虹膜睫状体炎

主要分类为两类(1)感染性:由细菌、病毒、真菌、立克次体、寄生虫等病源体感染所致。(2)非感染性:又分为外源性和内源性

1、外源性:主要由于外伤、手术等物理性损伤、酸碱及药物等化学性损伤所致,血—眼屏障破坏和血管通透性增加所致。

2、内源性:是主要和最常见的病因。主要是由于免疫反应及对变性组织坏死,肿瘤组织的反应所致。

临床表现:疼痛、畏光、流泪、视力减退、睫状充血或混合充血,房水浑浊、角膜后沉着物(简称K.P)虹膜失去正常光泽,纹理不清,瞳孔缩小,对光反应迟钝。

并发症和后遗症:继发性青光眼、白内障、视神经乳头炎、黄斑水肿、视网膜脱离、眼球萎缩等.目前单纯用西医治疗用药面比较窄,基本上靠激素加辅助用药。魏主任通过几十年来在临床上的诊治,采用中西医结合治疗方案,不仅疗程缩短,还收到了比较理想的治疗效果,复发率和并发症患病的机率大大降低。

从中医角度上如何认识虹膜睫状体炎

       中医称本病为瞳神紧小症,按症状分析可分别属于云雾移睛、视瞻昏渺等症。 虹膜中医称为黄仁,属肝经,瞳神属肾,睫状体,脉络膜分别为肝、心所主,由于葡萄膜炎症波及所致的眼底视网膜水肿、渗出等,则属痰湿。

此病中医大致分四型

1、 肝经风热型:初期,症状出现眼珠坠痛、眉棱骨痛、视力下降、畏光流泪、睫状充血、角背出现灰白色点状沉着物,房水浑浊,虹膜纹理欠清,瞳孔缩小,舌淡、苔白或薄黄,脉浮数。 治则:疏风清热平肝法加减

2、 肝胃火盛型:以上证状加重治则:清肝胃火,通腹泻热法加减

3、 阴伤挟湿型:病情较缓,但迁延不愈或反复发作,角背沉着物呈点状或羊脂状,迟迟不退,房水混浊,虹膜纹理欠清,虹膜后粘连,玻璃体混浊,眼底不清,乳头充血,边界不清等,舌质红、苔白或浊腻,脉弦滑或脉细数。 治则:养阴清热化湿法加减。

4、 肝肾阴虚型:视力下降,眼前有飞蚊影,有时会出现闪光感或有蓝色幻视,眼微痛有轻度睫状充血等症状。 治则:补益肝肾法加减。以下是通过举例魏鸿友主任治疗患者图片举例说明中医治疗该病的过程

       

       以上病例资料均为在魏氏中医眼科经过治疗的典型临床病例。为了便于图文介绍只经过裁剪,未经过任何形式PS修改。门诊均有未裁剪原始备份存档可供查询。魏医生在继承祖辈百年临证经验基础上加上自己从医四十余年的总结出各个阶段对应的诊疗方案,(具体治疗方案需要辩证后方可施治)只有合理运用中西医结合治疗的方法,根据病情发展的阶段结合患者自身的体质制定不同的时方治疗本病才能达到缩短治疗时间,解决本病易复发的难题。

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