes of the eyes, mouth and genitals comes from Schengren’s syndrome. Friction can cause rheumatic bumps to grow in the elbows, fingers and toes. Blanching of the fingers or Raynaud’s symptom is a signal of vascular disease. Pleurisy and rheumatic nodes develop in the lungs, and sometimes serious pulmonary changes occur.Amyloidosis (impaired protein metabolism) occurs as a result of prolonged active inflammation, but kidney damage caused by it is currently rare.

  Diagnosis

  At the onset of the disease, articular rheumatism is difficult to diagnose. If articular rheumatism is suspected, the patient is referred to a specialist doctor. Symptoms of the disease are obvious swelling of the joints, especially fingers and wrists, sensitivity of the ball of the foot, increased blood inflammation (ESR, CRP) and rheumatic factor.Articular rheumatism is assessed according to seven criteria. If four of the seven criteria are met, the patient is diagnosed with articular rheumatism, and active treatment should be started as early as possible.

  Symptoms of immunological disorders are confirmed by rheumatic factor in the blood, and sometimes antibodies. The rheumatic factor was detected not in all patients with articular rheumatism. It can also be found in people with other diseases or in perfectly healthy people. Therefore, the diagnosis of articular rheumatism is radically independent of the presence of a rheumatic factor.

  Classification of articular rheumatism:

  morning stiffness of the joints for at least an hour

  swelling of at least three joints

  edema of the arm joint

  symmetrical swelling of the joint

  rheumatic cones

  rheumatic factor in the blood

  lesions in the joints visible on x-ray

  Treatment

  Treatment of articular rheumatism should be multifaceted. It is important for patients with chronic diseases to know more about the disease and the possibilities of its treatment.

  The course of articular rheumatism does not allow it to be influenced by other means than drugs. Sometimes surgery and physical therapy are required to prevent disability. Effective drug treatment is especially important in the early stages and when joint destruction is progressing.

  At the initial stage, the treatment includes, first of all, drugs that slow down the course of the disease. In the complex treatment of articular rheumatism, methotrexate, sulfasalicylate, hydroxyclorokine, gold preparations, leflunomide and cyclosporine are used; biological drugs can be tried.Despite the side effects, the benefits they bring are much greater than the harm. Treatment started early is more effective.

  Most patients require pain relievers (paracetamol, anti-inflammatory drugs). They do not inhibit the progression of the disease, but good pain relief improves the quality of life. Cortisone medications are used as supportive therapy to relieve pain as well as keep joints working. Cortisone injections directly into the joint temporarily relieve swelling and significantly improve mobility.The attending physician should have the cortisone syringes needed by the patient ready.

  Surgical treatment can be used to remove inflamed tissue not susceptible to drugs from a joint or from a tendon, as well as to correct an already damaged joint. Often, an artificial joint can prevent the development of disability.

  Physiotherapy is used to treat pain and keep the joints moving with the help of special exercises. In the active phase, it is necessary to maintain the mobility of the joints and the physical condition of the muscles.

  A specialist doctor teaches gentle movement skills. Various splints are used to reduce joint pain and prevent joint misalignment.

  Rehabilitation supports work and physical activity. In rehabilitation courses, immediately after the detection of the disease, patients receive information about the disease and its impact on daily life. Sufficient attention should be paid to the professional rehabilitation of the working population and youth. KELA organizes rehabilitation in especially difficult cases.

  Forecast

  At the initial stage of articular rheumatism, it is rather difficult to make a prognosis. Therefore, even the mild symptoms of articular rheumatism should be taken seriously. Currently, most of the patients are living a normal life, starting a family and retaining their ability to work. Although there is an improving treatment, articular rheumatism progresses for decades and destroys the joints, but there is no threat of complete loss of motor activity.

  8. JOINT RHEUMATISM II

  Arthrosis or osteoarthritis is a common disease of the joints.It is associated with an increase in the average age of the population. Almost every pensioner has osteoarthritis, but only some of them cause significant harm to health. Due to the inability of older people to move independently, society incurs significant costs. To preserve the motor ability of the elderly, thousands of hip and knee replacements are performed in Finland every year.

  More often arthrosis manifests itself in the interdigital joints of the foot, the first metatarsophalangeal joint of the hand, in the joints of the spine, but arthrosis of the hip and knee joints brings the greatest harm to health.

  Causes

  The occurrence of arthrosis of large joints is promoted by old age, hard work, sports with stress on the joints, obesity, injuries and inflammations of the joints, heredity. A big problem is weight gain, which causes and always complicates most of the knee arthrosis. Arthrosis of the toes and hand is, for the most part, a hereditary disease.

  Symptoms

  At the initial stage of arthrosis, the most important symptom is pain, which intensifies when starting to move after rest (starting pain).The primary pain arises when going down the stairs, later on, pain when going up is added to it. With the development of the disease, the range of motion of the joint decreases. The knees are turned to the sides, and bow-legged appears. In the fingers, at the site of the joints, bone cones grow. The uneven cartilaginous surfaces of the joints crunch when moving.

  Osteoarthritis worsens gradually over the years. The problems depend on the affected joint. Arthrosis of the spine leads to the formation of bone spurs and compression of the nerves coming out of the spinal cord, as a result of which the back pain passes into the legs (sciatica).Osteoarthritis of the hip and knee joints complicates movement and can cause severe pain.

  Course of the disease

  At the onset of arthrosis, the smooth cartilage covering the surface of the joint begins to decompose. The organism reacts to this by the growth of cartilage bone tissue. The joints become firm and in contact with each other, and their range of motion decreases. Usually the joint takes a forced position. Gradually, the inner surface covering the articular membrane of the damaged joint becomes irritated and inflamed.Fluid builds up in the joint and may turn red. The joint becomes inflamed and arthrosis progresses.

  Diagnosis

  The doctor makes a diagnosis of arthrosis based on symptoms and X-rays. However, multiple arthrosis can be mistakenly treated like gout or articular rheumatism. A blood test does not diagnose arthrosis.

  Treatment

  Arthrosis cannot be cured. First of all, paracetamol and, if necessary, anti-inflammatory drugs are used as anesthesia.Some are helped by glucosamine. Anti-rheumatic gel ointments containing anti-inflammatory drugs help with arthrosis of the fingers. Your doctor may inject cortisone medications into irritated and swollen joints. Arthrosis of the knees can be treated with hyaluronate injections. Complex and painful arthrosis of the hip and knee joints is treated by surgery.

  Excessive stress on sore joints should be avoided. A wand or rollator and high-legged chairs make everyday life easier.You should also stop carrying heavy loads.

  Weight management is an important part of treatment because excess weight, first of all, loads the joints. Joint performance is supported by movement, and muscle condition is maintained by regular physiotherapy exercises. Exercise is needed to straighten the hip and knee joints. To straighten your knees, you can exercise while sitting on a chair. If pain is felt, straightening movements can be done while lying on your back, with a pillow under your knees. A cold compress in the acute phase soothes sore and painful joints.In the calm phase of the disease, warming the joints brings a sense of relief. When treating arthrosis of the fingers, regular exercise keeps them mobile.

  Forecast

  Most of the patients are coping well with their illness. More painful are diseases that begin at a young age and in several joints at the same time. Osteoarthritis causes a deterioration in normal life. The increase in the overweight of the population is the cause of arthrosis in the future. Joint replacement surgery can avoid the patient’s disability.

  9. JOINT HYPERMOBILITY

  Joint hypermobility is a set of symptoms in which the joints have an abnormally wide range of motion. Joint hypermobility is especially pronounced in children and young women. It is rare in the elderly. Some occupations (musician, acrobat) benefit from a wide range of joint motion, but it can be harmful to the joints.

  Causes

  The weakening or tension of the articular ligaments in people is different.Probably, there are differences in the structure of the binding protein, collagen, and connective tissue. Joint hypermobility is often hereditary. It is difficult to distinguish it from Ehlers-Danlos syndrome (skin hyperelasticity).

  Symptoms

  Joint hypermobility is not necessarily harmful. A common symptom is pain that is localized in the joints (hip, knee, shoulder, wrist) or back. Common pain conditions are easily interpreted as fibromyalgia, one of the causes of which may be hypermobility of a joint.In complex forms of the disease, the joints can easily twist. Hernia, varicose veins, impaired venous circulation, prolapse of the uterus and urinary problems can also join the complex of symptoms. Hypermobility can lead to arthrosis.

  Diagnostics

  Joint hypermobility is determined by the Beighton scale. If a person has five criteria out of eleven, the joints are considered hypermobile.

  Beighton scale

  passive dorsiflexion of the little finger more than 90 ° (left and right hand)

  passive adduction of the thumb to the flexor surface of the forearm (left and right hand)

  hyperextension of the elbow joints more than 10 ° (left and right hand) )

  overextension of the knees more than 10 ° (left and right leg)

  bending forward without bending the knees, with palms touching the floor

  Treatment

  The patient should be aware of the origin of the symptoms.There is no complete cure, but symptoms can be relieved with joint and muscle exercise therapy. Activities that increase the risks and lead to a wide range of motion of the joints and dislocations should be discontinued. Conventional pain relievers reduce pain. Joint hypermobility should be considered when choosing a profession.

  Forecast

  With age, the range of motion of the joints decreases. This improves the long-term prognosis.

  10.OSTEOPOROSIS

  Osteoporosis is a progressive decrease in bone density, leading to a decrease in bone strength and an increase in the likelihood of fracture. After age 30, bone density begins to slowly decrease. Older people are at increased risk of bone fractures from falls. In Finland, more than 400,000 people suffer from osteoporosis, most of whom are women over 50.

  Causes

  Age-related decrease in bone density is a normal physiological process.But a sharp decrease in bone density leads to osteoporosis. Osteoporosis is more common in women than in men. The risk of disease in women increases during menopause, when the production of female sex hormones (estrogens) decreases, which regulate bone metabolism and prevent osteoporosis. A short period of puberty (late onset and early end of menstruation) is also a cause of osteoporosis.

  A lean physique, lack of exercise, vitamin D (sunlight) and / or calcium, smoking, excessive salt intake, bowel disease, rheumatism, diabetes, kidney disease, and certain medications (cortisone, antiepileptic drugs) increase the risk of osteoporosis.Overweight, although it is a dangerous disease, to some extent protects against osteoporosis. The predisposition to osteoporosis is hereditary.

  Symptoms

  Osteoporosis is asymptomatic. Problems arise with bone fractures, the most common of which are vertebral fractures. In this case, height decreases and posture changes. Fractures of the femoral neck are considered complex. Over the past 15 years, the number of upper femoral neck fractures has doubled in Finland.Although fractures caused by osteoporosis are treated with surgery, the quality of life of older people is impaired.

  Diagnosis

  An experienced doctor can quickly diagnose an elderly person by measuring their height. If over the years the growth has decreased by more than 5 centimeters, and the posture has become stooped, the diagnosis is correct.

  Bone density can be measured. The measurement is made based on an analysis of the bones of the back and upper thigh bone.

  Hospitals and private clinics have devices for examining osteoporosis.Based on international criteria, women are diagnosed with a bone density below 2.5 units. standard deviation than at a young age. For men, the border is 3 units. standard deviation.

  A conventional bone X-ray can be used to assess the initial stage of osteoporosis. The X-ray shows a fracture of the bones of the spine. Density is measured by ultrasound examination of the calcaneus, but in this way it is impossible to establish the exact location of the fracture.

  Prevention

  Osteoporosis can be prevented. Young girls need to increase bone density and build bone mass that protects against possible fractures as they age.

  Prevent osteoporosis:

  Ÿ Move constantly

  Ÿ Lose weight carefully and avoid a sharp drop in weight

  Ÿ Go out into the fresh air more often, thus you will get vitamin D

  Ÿ The diet should include milk, cheese, wild mushrooms and fish

  Ÿ Do not smoke

  Ÿ Consume a limited amount of salt

  Ÿ Brew tea, which contains Florid, which strengthens bones

  Ÿ Women over 40 are recommended to be tested for the presence of estrogens

  90 200 Ÿ In the dark, people over 50 For years it is recommended to take vitamin D and calcium

  Ÿ Falling is especially dangerous in old age, therefore it is recommended to wear special clothing protecting bones.

  Treatment

  Osteoporosis is difficult to treat because bone is slowly regenerating. Cortisone treatment is given to people who have had fractures and their bone density is constantly decreasing.

  Treatment provides for an adequate supply of vitamin D and calcium. The daily intake of calcium is 800 mg, it is contained, for example, in three glasses of milk or kefir. Cheese and other dairy products are also good sources of calcium.

  Vitamin D is obtained by a person under the sun, as well as from food, for example, fish and mushrooms are rich in vitamin D.For people over 70, it is recommended to take 15 micrograms of vitamin D daily (600 units). This amount is difficult to obtain from food, which is why it is prescribed for older people in the form of dietary supplements.

  The drug treatment of osteoporosis is constantly evolving. Treatment is lengthy and quite expensive. An important drug group is bisphosphonates (alendronate, etidronate, residronate and ibandronic acid). Currently, the dosage of drugs is calculated so that they need to be taken no more than once a week or month.Medicines come in the form of a nasal spray. Also, women can take drugs containing the hormone estrogen or drugs that act in the same way (raloxifene). In difficult cases, strontium and teriparatide are used.

  11. RHEUMATIC POLYMIALGIA

  Polymealgia is a fairly common disease that causes muscle pain. Poly means a lot, myalgia means muscle pain.

  Causes

  The causes of the disease are not clear, but a viral infection can provoke the disease.Most often women get sick with polymyalgia after 50 years.

  Symptoms

  Symptoms of the disease appear rather slowly. Pain and numbness (stiffness) appear in the muscles of the neck, shoulders, lower back and hips. Muscles become tender and sore when moved and touched. Swelling of the joints is rare. Due to the appearance of muscle and joint pain, it is difficult to get up in the morning. The patient may also have fatigue and fever. In the blood test, the indicators of inflammation are increased, so a previously healthy and vigorous person feels seriously ill.

  Often arterial inflammation joins the muscular form of rheumatism. Inflammation of the temporal artery causes pain in the temples or cheeks, such as when chewing food. An inflamed artery can sometimes be seen in the temple area, it is tense and enlarged. There may be no pulse in the artery. It is important to detect temporal artery inflammation (temporal artery) in time, because the branch of the temporal artery goes to the base of the eyes. Obstruction of the temporal artery can lead to loss of vision.

  Diagnosis

  The doctor makes a diagnosis based on the symptoms of the disease, the patient’s age, pain, general condition and blood test. Elderly people are prescribed other types of examinations. If an inflammation of the temporal artery is suspected, the patient is referred to the Central Hospital for examination.

  Treatment

  Cortisone preparations are prescribed for the treatment of polymyalgia. Treatment lasts at least a year and the dose of cortisone is gradually reduced based on observations of the course of the disease, symptoms, and blood counts.Other drugs are also used for treatment, such as methotrexate. Inflammation of the temporal artery is treated in a hospital.

  Forecast

  The forecast for polymyalgia is good. With the right approach to treatment, in a few years health returns to almost all sick people.

  12. POLYMYOSITIS

  Polymyositis is a rather rare inflammatory muscle disease that manifests itself both with rheumatism and an independent disease of the connective tissue.Also, the disease includes cutaneous and inclusive myositis.

  Approximately 20 people fall ill each year in Finland. Adults are more likely to get sick, but the cutaneous form of myositis is also found in children.

  Causes

  The causes of myositis are unknown, but obviously, we are talking about a dysfunction of the autoimmune system, as in other systemic diseases of connective tissues. Muscle inflammation can present with mild articular rheumatism, Shegrin’s disease, or SLE symptoms.The cutaneous form of myositis can occur in the presence of cancer.

  Symptoms

  An important symptom of polymyositis is muscle weakness. Symptoms usually develop slowly, and pain first appears in the thigh, hip, and shoulder muscles. Difficulty getting up and raising arms up. Patients also have difficulty swallowing food. With the cutaneous form of myositis, symptoms appear on the skin of the hands and face. Inclusive myositis manifests itself more slowly than other forms of myositis.In children, after inflammation, calcium is deposited in the scar tissue. The inflammation causes fatigue, weight loss, and fever.

  Diagnosis

  The diagnosis of myositis is based on a blood test. A biopsy is also done. If necessary, electroneuromyography (ENMG) and magnetic resonance imaging are done. Elderly people, if necessary, undergo additional examination.

  Treatment

  Treatment begins in the hospital with fairly high doses of cortisone.If cortisone treatment is not enough, methotrexate is given. In difficult cases, new biological rheumatic drugs are prescribed.

  The treatment lasts for years, so it is important to keep your muscles in shape.

  Prevention

  Previously, myositis was a dangerous disease, but now it can be completely cured of it.

  13. REACTIVE ARTHRITIS AND REITER’S SYNDROME

  Infectious diseases of the bowel, urinary tract or sexually transmitted infections can cause inflammation of the joints.In the future, this leads to reactive inflammation of the joints (arthritis), that is, the body’s immunological response to infection. In Reiter’s syndrome, patients may have inflammation of the mucous membrane of the eyes, skin or mouth, genitals, or urinary tract.

  Causes

  The lining of the joint reacts with inflammation to bacteria-infections. The body makes antibodies (immune response) against itself. Reactive joint inflammation begins, for example, with chlamydia, salmonella, or a common bowel disorder.There is a high risk of intestinal infections in large tourist centers in hot countries.

  The disease has a hereditary predisposition. HLA-B27 antigen was found in most of the patients. Reactive arthritis mainly affects young people.

  Symptoms

  Symptoms of reactive arthritis begin one week after an intestinal or venereal infection and are manifested by pain and swelling of the joints. The initial infection usually goes away. The disease is manifested by inflammation of several joints.Usually the lower limbs are affected more often than the upper ones. Also, the sacrum and ilium become painful.

  Reactive arthritis and Reiter’s syndrome cause flaky redness of the skin on the feet, toes and genital mucosa (balanitis). Also, patients may have redness of the mucous membrane of the eyes or inflammation of the ureters. Fever and fatigue are common symptoms of the disease. A blood test indicates the presence of an infection in the body.

  Diagnosis

  Diagnosing reactive arthritis is easy enough if the patient has recently had a venereal or intestinal infection.Sometimes there are few or no symptoms of infection. Then the causes of infection are found out by culture or blood test for antibodies. Sometimes it becomes necessary to exclude other diseases, such as incipient articular rheumatism.

  An ECG is also done because there is a risk of heart inflammation.

  Treatment

  The infection that causes joint inflammation is treated with antibiotics. Chlamydia treatment is also prescribed. Anti-inflammatory drugs, pain relievers, and sometimes cortisone-containing drugs are given as injections into the affected joint or as pills.Swollen joints should not be overloaded, but supportive exercise is not contraindicated.

  Cold treatments such as an ice pack can also be used to relieve inflammation and pain.

  If the inflammation of the joints does not go away within a few months, then rheumatic drugs are prescribed, one of them is sulfasalacin.

  Re-inflammation can be avoided by safe sexual intercourse, good hygiene and good nutrition.

  Prophylaxis

  Usually, reactive arthritis heals in a few months, but joint pain can last for a long time.After a sexually transmitted infection, the disease is more difficult to treat than after an intestinal infection. Individuals with the HLA-B 27 antigen are at increased risk of re-disease.

  In some patients, reactive arthritis turns into a chronic form of rheumatism, spondylatropathy (ankylosing spondylitis), for example, in rheumatism of the spine.

  14. SPINE RHEUMATISM AND BEKHTEREV’S DISEASE

  Spinal rheumatism is a long-term inflammatory disease of the spine, sometimes manifested in the joints of the extremities.In addition, it can cause inflammation in the attachment points of the tendons and in the eyes. Sometimes the inflammation can be in the heart or on the walls of the aorta. Spinal rheumatism refers to spondylatropathy.

  Rheumatism of the spine occurs equally often in both men and women, but in men the disease is more serious. Most of the patients in the hospital are men. Almost all women with spinal rheumatism are unaware of their illness. Heredity is a risk factor.In Finland, about 10,000 patients with rheumatism of the spine need treatment. But according to statistics, patients with rheumatism of the spine can be one percent of the total population.

  Causes

  The causes of the disease are unknown, but infectious diseases are one of the factors. Spinal rheumatism may appear after suffering from reactive arthritis. In 95% of patients with rheumatism of the spine, the hereditary antigen HLA-B27 was found.

  Symptoms

  A young man who starts waking up at night with pain in the lumbar region is a typical patient.The pain can radiate to the back of the thigh. Your back won’t bend in the morning, but a little exercise will ease the pain. In half of the patients, the joints of the arms and legs also become inflamed, the knees, legs and hips are swollen. Sometimes the disease begins with swelling of the joints of the hands and feet, less often with eye inflammation. Quite often, the disease is accompanied by chest pain.

  Symptoms of spinal rheumatism may be short-lived. Sometimes the disease manifests itself again after a while. There are pains in the spine when bending forward.Bone bridges grow between the vertebrae. Posture changes and the flexibility of the spine decreases. The joints of the arms and legs are also affected. The joints of the hips, knees and shoulders are especially affected.

  At the next stage of the disease, some patients develop eye inflammation – iritis. One or two out of a hundred patients with rheumatism of the spine subsequently develop inflammation of the heart.

  Diagnosis

  Due to the fact that back pain is common, the diagnosis of rheumatism of the spine is very easy to miss.At the initial stage of the disease, the flexibility of the spine is in good shape, but over time, the back grows numb and the flexibility of the spine deteriorates. Sometimes the diagnosis of rheumatism of the spine can be made only five or even ten years after the first symptoms of the disease appear.

  The disease is confirmed by an X-ray of the sacral spine, which shows inflammatory changes. In the early stages, you can take a magnetic image. Later, bone bridges (syndesmophytes) are visible between the vertebrae.The blood test shows high levels of inflammation and low hemoglobin. In some cases, the blood test may be normal. There is no rheumatic factor in the blood. A test for the presence of the HLA-B27 antigen is prescribed.

  Treatment

  Exercise is important in the treatment of back rheumatism. Rheumatism affects the spine and a forward bend is formed. By exercising daily, you can maintain good posture and flexibility in the spine. Straighten your back at least once a day.This can be done by approaching a wall, pressing your heels, buttocks and shoulders against it. The chest can be kept in good condition by taking deep breaths in and out. It is advisable to direct the patient to physical education and explain what needs to be done to keep the body in good shape. Classes with a professional instructor are especially important for young patients.

  Pain relievers and anti-inflammatory drugs are prescribed for mild forms of the disease. Sulfasalacin is prescribed to prevent the development of the disease in the spine.Other medications are also prescribed. For example, new biological antirheumatic drugs that are effective in treating rheumatism. If rheumatism affects the joints of the hips and knees, then patients undergo joint replacement surgery.

  Pain and redness of the eyes can be a sign of inflammation, for this it is recommended to consult an ophthalmologist.

  Prevention

  Good treatment is prevention. Spinal rheumatism is not cured, but it can be prevented.The acute period of the disease rarely occurs in people over 40 years of age. Most people retain their working ability, and only a small proportion of those who fall ill are disabled.

  15. HEREDITARY DISEASE OF CONNECTING TISSUE

  Connective tissue connects all tissues in the body, it consists of cells, fibers, water and intercellular substance. Connective tissue fibers are proteins or proteins, the structure of which is inherited from the father and mother. If there was an error in the genes of the parents, then in the new, born gene there will also be an error, which will lead to the appearance of the disease.

  Collagen is a protein in the body. They are tough fibers that can withstand stretching. Tendons, ligaments and muscle membranes are formed from collagen, and collagen is also found in other tissues. There are many types of collagen. Collagen I is found in bone tissue, collagen II – in cartilage tissue.

  Elastin are fibers that stretch like rubber. Elastic fibers wrap around fibrillins like fishnet tights wrap around a woman’s leg. In all protein fibers, hereditary diseases caused by an error in genes can manifest.

  Ehlers-Danlos Syndrome (EDS)

  There are about 1000 patients with EDS in Finland.

  Causes

  The cause of the disease is heredity. If the parents of the child are sick with Ehlers-Danlos syndrome, then the probability of the child’s illness increases by 50%. But it is possible that the affected gene of one of the parents will never lead to the disease. If the genes are affected in both parents, then the child’s chance of getting sick is one in four. Ehlers-Danlos Syndrome is a group of inherited connective tissue disorders that affect the skin, joints and blood vessels, causing them to stretch.With this syndrome, there are disorders in the structure of collagen.

  Symptoms

  The symptoms of the disease are varied: easily damaged elastic skin, hyper-movable joints, varicose veins, hernias, ruptured blood vessel walls, inflammation of the gums and tooth loss. Symptoms depend on the type of disease.

  The Apila Rehabilitation Center organized courses for EDS patients, where people with this disease are helped to cope with their difficulties and problems: pain, joint flexibility, dental problems, muscle weakness, bruising and bleeding, slow wound healing and scarring, problems bowel dislocation, fatigue and swelling.In women, prevention of miscarriages.

  Types of EDS-syndrome

  Currently, EDS-syndrome is divided into different forms of the disease.

  Hypermobility – hypermobility (formerly type III)

  The main symptom of the hypermobile type is increased mobility in large and small joints, sometimes dislocations and pain. The skin is stretchy and velvety. The disease can manifest itself in relatives.

  Classic form of EDS (earlier forms I and II)

  In the classic form of the disease in patients, the skin is soft and velvety, pronounced elasticity of the skin, a tendency to damage with minor trauma, as well as to the formation of bruises or hematomas, scars, subcutaneous pseudotumors, increased mobility in large and small joints, frequent varicose veins.Patients also have inguinal and diaphragmatic hernias, bruising, muscle weakness, hemorrhoids, and gum disease. The disease is hereditary.

  Vascular form (formerly form IV)

  In patients, this form of the disease is manifested by joint hypermobility. Vessels are easily damaged because the vascular walls are weak, which is vasculitis, that is, inflammation of the vascular walls.

  The skin of these people is thin, transparent with translucent vessels. Bruises easily.

  EDS kyphoscoliosis (formerly type VI)

  Kyphoscoliosis is a rare disease, but the affected gene is now being extensively investigated. This disease affects about 60 people on Earth. They have severe muscle weakness, which leads to incorrect posture of the spine – scoliosis. In some cases, there may be increased eye vulnerability and corneal thinning.

  Arthrochalasia type EDS (formerly types VII A and VII B)

  In a rare form of arthrochalasia type EDS, there are strong changes in connective tissues that weaken the joints, make the skin easily damaged, lead to inflammation of the joints, brittle bones and orthopedic problems.About 30 people are sick on Earth.

  Dermatosparaxis EDS (formerly type VII C)

  Severe skin vulnerability and its increased elasticity. One gets the impression that there is a lot of skin. Scars and hernias are common. Pregnant women are at risk of premature birth due to the weak membrane of the fetus.

  Treatment

  It is impossible to change the gene and eliminate the cause of the disease. Treatment is aimed at reducing symptoms and preventing them from worsening.

  It is important to determine the cause of the disease and to provide the patient with complete information about the disease. Knowing about the nature of the disease, the patient himself plans his life so that the disease does not affect it. When choosing a profession, young people should take their illness into account.

  For joint pain, you can take paracetamol and anti-inflammatory drugs. For large joint lesions, joint implantation operations are performed.

  Before surgery, EDS patients need to tell the surgeon about their illness in order to avoid complications during wound healing.

  There are a number of different tools that can help EDS patients in their daily lives. By avoiding dangerous situations, you can keep your joints intact. Supportive elastic bandages can be worn around the joints. Muscles need to be strengthened. The skin should be moisturized with creams. It is recommended to wear supportive tights and golf to prevent varicose veins. Regular visits to the dentist can help prevent dental problems.

  Patients themselves know how important it is to receive information about the nature of the disease.A calm life, rest and relaxation, as well as the support of loved ones help to overcome life’s difficulties. It is necessary to avoid sudden movements, use tight bandages for joints, regularly take medication, eat right, try Reiki treatment, yoga, zonotherapy and lymphomassage. Try to do everything that you can and can do.

  Other damage to the structure of collagen

  Stickler syndrome is a fairly common disease that is caused by a violation of the structure of type II collagen.The disease is often mild. Stickler’s syndrome is a complex of hereditary abnormalities of the eyes and joints. The first symptoms appear in childhood: congenital severe myopia, often blindness, cataracts, secondary glaucoma, chronic uveitis, keratopathy, wrinkling of the eyeball develop in the blind eye. Joints become hyper-flexible, painful, and prone to fracture. In some cases, violations in the structure of the face are noted: a small chin, split jaws.

  Connective tissue dysplasia (MED) is caused by a structural disorder of type IX collagen. These abnormalities in the structure of articular cartilage lead to growth retardation and joint destruction.

  Imperfect osteogenesis is a bone disease caused by a type I collagen mutation that can cause fetal death while still in the uterus. In a mild form of the disease, bones are weak and break easily. In addition, there may be problems in the connective membrane of the eyes, hearing problems and deafness.

  Other genetic problems of protein fibers

  Williams syndrome is a syndrome that occurs as a consequence of the chromosomal abnormality of elastin. Elastin and collagen form a fibrous protein, with the help of which the walls of blood vessels, lungs and other organs are able to stretch. This disease affects one child in 20,000. They develop problems in the cardiovascular system. The aorta and pulmonary artery is narrowed already in childhood, later there are problems with blood pressure. Children are born small, feeding problems, colic appear.Also, there are changes in the structure of the teeth (large gaps between the teeth), weak muscles, hypermobility of the joints. In adults, the joints are less mobile.

  Marfan syndrome is caused by a change in fibrillin type I. Fibrillin is a fibrous protein.

  In connective tissue, it forms a protective mesh around elastin. In addition to the characteristic changes in the organs of the musculoskeletal system (elongated bones of the skeleton, hypermobility of the joints), pathology is observed in the organs of vision and the cardiovascular system.

  16. SHEGRIN’S SYNDROME

  Shegrin’s syndrome is a systemic autoimmune disease characterized by dryness of the mucous membranes of the eyes, mouth and genitals caused by damage to the lacrimal, salivary and genital glands. Most often, women are ill. Shegrin’s syndrome affects people over 50 years of age. There is no reliable information about the disease, but according to experts, 3-4% of adults suffer from Shegrin’s syndrome.

  Causes

  Autoimmune disorders, in which the immune system opposes its own tissues, are considered the basis of the mechanisms of the development of the disease.The syndrome can develop independently (primaarinen) or together with other rheumatic autoimmune diseases, in particular, articular rheumatism (sekundaarinen). One of the causes of the disease is considered to be a change in sex hormones, because most of the sick are women.

  Symptoms

  With Shegrin’s syndrome, dryness of the mucous membranes appears. The first signs of the disease are irritation and dryness in the eyes. There is a dry mouth and difficulty in swallowing food, there is a need to drink food.The voice sits down. Due to the decrease in salivation, caries forms on the teeth and the gums become inflamed. Inflammation of the salivary glands may occur. Dry skin causes itching. Dry nose and dry cough appear. In women, dryness of the mucous membranes of the genitals appears. Disorders of the glands of the stomach and intestines cause malabsorption of iron and vitamin B12.

  In Shegrin’s syndrome, fatigue appears, joint pain resembles fibromyalgia, skin irritation and fever appear. Possible kidney disease, swelling of the lymphatic glands and disorders of the nervous system.

  People with Shegrin’s syndrome increase the risk of cancer of the lymphatic glands (lymphoma). With severe edema of the lymphatic and salivary glands, it becomes necessary to examine them.

  Diagnosis

  Shegrin’s syndrome is determined by the dryness of the mucous membranes typical of this disease. Tear production is measured by the Schirmer test, which examines the rate at which absorbent paper becomes wet behind the lower eyelid. The secretion of salivary fluid is measured by the collection of saliva. Microscopic examination of the lips indicates the presence of an inflammatory process.Blood levels of inflammation are elevated. Almost all patients have rheumatic factor of Shegrin’s syndrome and antibodies in their blood.

  In the elderly, dryness of the mucous membranes is an age-related indicator and is not a symptom of Shegrin’s disease.

  Treatment

  If rheumatism of the joints or another disease of rheumatism is included in the secondary Shegrin’s syndrome, then it is treated in the usual way. Dysfunction of the glands in Shegrin’s syndrome is incurable, but moisturizing can alleviate dry mucous membranes.

  Moisturizing eye drops and safety glasses prevent dry eyes. The indoor air should not be very dry. Moisturizing drops are instilled regularly at regular intervals. The use of xylitol chewing gum, as well as medications such as pilocarpine and bromhexidine, increase saliva production. You need to monitor the condition of your teeth. Fungal infections of the mouth and genitals need to be treated with antifungal medications. The female genitals are treated with special moisturizers.

  Primary Shegrin’s syndrome is treated with low doses of cortisone. In difficult cases, methotrexate and other newer rheumatic drugs are prescribed.

  Prevention

  Shegrin’s syndrome is not cured. Treatment slows the progression of the disease, but you need to learn to live with the disease. Disability caused by illness is rare. Prevention is more influenced by the nature of the course of the primary disease or rheumatism than dryness of the mucous membranes.

  17. SERONEGATIVE SPONDYLOARTHRITIS

  Spondyloarthritis defines a group of diseases, the exact diagnosis can not always be determined.We are talking about seronegative rheumatism of the spine, with spondyloarthritis there is no rheumatic factor in the blood, but there is a tendency to cause inflammation in the joints of the spine.

  Spondyloarthritis includes:

  rheumatism of the spine (Spondylarthritis ancylopoetica, ankylosing spondylitis)

  reactive inflammation of the joints and Reiter’s disease

  ulcerative inflammation of the large intestine and Cronin’s disease

  part of childhood rheumatism of the spine

  3 diseases can cause inflammation in the joints of the limbs and spine.A feature of these diseases is inflammation of the intermediate joint between the sacral and iliac bones (sacroilitis). During examination, the hereditary antigen HLA-B27 is found in patients. Usually these diseases develop at a young age, inflammation of the eyes (iritis), heart and aortic walls appear. All symptoms are rare at the same time. At the beginning of the disease, inflammation of the joints brings problems and pains, but later they can disappear even without treatment.

  Spondyloarthritis manifests itself like other rheumatic diseases.Perhaps the cause is a previous intestinal or venereal infection, as with reactive inflammation of the joints. The hereditary factor is of great importance.

  Finns live in cold climates and the presence of the HLA-B27 antigen is quite common. 15% of Finns have the HLA-B27 antigen, while only 8% of Central Europeans, 1% of Japanese, and even less of South American Indians. People with the HLA-B27 antigen in their bodies have a hundred times higher risk of developing spondyloarthritis than others.

  Spondyloarthritis is a long-term illness, but it rarely causes disability. In mild forms of the disease, the patient is treated with small doses of drugs. In difficult cases, biological rheumatic drugs are prescribed.

  18. SYSTEMIC LUPUS ERYTEMATOSUS (SLE)

  Systemic lupus erytematosus (SLE) is a systemic autoimmune disease of the connective tissue. The body produces antibodies, which, instead of protecting, attack the connective tissues of the body.The symptoms of the disease appear in different parts of the body. There are about 2,000 SLE cases in Finland, 90% of whom are women. Half of them are under the age of 30. In older people, the disease is mild.

  Causes

  The causes of the disease are unknown. In women in adulthood, sex hormones affect the disease. Heredity also affects the disease. Certain medications (hydralazine, procainamide), chemicals, and ultraviolet light increase the risk of SLE.

  Symptoms

  Common symptoms of SLE are fatigue, weight loss and fever. Skin rashes appear on exposed parts of the body, caused by exposure to sunlight. A red butterfly-shaped rash appears on the face around the nose. Joint pain and inflammation, hair loss, mouth ulcers, kidney disease, inflammation of the membranes of the lungs and heart, and neurological diseases. Pain or rheumatic inflammation in the joints manifests itself in almost all patients, skin rashes – in a fairly large part of the sick, and kidney disease – in almost half.The joints are not destroyed, but they can become deformed. The symptoms of the disease are manifested differently in different people. More often the disease is mild and does not affect the patient’s lifestyle. It is quite difficult to identify the form of the disease.

  Diagnosis

  The diagnosis of the disease is made on the basis of symptoms and laboratory tests. There are 11 criteria for disease. If 4 or more criteria are manifested in the disease, then the diagnosis of systemic lupus erytematosus is correct.The calculation of the criteria is more theoretical. In the analysis of blood, the indicators of inflammation increase, but as with other diseases of rheumatism, the CRP is not increased. Almost all patients have antibodies in their blood. By the quantity and quality of antibodies, one can assess the stage of the disease and the result of treatment. Leukocytes and platelets may be lowered. Anemia is possible.

  Treatment

  Mild cases of SLE do not require treatment. The sick person takes care of himself, avoiding the sun’s rays and using protective creams.It is enough to get by with weak drugs, for example, small doses of cortisone and hydroxychloroquine. In difficult cases, the patient is given large doses of cortisone.

  Pregnancy can cause problems. It is recommended to consult a rheumatologist about the observation and treatment of SLE disease during pregnancy. Infections can also cause complications. It is imperative to find out the reason for the rise in temperature in order to know whether it is caused by an infection or an exacerbation of SLE disease.Treatment is directed at the affected organ. Almost always resembles treatment for osteoporosis.

  Prophylaxis

  The prophylaxis of systemic lupus erytematosus is constantly evolving. The disease is dangerous for people with serious diseases of the kidneys, lungs or central nervous system. With age, the disease subsides. SLE- drug-induced illness resolves with drug withdrawal.

  SLE criteria:

  1. Red butterfly rash on nose and cheeks

  2.Scaly redness on the skin

  3. Redness of the skin under the influence of sunlight

  4. Ulcers in the mouth

  5. Inflammation of the joints

  6. Inflammation of the membranes of the lungs and heart

  7. Kidney diseases

  8. Neurological symptoms (convulsions or psychosis)

  9. Blood changes (anemia, decrease in leukocytes or platelets)

  10.Immune changes in blood (DNA, false positive cardiolipini test)

  11. Antibodies

  19. SYSTEM SCLEROSIS (SYSTEMIC SCLERODERMIA)

  Systemic sclerosis is a rheumatic disease of the connective tissues. One of the forms of the disease is scleroderma (sclero is hard, dermis is skin). With this disease, the skin becomes rough. Also, the connective tissue of internal organs is scarred, but this symptom is rare. In Finland, 20-50 people fall ill every year, most of them are women.Children rarely get sick.

  Causes

  The cause of systemic sclerosis is unknown, but many chemicals can cause it. For example, in 1981 in Spain there was a wave of this disease caused by low-quality vegetable oil. A substandard tryptophan marketed as a natural product caused a second epidemic at the end of the same decade. Also, coal and silica dust, vinyl chloride, triclorothylene and other chemicals can cause disease. Silicone implants are one of the suspected causes.In most patients, the causes of the disease are unknown.

  Symptoms

  The disease begins with circulatory disorders in the fingers and toes. Raynaud’s symptom appears when the vessels contract so strongly that the fingers turn white at a cool ambient temperature. Skin changes appear on the fingers. The skin of the fingers swells and hardens. Skin wrinkles and folds disappear. Over the years, the skin becomes thin and taut, sometimes calcium is deposited in the skin. Symptoms can spread throughout the body, and the skin becomes denser and deformed.The muscles of the face become immobile, the mouth contracts. The dilated subcutaneous vessels are visible.

  Scleroderma can affect not only the skin, but also the internal organs. If the esophagus is affected, there are problems with swallowing. With damage to the lungs, kidneys and intestines, serious health problems appear. These diseases also include such unusual forms of the disease as eosinophilic faskitis. When the inflammation subsides, the skin will scar and resemble an orange peel.

  A common form of systemic sclerosis is CREST (from calcinosis – skin hardening), Raynaud’s symptom, esophagus (scarring of the esophagus), sclerodactyly and telagniectasia, that is, dilation of the subcutaneous vessels.

  Diagnosis

  Diagnosis is based on the picture of the disease. Indicators of rheumatism and antibodies are found in the patient’s blood. CREST detects the antibodies characteristic of this disease.

  Treatment

  Treatment of systemic sclerosis is difficult because there is not enough effective medicine. The patient needs to protect the skin from the cold. Stop smoking. Vasodilators (nifedipine) are prescribed. Moisturizers are used to prevent dry skin.To maintain mobility of the fingers, it is necessary to do gymnastics for the hands.

  Rheumatic drugs are being tested, but their effect remains negligible. Penisillamine and cyclosporine are widely used. When treating internal organs, symptomatic medications are prescribed.

  Prevention

  An important role in the prevention of systemic sclerosis is to limit the disease to the cutaneous stage, when other organs are not yet affected. Over time, the skin softens and the disease becomes mild.But damage to the lungs and kidneys remains a serious disease.

  20. VASCULITIS

  Vasculitis is an inflammation of the walls of blood vessels. The consequences of vasculitis depend on the number of affected vessels and sites of inflammation. In severe cases, vasculitis causes blood circulation problems. This leads to bleeding or tissue death.

  Vasculitis is classified based on the size of the vessels involved. Vasculitis affects the temporal artery, cutaneous vasculitis, small blood vessels. With temporal arteritis, large and multinucleated cells are visible in the wall of the temporal artery under a microscope, due to which the disease has received its second name – giant cell arteritis.

  Vasculitis is often manifested by rare diseases such as polyarteritis nodosa. As well as Shenlein-Genoch purpura, Churg-Strauss syndrome, Kawasaki disease, Wegener’s granulomatosis, and Takayashi’s arteritis.

  Causes

  The causes of the disease can be infections, tissue damage, foreign substances that cause immune reactions in the body. The mechanism of vasculitis has not been determined. Heredity matters too. Vasculitis can be either an independent disease or belong to a group of rheumatisms such as articular rheumatism or SLE disease.

  Symptoms

  Vasculitis is characterized by fever and weight loss. Due to vascular diseases, skin rashes of various types appear. Typical symptoms of the disease are muscle and joint pain, disturbances in the peripheral nervous system, nosebleeds, coughing up blood, blood in the urine, and abdominal pain.

  Highlights

  Half of the patients diagnosed with vasculitis and temporal arteritis show symptoms of polymyalgia. Symptoms of arteritis include headaches in the temporal region and pain in the cheekbones when chewing.With the disease, there is a risk of ocular artery blockage and loss of vision, so treatment should be started as soon as possible. Mostly elderly people get sick.

  Takayashi’s disease affects the aorta and the blood vessels emanating from it. The main symptom of the disease is circulatory disorders. The diagnosis is difficult. Mostly young women get sick.

  Polyarteritis nodosa is a rare condition in which inflammatory plaques form on the walls of the arteries.It manifests itself in young people. There are serious changes in the internal organs, the diagnosis is clarified during the operation.

  The initial symptoms of Wegener’s granulomatosis are upper airway disturbances, sinus inflammation, nasal congestion and nosebleeds. There may also be otitis media and deafness, impaired vision. Complex forms include kidney and lung damage. Some forms of the disease are mild. ANCA antibodies are present in the blood.

  With secondary vasculitis in combination with other autoimmune diseases, symptoms begin with lesions of small skin vessels. Wounds and necrosis form on the skin of the legs or arms.

  Diagnosis

  Diagnosis is made based on symptoms and skin biopsy. X-rays of the blood vessels (angiography) reveal vasculitis. Also, the diagnosis is based on laboratory tests. CRH increased.

  Treatment

  Treatment is aimed at eliminating the cause of vasculitis.First, the inflammation of the blood vessels is removed with drugs. After its termination, the underlying disease is treated more effectively. Cortisone is prescribed. Cytostatic agents are often used along with it. In critical situations, large doses of cortisone are prescribed. Biological medicinal products give good results.

  Prevention

  The prognosis of vasculitis improves with the development of treatment methods. In a large proportion of patients, symptoms improve. Although sometimes the disease can become severe.Extensive lesions of internal organs give a poor prognosis of the disease and urgent hospitalization.

  © 2016 Lappeenrannan reumayhdistys ry.

  Plastic reconstructive ophthalmic surgery – eye surgery in Moscow at the Clinical Hospital on Yauza

  Introducing the doctor

  We invite your attention to an interview with an exclusive specialist – Doctor of Medical Sciences, Professor Davydov Dmitry Viktorovich .

  This is a well-known plastic reconstructive microsurgeon with many years of experience, combining wide medical practice with scientific research and teaching at the department of postgraduate training of doctors at RUDN that he created.Recognized expert in the field of plastic surgery. Member of the Expert Council of the Higher Attestation Commission of the Russian Federation for Surgical Sciences. Author of over 30 RF patents, monographs, 133 publications in leading domestic and foreign journals.
  Certified in Plastic Surgery, Ophthalmology, Maxillofacial Surgery.

  sign up for a consultation

  {Anchor :: title (‘Plastic Reconstructive Ophthalmic Surgery’)}

  Areas of Competence in Plastic Reconstructive Ophthalmic Surgery

  Dmitry Viktorovich, what situations does plastic reconstructive ophthalmosurgery consider? What are its capabilities?

  Prof.Davydov D.V. Plastic surgery and surgical reconstruction in the area of ​​the orbits, midface and eyelids is performed for many pathologies, including:

  • Age-related changes in the skin of the eyelids and periorbital region 90 100
    90,097 conditions after previously performed cosmetic interventions on the eyelids (complications after blepharoplasty) 90 100
    90,097 ptosis of the eyelid due to various reasons 90 100

  • congenital and acquired deformities of soft tissues and bone structures in the orbital area (after injuries, oncological processes and operations) – displacement and retraction of the eyeball 90 100
  • persistent lacrimation and various disorders of lacrimation;
  • bulging of the eyeball with endocrine ophthalmopathy;
  • Modern individual eye prosthetics for anophthalmos, microphthalmos, subatrophy of the eyeball (irreversible loss of a functioning eye), which allows you to maintain the external attractiveness of the face, to make the external prosthesis move and at the same time develop the facial skeleton correctly, if a child has such a problem.

  Please tell us a little about each of them.

  {Anchor :: title (‘Disorders of lacrimation’)}

  Restoration of disorders of lacrimation

  Prof. Davydov D.V. Diseases in which tear flow is impaired are very painful for patients. Therefore, surgical interventions that allow you to quickly solve the problem become a salvation for a person. We carry out modern endonasal microsurgical endoscopic microinvasive laser interventions that restore the communication between the lacrimal sac and the nasal cavity, leaving no marks on the face.

  First, the patient undergoes MSCT contrasting . We inject contrast into the lacrimal system, immediately carry out multispiral computed tomography (MSCT), receive and analyze the images obtained in digital, that is, the highest quality. From their analysis, we understand at what level there is a violation of the outflow of tears and, accordingly, we plan the volume and method of surgical intervention.

  I perform the treatment only through the nose (endonasally endoscopically), so that there are no incisions of the skin on the face, postoperative scars.

  There are different methods of restoring patency. For example, in complicated cases, we install the thinnest polymer tubes and stents with a special coating in the lacrimal canal. After a while, these stents are removed, and the newly formed canal already independently performs the function of lacrimation. Such operations have been carried out by me for a long time, for more than 25 years. Rehabilitation is fast. The method is very effective, it allows you to solve the problems of lacrimation disorders in a complex way on the internal structures of the nose, without affecting the skin, that is, while maintaining high aesthetic standards.

  How long does the patient stay in the hospital after surgery?

  Prof. Davydov D.V. After the intervention, the patient remains under observation in our hospital, usually overnight. After discharge, I have an outpatient observation. The patient comes for an examination, undergoes medical procedures, dressings. Special drops are buried in the eyes, in the nose, other measures are taken to promote tissue healing. In a day or two, the patient can go to work if the work is in the office.

  In fact, in a few days a serious problem is solved, which for a long time has given the patient a lot of inconvenience?

  Prof. Davydov D.V. Yes. He gets rid of lacrimation and suppuration, pain, the threat of the risk of developing serious complications caused by the presence of a chronic infectious inflammatory process in the orbit in the immediate vicinity of the brain.

  {Anchor :: title (‘Endocrine ophthalmopathy’)}

  Endocrine ophthalmopathy

  And what help is possible with endocrine ophthalmopathy?

  Prof.Davydov D.V. Endocrine ophthalmopathy – bulging of the eyeball on the background of hyperthyroidism. For clarity, we can recall Nadezhda Konstantinovna Krupskaya – one of the historical figures who suffered from this pathology. This is a really big problem. The eyes with this disease are often literally bulging. Such patients often unsuccessfully “migrate” between ophthalmologists and endocrinologists, while often neither one nor the other can significantly help them.

  There are different forms of endocrine ophthalmopathy and we evaluate the form of the disease by MSCT of the orbit, the degree of process activity, analyze the options and effectiveness of the pharmacotherapy.

  Surgical treatment of endocrine ophthalmopathy

  Prof. Davydov D.V. In some cases, the effectiveness of conservative treatment of endocrine ophthalmopathy is extremely low, and the cosmetic defect is obvious, and visual functions also suffer. Therefore, there is an indication for surgical decompression. This method is not aimed at eliminating the cause of the development of exophthalmos, but allows to eliminate the functional and aesthetic problem. And the endocrinologist is engaged in the normalization of hormonal levels.

  As a result of the operation, we remove the excess fatty tissue located around and behind the eyeball and displacing it forward. If, as a result of planning the operation, I see that the volume of soft tissues will not be sufficient for the full effect, I perform an operation in which I also remove fragments of the bone walls. All actions are strictly verified, all parameters are calculated in advance during MSCT planning. These operations are very difficult, they require the appropriate equipment, which is available in the clinic, medication, and are carried out under general anesthesia.

  On average, after 1-2 days, patients leave the hospital, and then outpatient observation and treatment is carried out. I give detailed recommendations on the lifestyle, permissible loads, prescribed medication support, dressings are carried out under my control and dynamic observation.

  How stable is the result of the operation? Does exophthalmos recur after a while?

  Prof. Davydov D.V. So far, no patient has returned with a relapse of the disease.We remove soft and bone tissues in doses. The treatment is almost radical, but, I repeat, it is carried out according to strict indications – in the absence of the effect of treating exophthalmos with conservative methods. The effect of surgical treatment is obvious – the eyes are in the correct position in the orbit, the protrusion disappears.

  {Anchor :: title (‘Absolute Glaucoma and Ophthalmic Prosthetics’)}

  Absolute glaucoma and ocular prosthetics

  Prof. Davydov D.V. Glaucoma is a condition associated with increased intraocular pressure that, if untreated, leads to loss of vision.Absolute glaucoma is the final phase of the disease, when the eye is already completely blind, without the prospect of restoring visual function, and it hurts. Moreover, it hurts so that the pain can be very similar to pain syndrome, as in myocardial infarction. Absolute glaucoma develops in patients who do not control intraocular pressure, start the disease, ignore the doctor’s recommendations, and do not carry out treatment. They not only lose their eyesight, but end up suffering from unbearable pain. At the same time, at the height of the painful attack, they are not undertaken to operate because of the threat that the eye will simply burst due to high intraocular pressure.

  Surgical treatment of absolute glaucoma. Stage cosmetic prosthetics.

  We take on these difficult cases, achieving two goals at once:

  • First, we relieve the patient from severe unbearable pain.
  • Secondly, we carry out the operation in such a way as to provide the best aesthetic effect, so that the loss of the eye is outwardly completely invisible.

  How is this possible ?!

  Prof.Davydov D.V. At stage 1, we preserve the entire shell of the eye, all its external structures, all oculomotor muscles, form a supporting movable eye stump, using individual endoprostheses. After a while, an individually made eye prosthesis with planned replacement is placed in the conjunctival cavity.

  Such individual cosmetic prosthetics allows you to completely preserve the range of eye movements so that no one understands that this is a prosthesis and not a real eye.After such an intervention, the eye no longer hurts, while the patient completely retains his appearance, he is not disfigured. The prosthetic eye makes friendly movements with the healthy eye to the right, left, up, down.

  Individual prosthesis fabrication

  The manufacture of an external eye prosthesis is carried out in special laboratories with which I have been cooperating for many years. It is carried out on the basis of the most accurate measurements and calculations and meets the most modern criteria and requirements for an individual approach to each patient.

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  Maintaining a healthy eye

  Prof. Davydov D.V. If such an operation is not performed, a diseased eye (especially if it has been repeatedly operated on) can negatively affect a healthy one. At the same time, the sore eye can be enlarged, reduced, inflamed, etc. The deformed eye will certainly disfigure the patient’s face. If microsurgical intervention is carried out on a sore eye without taking into account all the numerous aspects, there is a high risk of the development and progression of already other pathological processes, and with them there is a danger of losing sight in the remaining healthy eye.With the proposed operations, we prevent the development of such problems.

  Use of copyright technologies

  In the surgical treatment of patients with anophthalmos and deformities of the orbit and during ocular orbital endoprosthetics, I use my own proprietary patented surgical technologies, which have proven their high efficiency over 25 years.

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  Photo BEFORE and After stage cosmetic eye prosthetics

  Examples of staged cosmetic eye prosthetics.The operations were performed by Dr. med. prof. Davydov D.V.

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  Ophthalmic prosthetics for children

  Prof. Davydov D.V. One of the most difficult problems is children who have their eyes removed because of a tumor (eg, retinoblastoma). Also, babies need eye prosthetics with congenital deformities of the orbital region (bone and soft tissue), the absence of an eyeball (anophthalmos and microphthalmos).

  At any age, for various reasons, subatrophy of the eyeball can develop – wrinkling, deformation of the eyeball, or, on the contrary, its enlargement (buphthalmos), usually occurs in children or adults with uncontrolled glaucoma). In this case, the diseased eye is completely blind.

  “It is important to do the operation correctly and on time”

  Prof. Davydov D.V. If corrective intervention is not carried out on time (as early as possible), if the volumetric supporting stump of the eye is not formed correctly, in small patients, over time, a difference in the growth of the skull bones develops and a persistent deformity is formed for life.

  We have to deal with such disfigured patients of all ages, including adults. Adults, as a rule, cannot completely correct an already developed deformity of the face, even after many surgeries. If they had been operated on correctly and on time – in childhood, then such an ugliness would not have arisen.

  I perform staged cosmetic eye arthroplasty operations at the Clinical Hospital on Yauza for adults and children aged 1 year and older.We see it as our task to create a clinic for such patients where they can receive timely and high-quality help, regardless of their address. It is important to do the operation correctly and on time.

  The hospital has everything for the successful treatment of such difficult patients – excellent anesthesiologists – very competent, very qualified, highly professional nurses, excellent modern high-tech equipment, a hospital for monitoring patients after surgery and a polyclinic for subsequent rehabilitation.

  And if a patient comes to you with an already missing eye or other already developed deformity, pathology. How can you help him?

  Prof. Davydov D.V. First of all, we will carry out a full diagnosis of him – we will see the state of his bones and soft tissues, calculate the volume of his orbits, consider a variety of rehabilitation options. And, if he agrees to surgical rehabilitation, we are engaged in MSCT planning. Taking into account the characteristics of this particular patient, according to his measurements and calculations, we manufacture individual implants.We write out the complete treatment plan for months in advance, and, perhaps, for years. We start and implement this treatment plan.

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  MSCT planning

  Prof. Davydov D.V. Plastic reconstructive ophthalmic surgery is preceded by careful MSCT planning.

  Research algorithms. Not every CT study performed, especially the standard one, is suitable for MSCT planning.Computed tomography should be carried out according to a specific research algorithm. We carry out MSCT research according to a specific algorithm developed and patented by us, taking into account specific tasks.

  Calculation accuracy and equipment supporting it. We calculate all actions, the dimensions of the future implant with an accuracy of fractions of a millimeter. The required scanning step is 0.5 mm, that is, the tomograph takes pictures of the area under study every half a millimeter. Such accuracy is absolutely necessary, because the wrong size of the endoprosthesis can lead to undesirable consequences – tissue stretching, increased fibrosis in this area and other complications or insufficient correction of the defect to be repaired.

  The equipment of the hospital and the qualifications of the doctors of the Department of Radiation Diagnostics allow conducting studies of the required accuracy.

  Calculations are carried out according to the parameters of the paired side. If this is a situation associated with post-traumatic changes in orbits with bone disorders, then we calculate not only the size of the bone changes, but also the soft tissue defect, taking it into account during the planned surgical intervention.

  Stereographic modeling. If necessary, we send all calculations to a special center, where a model of the skull is made for us, on which we see the bones of the facial section of the skull, we analyze in detail all the moments of the upcoming operation.This is called prototyping or stereographic modeling.

  To get a good result, you cannot neglect any nuances.

  Dmitry Viktorovich, thank you very much for the interesting story.

  sign up for a consultation 90,000 prices for treatment, symptoms and diagnosis of ethmoiditis in the “CM-Clinic”

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  Ethmoiditis is an inflammatory disease that occurs in the lining of the ethmoid bone.The ethmoid bone is the bone of the cerebral skull, which is located in the center, between the bones of the face and is part of the nasal cavity and eye sockets. It consists of thin bony plates that are located outside the air cavities. The ethmoid bone is bordered by all the paranasal sinuses – sphenoid, frontal, maxillary. Children suffer from ethmoiditis more often than adults.

  Symptoms of ethmoiditis

  Ethmoiditis is acute or chronic. It becomes chronic due to inadequate treatment of the acute phase or concomitant inflammation of other sinuses.Acute ethmoiditis causes the following symptoms:

  • Severe pain in the region of the bridge of the nose, root of the nose, medial edge of the orbit. The pain occurs sharply, it can intensify at night. It happens dull or throbbing, often gives to the forehead, eye.
  • Headache.
  • Violation of the perception of odors or lack thereof.
  • Deterioration of nasal breathing.
  • Feeling of bloating in the nose.
  • Increased body temperature.
  • Rapid eye fatigue.
  • Nasal discharge, serous in the first days, later becomes serous-purulent.
  • Redness and swelling of the inner part of the orbit, eyelids.
  • Insomnia.

  If you experience these symptoms, we advise you to make an appointment with your doctor. Timely consultation will prevent negative consequences for your health. Phone for appointment +7 (495) 292-39-72

  Causes of ethmoiditis

  On the development of ethmoiditis, anatomically narrow excretory canals of the ethmoid labyrinth, a narrow middle nasal passage, proliferation of adenoids.Inflammation is caused by various viruses and bacteria. Most often, the disease occurs as a complication of inflammation in other sinuses (rhinitis, sinusitis, frontal sinusitis). This is how ethmoiditis develops more often in adults.

  In children, the disease occurs as a complication against the background of acute respiratory viral infections and bacterial infections (tonsillitis, scarlet fever, influenza, measles, tonsillitis, etc.). The infection spreads from the primary focus with the flow of blood, lymph.

  Diagnostics of ethmoiditis in the “CM-clinic”

  Qualified otolaryngologists are engaged in diagnostics of ethmoiditis in the “CM-clinic”.After finding out a complete history of the disease, studying the symptoms and conducting additional research, the doctor will be able to determine the methods of treatment and the most rapid relief of the patient’s condition.

  Examination of the patient’s appearance will already give the specialist an understanding of the first distinctive signs of ethmoiditis – edema and redness of the eyelids, narrowing of the palpebral fissure. Then the doctor of our center in Moscow will conduct a rhinoscopy – an examination of the nasal cavity, which gives an idea of ​​the state of the mucous membrane, anatomical features, the presence of neoplasms and the nature of the discharge.

  A more modern, endoscopic examination technique, which is also widely used by SM-Clinic doctors, will allow a complete examination of the outlet openings of the ethmoid cells. Additionally, an X-ray examination of the sinuses, CT scan and a complete blood count may be prescribed, which will show the nature of the inflammatory reaction.

  Treatment of ethmoiditis in the “CM-clinic”

  How to cure ethmoiditis, effectively and quickly relieve the symptoms of the disease, otolaryngologists of the “CM-clinic” know.Our doctors approach each patient individually, taking into account age and any other characteristics.

  In case of acute inflammation, you will need a course of antibiotic therapy, this will allow you to get rid of pain and swelling as quickly as possible. Locally applied vasoconstrictor drugs, this improves the outflow of discharge and relieves tension in the sinuses. If necessary, the patient can be prescribed antipyretic and analgesics. After improving the condition, the doctor will prescribe physiotherapy procedures that perfectly sanitize the nasal cavity, remove inflammation.

  Conservative therapy is not always appropriate. It is not uncommon for a patient to come with complicated inflammation and require surgery. Where to treat complicated ethmoiditis? The otolaryngologists of our center have extensive experience in ethmoid bone surgery. Doctors perform the dissection of bone cells using a modern endoscopic method through the nose. This minimizes the risk of complications and trauma to facial tissues.

  Prevention of ethmoiditis

  Methods of disease prevention include:

  • hardening;
  • good nutrition;
  • timely treatment of colds, other sinusitis;
  • immunocorrection.

  You can sign up for a consultation, find out the cost of treatment, diagnostics and ask any other questions regarding the work of the “CM-clinic”, you can contact our consultants.

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  90,000 Pain in the corners of the eyes | Articles

  One of the common complaints of ophthalmologist patients is pain in the corners of the eyes. It can manifest itself both in the outer and in the inner corner, it can be permanent, or it can arise only periodically.

  Pain in the corners of the eyes is just one of the manifestations of a whole complex of symptoms of various diseases of the organs of vision.Often this pain is accompanied by:

  90 096

• itching and redness of the skin on the eyelids;

90,097 redness and discharge from the eyes;

• active lacrimation.

Why there is pain in the corners of the eyes

Unpleasant sensations in the corners of the eyes can be caused by various diseases. The main ones are:

• canaliculitis. Inflammation of the lacrimal ducts located in the inner corner of the eye.The cause of inflammation can be the penetration of infections into the eye and into the nasal cavity. Canaliculitis is accompanied by edema and redness of the eyelid, profuse purulent discharge and increased lacrimation. For the treatment of this disease, antibacterial and anti-inflammatory drugs are prescribed in the form of drops.
• obstruction of the lacrimal passages. There is partial and complete obstruction. In addition to painful sensations, it is accompanied by profuse lacrimation and discomfort in the area of ​​the inner corner of the eye.Obstruction of the lacrimal passages, as a rule, occurs due to injury or tumor. Restoration of the lacrimation pathways is usually performed through surgical intervention.
• dacryocystitis. Inflammation of the lacrimal sac. It is accompanied by severe pain in the inner corner of the eye, the appearance of edema. With dacryocystitis, the lacrimal openings begin to produce abundant purulent discharge. Conservative methods are used to treat the disease. In difficult cases, when the disease acquires a chronic stage, surgical intervention is prescribed.
• blepharitis. Inflammation of the skin of the eyelids, accompanied by pain and itching. At the initial stage, it can proceed with painful sensations in the outer and inner corners of the eyes.
• angular conjunctivitis. Infectious inflammation of the mucous membrane of the eye. The cause of the development of the disease is the Morax-Axenfeld bacterium. This form of conjunctivitis is accompanied by lesions of the eyelid skin in the corners of the eyes. The skin begins to redden, become covered with small cracks and hurt. The unpleasant sensations are aggravated by blinking.
• ocular herpes. In the initial stages, herpetic eye infection is accompanied by discomfort in the outer corner of the eye. With the development of the disease, this sensation intensifies. With an increase in symptoms, swelling of the eyelids, photophobia and redness of the eyes appear.
• ingrown eyelashes. One of the reasons for the discomfort in the inner corner of the eye is improper growth of ciliary hair. Ingrown hairs cause itching, redness, and pain. The problem is that it is impossible to see an ingrown hair with the naked eye.Only a specialist can diagnose it during a comprehensive examination.
• allergic conjunctivitis. Along with pain and itching in the corners of the eyes, the disease is accompanied by lacrimation, allergic rhinitis, and nasal congestion. Therapy consists of taking antihistamines with local and complex effects.
• incorrect glasses. Pain in the corners of the eyes can occur due to the pressure on them of the nasal pads in the frame of the glasses. The solution to this problem lies on the surface: you need to contact a certified optician for the selection of glasses.
• computer visual syndrome. Painful sensations in the corners of the eyes can occur due to prolonged work at the computer, active use of a tablet or smartphone. The severity of symptoms directly depends on the time spent in front of the screen. In most cases, this problem does not require drug therapy. All unpleasant symptoms go away on their own after a night’s sleep.

Treatment

It is possible to eliminate pain in the corners of the eyes only after identifying the cause of the discomfort.Only an experienced specialist can help in this matter. He will conduct a diagnostic examination of the eyes and prescribe a competent treatment. To relieve discomfort, you can use moisturizing drops yourself or apply cold compresses to your eyes. However, it should be remembered that self-treatment is not always effective. Pain in the eyes, accompanied by a decrease in visual acuity, redness of the mucous membrane and other symptoms is a reason to immediately consult a doctor.

In the “Center for the restoration of vision” you can be examined using modern diagnostic equipment.Based on the results of the diagnosis, you will receive a consultation from an experienced doctor. Our ophthalmologists are specialists with over ten years of experience. They advise patients of all ages – adults and children. We work for you seven days a week from 8:00 to 20:00. Our experts in the field of ophthalmology will help to identify the cause of discomfort in the eye area or loss of visual acuity and will provide competent treatment of diagnosed diseases.