Eye disease associated with an infection

2021-02-02 12:00 AM

Many systemic infections caused by bacteria, parasites, and fungi can cause eye damage. Among them, the most common are tuberculosis, syphilis, toxoplasma, candida.

The eyes are closely related to the other organs of the body. Many systemic diseases with eye manifestations and many eye conditions may be signs of systemic illness.

For many patients, an eye exam not only allows the detection of eye lesions caused by systemic disease but also helps to confirm diagnosis, prognosis or evaluate the results of systemic treatment.

Many systemic infections caused by bacteria, parasites and fungi can cause eye damage. Among them, the most common are tuberculosis, syphilis, toxoplasma, candida.

Tuberculosis

Tuberculosis of the eye is usually caused by the direct development of tuberculosis in the body. TB lesions can be seen in different parts of the eye.

Eyelid: lesions in the form of TB nodules look similar to piecing.

Conjunctivitis: chronic conjunctivitis, ulcerative conjunctival, tuberculosis nodules, tuberculosis nodules

Cornea: purulent conjunctivitis, interstitial keratitis, ulcerative corneal, corneal infiltrates or oedema.

Uveitis: often chronic anterior uveitis. In tuberculosis, uveitis is granulomatous (keratoconjunctivitis with large, opaque white-coloured precipitation after the cornea, often with nodules on the iris (peri-pupil Koeppe nodules or Busacca nodules on the surface of the iris), or posterior uveitis in the form of small, scattered nodules, yellow, with an unknown margin.

Inflammation on the retina and Dót Busacca on the surface of iris

Retina: inflammation around the retinal veins (veins have a white coating, can block each segment), Eales disease (also called recurrent vitreous haemorrhage in young people)

Sockets of the eye: bulging eyes, lacrimation

Ocular nerve: paralysis of the optic nerve (especially the VI nerve), dilated pupils, pupil reflex disorder, neuritis.

Syphilis

The eye damage caused by syphilis is common in stages 2 and stage 3 and can be seen in most parts of the eye.

Conjunctivitis: chancre (painless ulcer) or syphilis gum, granulomatous conjunctivitis.

Cornea: interstitial keratitis (most common in congenital syphilis).

Scleritis: conjunctivitis or scleritis, often accompanied by conjunctivitis.

Uveitis: eyelid iritis (granulomatous form, often accompanied by interstitial keratitis).

Black retinitis, neuritis-retinitis.

Retina: Retinal vasculitis, retinal anaemia, retinal neovascularization, retinal detachment due to secretion, retinal central venous obstruction.

Ocular nerve: papillitis, papillary oedema, nerve atrophy, ophthalmic paralysis (the most common is the paralysis of the number III and VI nerves), Argyll-Robertson pupil (loss of pupil reflex with light but also reflect pupil with regulation and concentration). Vision damage due to interference at and after visual interference.

Neuritis retinal due to syphilis diagnosisbook

Sarcoid disease (sarcoidosis)

Sarcoidosis is a multisystem disease characterized by the presence of pea-free granulomas in many parts of the body: lungs (hilar lymphadenopathy, infiltrates, leading to pulmonary fibrosis and bronchiectasis)., skin (erythema nodosum, cutaneous granulomatosis, lupus), neurological (cranial nerve paralysis, intracranial or spinal cord infiltrates or tumours) Diagnosis of sarcoid is based on chest x-ray, biopsy (lung, conjunctiva, tear gland) and other tests.

Ocular manifestations of sarcoidosis can be found in most parts:

Eyelid: infiltrates in the skin or subcutaneous nodules.

Tear glands: tear gland inflammation or tear gland infiltrates cause dry eyes. Damage to the tear gland may be a manifestation of Mikulicz syndrome (enlarged salivary and salivary glands) or Hereford’s syndrome (enlargement of the tear glands and parotid glands, uveitis, facial paralysis, hepatosplenomegaly).

Conjunctivitis: nodules on the conjunctiva or Parinaud conjunctivitis.

Cornea: interstitial keratitis or bandage keratitis.

Sclerosis: inflammation of the sclera.

Uve: acute or chronic granulomatous iritis, intermediate uveitis.

Sarcoid uveitis diagnosisbook

Retina: inflammation around the veins, retinal and subretinal neovascular inflammation, macular oedema, retinal anaemia.

Neuropathy: Granuloma of the optic nerve.

Toxoplasma disease (toxoplasmosis)

Toxoplasmosis is a disease caused by a parasitic protozoon in cats. A human can be an intermediate host infected with Toxoplasma gondii from eating undercooked meat or food containing parasitic spores, cat faeces, or placenta. Toxoplasma can be either congenital or acquired.

Black astrophy of the retina caused by toxoplasma disease

Posterior uveitis is the most common lesion, manifested as a yellowish-white mass and an aqueous supernatant, sometimes accompanied by a typical scar (retinal dark atrophy with surrounding hyperpigmentation).

Other possible lesions: neuritis, focal vasculitis, occlusion of arteries or veins of the retina.

Candidiasis

Candida albicans fungal disease is common in drug addicts, immunocompromised people (AIDS, cancer), patients with urethral catheterization or long-term intravenous infusion. Lesions are common in the skin, mouth, digestive tract and genitals. Eye manifestations include:

Dark retinitis caused by candidiasis

Necrotizing granulomatous retinitis: contains many necrotic, white-yellow marginal lesions, possibly with retinal haemorrhage. Retinitis is often accompanied by vitreous inflammation, leading to retinal detachment due to contractile vitreous fluid.

Anterior uveitis has anterior chamber pus.

Endocarditis, inflammation of the entire eye.

Neuropathy.

In immunocompromised individuals, it is necessary to distinguish candida retinitis from mega cellular retinitis or toxoplasma retinitis.

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