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Scleral edema

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[Intro]

scleral edema is common in scleritis. sclera for a few cells and blood vessels are, most of the collagen composition of the organization. The surface of the conjunctiva and tenon covered, not in direct contact with the external environment, so it is rarely sick. according to most scholars statistics, the incidence rate in patients with eye disease only about 0.5% of the total. Since the basic components of scleral collagen nature of the decision of the pathological process is slow and difficult to repair due to collagen disorder. collagen eye is the "window", so scleritis (scleritis) is a systemic connective tissue diseases often ocular manifestations.

[Cause]

prolonged pregnancy is caused by what the?

(a) causes the cause of prolonged pregnancy is not clear, the current observation may lead to prolonged pregnancy reasons: 1. Despite the low levels of estrogen's mechanism is very complicated in labor , the blood level of estrogen is closely related with the labor, prolonged pregnancy may be associated with low blood levels of estrogen related. However, in a large number of prolonged pregnancy, there is no normal estrogen levels lower than normal pregnancy direct proof. (2) the lack of placental acid lipase acid lipase lack of placental (placental sulfatase deficiency) is a rare sex-linked recessive genetic disease, the disease was reported by the Ryan 1980, although the risk of fetal adrenal gland disease who had a sufficient amount of 16α -OH-DHEAS, but the lack of placental acid lipase, this activity can not be less dhea into estradiol and estriol, thus resulting in prolonged pregnancy. 3 cephalopelvic disproportion prolonged pregnancy in a large part of the fetus, the fetal head has not yet been Rupen, stimulation of the cervix to have been so delayed the start of labor. This is the more common reasons. 4 There are few women during pregnancy genetic longer, a few tires are overdue pregnancy occurs, there is a family fashion found, indicating that this tendency may be genetic. (B) any of the pathogenesis of a biological growth to the aging process from the normal, the placenta is no exception, from normal pregnancy to term pregnancy, the placenta also appear the aging performance of some, but not all of prolonged pregnancy These placental abnormalities will occur, however, increase the frequency of abnormal performance. Under normal circumstances, the placenta in the first five months of pregnancy, when fully developed, it can adequately supply oxygen and nutrients to prepare for fetal growth, development needs, while 36 weeks of pregnancy, the play has reached its peak of growth and function Since then, although a good part of the placenta remains functional status, but the most part, the growth rate slowed down, full-term pregnancy after the slower growth rate, after 42 weeks of pregnancy, except for a few placenta, the growth has stopped aging performance has become increasingly evident. 1 changes in placental maternal surface of placental infarction eye area and calcification more than the normal placenta, the placenta is less than the normal individual, particularly those in more mature fetal too obvious. The fetal placental surface sometimes stained phenomenon. 2 blood vessels were observed mainly to reduce the hair, so hair perfusion flow rate decreased, while an increase in secondary cell nodules fit and interstitial fibrosis; as placenta mild ischemia, there cytotrophoblast hyperplasia with mild or moderate and trophoblastic basement membrane thickening. In the electron microscope, have seen fit reported significantly reduced cell surface microvilli, fit pinocytotic vesicles within cells decreased vacuolation of endoplasmic reticulum, mitochondria, golgi complex and secretory granules decreased trophoblastic basement membrane thickening. Stop the growth of the placenta, which means the supply of oxygen and nutrients are not increased and a decreasing trend, the placenta is in a state of chronic dysfunction, accounting for 5% of all pregnancies to 12%, 20% to 40% of perinatal child mortality than changes seen in placental examination. The greatest impact on the fetus is chronic hypoxia, in the post-neonatal death in 60% to 70% is caused by chronic hypoxia (Minning, etc., 1982). Interestingly, recent Smith and Barkel (1999) found that 41 to 42 weeks of pregnancy placental apoptosis (programmed cell death) compared with 36 to 39 weeks of pregnancy, the placenta was significantly increased, which may be prolonged pregnancy study provides a new direction . 3 fetus performance thin, small changes in the fetus with the placenta and the fetus is generally different from the performance of thin and small. Cliford (1957) had these mature dysfunction syndrome (dysmaturity syndrome) in neonates divided into three: the first grade Ⅰ: the lack of subcutaneous fat, slender limbs, the skin dry and wrinkled, like, such as parchment, grease and tires lanugo small, long nails, the performance of neonatal malnutrition, but no meconium contamination, hard skull, but the face is still alert response. First grade Ⅱ: neonatal manifestations, such as the first grade Ⅰ, but accompanied with meconium in amniotic fluid, meconium can be contaminated with skin, placenta, fetal membranes and umbilical cord of the surface, but no yellow dye performance. Section Ⅲ grade: grade Ⅰ neonatal performance as the first, except there is meconium contamination, the newborn nails, yellowish discoloration of skin, placenta, fetal membranes and umbilical cord are stained yellow-green surface. 4 pathophysiology of prolonged pregnancy associated with placental lesions of the major pathophysiological changes in the fetus is a gradual increase of chronic hypoxia and nutritional disorders in the process. The pathophysiological changes can be summarized as follows: ① the placenta during pregnancy is generally 41 Zhou Housheng long stop; ② placental degenerative changes can occur; ③ fetal growth stopped; ④ reduced supply of oxygen and nutrients; ⑤ fetal - placental unit functions tend to increase in pathological ; ⑥ meconium contamination rate increase; ⑦ amniotic fluid volume reduction; ⑧ fetal distress and perinatal child mortality. Although the pregnancy has not expired but the attenuation of placental function were the biggest danger is that the fetus is too large, fetal weight ≥ 4000g or ≥ 4500g birth 40 weeks of pregnancy and those who compared the incidence significantly increased. The problem of prolonged pregnancy fetal malformations also received attention, because of prolonged pregnancy is also higher than in normal pregnancy, fetal abnormalities, according to Ahn and phelan (1989) report abnormal rate of 2.5%, with neurological abnormalities more common. prolonged pregnancy the fetus is too often as children mature, over mature children is independent of the concept of prolonged pregnancy, the fetus in the intrauterine growth is more than the normal state of a group of pathological conditions. clifford (1954) had cooked the children divided into three degrees, was: amniotic fluid clear; second: skin dyed green; three: yellow-green skin. 41 to 43 weeks of pregnancy, over-mature children was 10%, up to 44 weeks and up to 33%. Children had cooked lean, zhang eye was "alert status", so like the old man face, more wrinkled skin, especially the more obvious parts of the palm foot, and often flaky peeling, nails longer. It is important that children are more prone to over-mature asphyxia, meconium aspiration and brain injury, perinatal child mortality significantly increased. One reason for oligohydramnios during pregnancy the fetus to expire decrease renal blood flow (Veille et al, 1993). amniotic fluid and fetal swallowing of amniotic fluid to reduce the amount of reduction so decreased urine output, and decreased urine output is the cause of oligohydramnios. Frimmer et al (1990) Application of ultrasound diagnosis in 38 patients with 42 weeks of gestation of maternal hourly continuous determination of fetal bladder volume, decreased urine output was found to cause oligohydramnios. As part of the amniotic fluid secreted from the placenta, it does not rule out the possibility of reduced placental origin. amniotic fluid, umbilical cord came off easily under pressure, leading to fetal distress. LJeveno (1984) reported 727 cases of prolonged pregnancy fat production fetal distress, abnormal fetal heart rate changes were three kinds: ① continuous deceleration, 3 / 4 of an emergency cesarean section; ② variable deceleration: ③ baseline jumps, fluctuations over 20 times / min, and merge oligohydramnios. The authors believe that these changes not due to placental dysfunction, but oligohydramnios umbilical cord compression results. 5 the impact of fetal infants (1) fetal growth restriction: fetal growth restriction defined as birth weight less than that of the average gestational age birth weight, fetal sex with the two standard deviations (2SD). stillbirth in prolonged pregnancy 1 / 3 is due to fetal growth restriction. Divon et al (1998) and Clausson et al (1999), analysis of 1987 to 1995 nearly 70 million births in the ≥ 42 weeks of fetal growth restriction in prolonged pregnancy is an important cause of stillbirth. Unexpired term in the fetal growth restriction in pregnancy is also the main reason for stillbirth. Alexander et al (2000) analysis of 355 cases of ≥ 42 weeks and weighing ≤ third percentile prolonged pregnancy baby weight with 14,520 cases in the third percentile of the babies, the results found that both growth-restricted infants increase in mortality or disease rates. (2) placental dysfunction: the body's organs and general body of its survival is the same life, and the function of the placenta to maintain fetal growth and development, so the presence of the placenta the same period and pregnancy, fetal growth and development theory mature, placental function has been completed. Clinical detection of pregnancy 42 weeks or more the incidence of fetal hypoxia increased, therefore, can deduce certain aspects of placental function in some degree of loss. Back in the 1950s, clifford (1954) proposed a theory of aging placenta, prolonged pregnancy, but in the next 40 years, in the placenta could not be found based on morphology, Larsen, etc. (1995), Smith and Barker (1999) found that 41 42 weeks and 36 to 39 weeks of pregnancy the placenta compared to the former significantly increased apoptosis. apoptosis is a normal cell death program, is a physiological process. placenta is the organ with a limited life, the fact that accelerated apoptosis of placental cells, organs can be considered progressive signs of aging. The main function of the placenta of the mother and child is one of the oxygen exchange, if they can prove that umbilical venous oxygen saturation decreased, it indirectly proves that placental oxygen exchange function, in view of partial pressure of oxygen is the only erythropoietin-stimulating factor, determined erythropoietin factor can indirectly presumed oxygen saturation, but also indirect determination of placental function. Jazayeri (1998) measured 124 cases 37 to 43 weeks of pregnancy normal delivery cord blood red blood cell growth factor, found that 41 weeks of pregnancy cord blood erythropoietin factor increased. After 42 weeks of pregnancy increases fetal weight still increased at least up to 42 weeks of pregnancy (Nahum et al, 1995). Placental transfer of fetal weight gain necessary nutrients, gas exchange and nutrient delivery but not the same mechanism, different nutrient transport mechanisms are also different, so in fetal weight was still 41 to 42 weeks and 41 weeks after the increase in impaired oxygen delivery things are not contradictory.

[Sign]

expired early pregnancy symptoms?

reached or more than 42 weeks gestation (294 days) without producing trillion.

as in the past menstrual history is normal, but this last menstrual period and is very clear, but there is evidence of early diagnosis of a variety of inspection, the diagnosis of prolonged pregnancy is not difficult. However, in the following cases the diagnosis of prolonged pregnancy should caution, such as: irregular menstrual cycle or menstrual cycle length, when the pregnancy during lactation, use of oral contraceptives in pregnancy, accidental delay ovulation, so for some time there last menstrual doubtful or simply confuse the pregnant women, it must by means of other methods.

1. the epidemiological situation of prolonged pregnancy understanding

(1) previous pregnancy history: there have been scholars have found previous pregnancy is overdue pregnancy, this possibility of the occurrence of prolonged pregnancy is 50%.

(2) neonatal sex: male fetal pregnancy expired more than female fetuses, each at 8.5% and 4.0% (Votherr, 1975).

(3) parity: primipara The higher incidence of prolonged pregnancy by mothers.

(4) fetal abnormalities: fetal malformations, especially in children without brain, expired pregnancy (about 9%) than in normal fetuses.

2. Many women have basal body temperature or other causes of infertility measure basal body temperature, as in the past period is not normal, basal body temperature is a very effective help. Many women's cycle of 40 days, the general average luteal phase is 14 days, although the date of the last menstrual period can be calculated by the expected date, but with a more reliable determination of basal body temperature, basal body temperature rise when no longer fall, with the blood or urine hcg determination, can be combined to calculate a conception date, you can get more accurate due date.

3. first first fetal movement fetal movement (quickening) is very important for pregnant women, pregnant women tend to perceive and recall, but by the early maternal and fetal maternal perception of time with different initial , Placental site also affect pregnant women on the initial perception of fetal movement. First fetal movement generally 18 to 20 weeks of pregnancy may be perceived, can also be much earlier, by the early primipara mothers. Gillieson et al (1984) found that the placenta is located in the anterior wall of the uterus in early pregnant women and the maternal fetal movement felt the time the first 19 weeks of pregnancy, and 17.5 weeks, but the placenta in the uterus wall, the early maternal and fetal movement by the time the mother was the first time for the 18 weeks and 16.1 weeks. Therefore, under normal circumstances, according to the initial increase of maternal fetal movement in the early 22 weeks plus 24 weeks after maternal can be regarded as due date.

4. the first time to hear the fetal heart in underdeveloped areas, people are still relatively primitive wooden handset applications, such as prenatal care more careful application of wood when the handset is in the pregnancy You can hear the fetal heart at 20 weeks.

5. fundal height measurements had antenatal visits, such as pregnancy reached 20 weeks, the end of the uterus is palpable and can be used on the edge of the pubic symphysis fundal height measurements and multiplied by 8 / 7, as gestational age, which is also called the McDonald rule.

Therefore, prenatal care should be based on the above examination to determine their expected date of birth to confirm whether prolonged pregnancy.

[Aftertreat]

ate prolonged pregnancy?

prolonged pregnancy diet (The following information is for reference only, details need to consult a doctor)

porridge diet to prevent pregnancy expired 2 the

spinach porridge

materials: spinach, brown rice, a little salt, some water.

production: the amount of water into the pot, brown rice, boil porridge will become, the addition of spinach, salt, and then continue to boil into a porridge.

effect: heat, cooling, diuretic. Pregnant mothers eat during labor, can easily produce skidding.

Winter Lay Amaranthus porridge

ingredients: Winter amaranth, brown rice, a little salt, some water.

production: the amount of water into the pot, brown rice, boil porridge will become, adding winter spinach, salt, then stir and boil Serve.

effect: heat, sliding awakened, cis-births.

Note: Pregnant mothers should be noted that these two should not eat porridge during pregnancy to prevent miscarriage.

patients with prolonged pregnancy what to eat for good health?

1. to eat more fresh fruits and vegetables, including dark green leafy vegetables and citrus.

2. should eat more whole grains;

3. should eat more calcium-containing foods;

4. should eat more foods containing zinc and tin;

patients with prolonged pregnancy what to eat is unhealthy?

1, pregnant women do not drink coffee.

2, avoid alcohol and tobacco.

[Prevent]

scleral edema should be how to prevent?

1. diet to restore: This method is very important for the prevention of this disease, usually to avoid too spicy Feigan Zi tired of the goods, excessive heat toxin worse, Taboo food more fishy hair thing, or help to heat of fire of the disadvantages. Eau should eat more fruits and the like, to clear Leeming head. Eat moist of the goods, the stool will help guide the fire down evil. In addition, smoking cessation should avoid alcohol, Xin heat to help prevent fire.

2. spirit to restore: the liver opens into the eyes, anger is liver injury. It is advised to avoid furious liver injury, so as not to cause anger Shangni induce the disease.

3. ferrite hyperactivity dampness of those, such as and cough, wheezing, phlegm dampness, red tongue, bitter yellow or yellow greasy, floating pulse. hyperactivity and timely solution to be clear, to prevent falling invasion and white eye. Choice of morus alba 15 grams, forsythia 15 grams, digupi 15 grams, 10 grams of wind, almond 10 grams, 10 grams of skullcap, arctium 10 grams, 10 grams tinglizi double flowers 21 grams decoction.

4. wang of ferrite, with insomnia, night sweats, hot flashes, gu Zheng, five heart heat trouble, red tongue, little coating, rapid pulse of patients. yin and purging fire of the choice of agent, medicinal rehmanniae 15 grams, anemarrhena 10 grams, treats 10 grams, ligustrum lucidum 15 grams, chrysanthemum 15 grams, digupi 15 grams, silver bupleurum 15 grams, 10 grams of licorice , decoction, day one.

5. for people with rheumatoid arthritis, tuberculosis, leprosy, syphilis and other parts of infected lesions, need early treatment to prevent spread to the sclera from the disease.

[Treat]

osteoarthritis treatment considerations?

prevention

there is no effective cure, can only add more calcium.

to pay attention to the prevention of osteoarthritis following areas:

avoid long-term strenuous exercise

long-term, excessive, strenuous exercise or activity is induced by bone proliferation of the basic reasons. Especially for discreet joints (such as knee, hip), excessive exercise to the articular surface force increased wear and tear. Long-term strenuous exercise can also make excessive bone and soft tissue force and traction, resulting in local soft tissue damage and uneven force on the iliac bone, leading to osteoarthritis.

appropriate physical exercise

avoid long-term strenuous exercise, is not inactive, on the contrary, the proper exercise hyperostosis is a good way to prevent one. Because the nutrition of articular cartilage from the synovial fluid, and synovial fluid only by the "squeeze" into the cartilage can promote cartilage metabolism. Appropriate exercise, especially in joint movement, increase intra-articular pressure is conducive to joint liquid penetration to the cartilage, reduce cartilage degeneration, thereby reducing or preventing osteoarthritis, especially the proliferation of articular cartilage and degenerative changes, so methods of recovery of bone proliferation is movement, meaning to eliminate or reduce proliferation of parts of the pain and the resultant dysfunction, and maximize the ability to work to restore their lives, improve and enhance the quality of life of patients.

timely treatment of joint injuries

joint injuries including soft tissue damage and bone damage. joint osteoarthritis with intra-articular fractures often have a direct relationship because of incomplete fractures, resulting in the articular cartilage surface is not flat, resulting in traumatic arthritis for patients with intra-articular fractures, if left untreated, anatomic reduction done, completely avoid traumatic arthritis and joint occurrence of osteoarthritis.

reduce weight

overweight is induced proliferation of bone joints of the spine and one important reason. excessive weight will accelerate the wear of articular cartilage, the articular cartilage surface of the pressure differential, caused by osteoarthritis. So for overweight people, weight loss can prevent the proper spine and joint osteoarthritis.

osteoarthritis Chinese medicine treatment methods

treatment of cervical osteoarthritis external use

(1) pain tincture

[components] snow an artemisia ginger, Dragon's blood frankincense, myrrh, borneol, etc.

effect: warm and cold, expelling wind and blood , Tongluozhitong suitable for lumbar, cervical osteoarthritis, osteoarthritis, frozen shoulder, rheumatoid arthritis.

has analgesic, anti-inflammatory, improve microcirculation three major effects.

the core mechanism of pain Tincture: positioning the adsorption induction therapy. because the product has a good anti-inflammatory effect, combined treatment of physiological responses, and finally product mechanism is divided into three steps, called pain tincture "bone-step therapy" mechanism: Step 1: Positioning pain.

Indications: qi stagnation type cervical spondylosis.

Indications: meridian Blockage-type cervical spondylosis. qi and blood, plus 15 grams of astragalus, fleece-flower root 30 grams. There is insufficient yin, yang points, clip real person with blood knot, hot and humid in others, the disease is more complex. However, these treatments are not proven satisfactory, only a temporary rather than permanent cure, the disease recur. Elected to use conservative treatment fails and serious condition, seriously affecting the lives of patients, surgery may be considered. Necessary to be done audiometry and binaural mastoid photos and other tests. pus of patients with tympanic membrane perforation nor by a medical examination to see whether the implementation of myringoplasty. burning is the edge of the tympanic membrane coated with a special kind of medicine to stimulate the growth of the tympanic membrane. This method is not cut, simple, out to do. Every 5 to 10 minutes, almost no pain. 7 to 10 days, subject to referral and re-burning time, until the tympanic membrane healed up.

(b) the prognosis

good prognosis. Duration of the acute, through the slow, gradual increase can be self-limiting, but easy to relapse. In the two months after menopause, they should go to hospital after regular prenatal care, especially in the 37 weeks of gestation after antenatal at least once a week.

2, if the expected date of birth sign is not more than a week, should take active steps to check the doctor according to fetal size, how much amniotic fluid, measured placental function, fetal maturity, or through " B-"to diagnose the pregnancy is out of date. If the diagnosis of prolonged pregnancy, induction of labor by a doctor in a timely manner.

[Examine]

scleral edema should be how?

inflammation infringement under the surface of the sclera, or scleral tissue site, symptoms and prognosis, generally accepted to be divided into such types of scleritis is more reasonable of.

(a) episcleritis

episcleritis (episcleritis) the scleral surface (or shallow) organization inflammation, and more at the limbus to the equator between the rectus muscle attached to the front line. There are periodic episodes of history, prognosis does not leave traces. Adult prevalence of both men and women, but women are more common, most patients as unilateral disease.

often unknown reasons, more common in foreign immunogenicity of antigen-antibody-induced allergenic responses, other systemic diseases such as metabolic diseases - gout. The disease mostly occurs in women, menstrual period, also with endocrine disorders. prone to allergic reactions scleral surface of the front, which is organized mainly by the surface of the sclera collagen fibers and elastic fibers composed of a rich network of blood vessels and lymphatic vessels, suitable for a variety of immune components on the accumulation of calm.

episcleritis clinically divided into two types:

1. Simple episcleritis (simple episcleritis) : also known as a transient recurrent episcleritis (episcleritis periodica fugax).

clinical symptoms of the lesion on the surface of the sclera and conjunctiva, sudden diffuse congestion and edema, color red, congestion or limited fan-shaped, the majority of lesions confined to a quadrant, a wide range are rare. Tortuous blood vessels on the scleral surface of the expansion, but still remain radial, non-vascular congestion of the deep purple tone, nor the limitations of nodules.

periodic recurrence of the disease, sudden onset, onset time is short, a few days Jiyu features. Accounted for half of patients have mild pain, but often burning, tingling discomfort. Occasionally due to the iris sphincter and ciliary muscle spasm caused the temporary miosis and myopia. Attack may be eyelid edema and neurovascular reactivity. In severe cases, may be associated with migraine headaches, vision is generally not affected.

2. nodular episcleritis (nodular episcleritis) nodular episcleritis to limit the Board characterized as a nodular episcleritis. Often acute disease, there is redness, pain, photophobia, tearing, tenderness and other symptoms. At the surface of the sclera at the limbus edema and infiltration on the soon to form a light red to fire red limitations nodules. nodules from small and large diameter ranging from a few millimeters. nodules at the top of the bulbar conjunctiva free promotion, and tenderness.

pink color conjunctival vascular plexus lesion site congestion, red is the fire department on the scleral surface of vascular plexus congestion. With anterior segment fluorescein angiography can be distinguished.

nodules were round or oval-shaped, mostly solitary, sometimes up to pea size. nodules located on the scleral tissue, the nodules in the sclera can be driven, that has nothing to do with the deep sclera. vascular plexus in the lower part of the scleral nodules remain normal.

duration of about 2 weeks or so self-limiting, nodules from the fire red to pink, round or oval shape but also by the deformation of the flat, the last can be completely absorbed, leaving the surface with schungite tone marks. The more inflammation can be here in his office after the secondary, a nodule subsided after a nodule appeared, Peter recurrence can stretch for more than a few months. As many times in different parts of the attack, which may eventually form a ring around the cornea sclera around the ring pigment. eye pain at night is even, there are not significant pain. vision generally unaffected. episcleritis with mild keratitis is the only complications. If photophobia, tearing indicates the mild keratitis, and to near the limbus at the Department of nodules more common.

(b) scleritis

scleritis (scleritis) or known deep scleritis. episcleritis more rare, but the incidence of acute and often accompanied by the cornea and uveitis, it is more severe than episcleritis, the prognosis is poor. General episcleritis rarely violated scleral tissue, scleritis violates the sclera itself. scleritis occurs in blood vessels than the front of the sclera through the sclera, while the rear of the equator with scleritis, and because they can not directly see small blood vessels, the incidence is also less likely to be ignored. scleritis can be divided into parts according to anterior scleritis and posterior scleritis. scleritis anterior scleritis is common. More often in young people or adults, more women than men, the incidence of both eyes can be successively or simultaneously.

scleritis for the endogenous antigen primary antibody caused by immune complexes, and more associated with systemic collagen disease, it is collagen disease areas, and autoimmunity. Benson (1988) attributed to the immunogenicity: a direct violation of inflammation itself or scleral collagen matrix (amino glucan). primary necrotizing anterior scleritis patient tolerance of the sclera-specific antigen may have a change, and the sclera soluble antigen delayed-type hypersensitivity. Found in rheumatoid arthritis immune complexes is support for this theory. But difficult to be found but the reasons most of scleritis.

1. anterior scleritis

⑴ diffuse anterior scleritis (diffuse anterior scleritis): This disease is scleritis The most benign and rarely associated with severe systemic disease.

clinical symptoms of sudden diffuse congestion and tissue swelling on the sclera, the sclera can not identify the case, for severe cases can be a high degree of conjunctival edema, and thus need to drop 1:1000 adrenaline in the conjunctival sac in order to confirm whether the deep vascular congestion and nodules. Diffuse more easily than the nodular proliferation. lesions can be limited to one quadrant or occupy the whole front of the eye, and more inflammation associated with scleral surface.

⑵ nodular anterior scleritis (nodular anterior scleritis): clinical symptoms of eye pain is quite intense and consciously, and radiation to the eyes around. Accounted for half of the patients eye tenderness. Inflammatory nodules were dark red can not activities, but above the scleral tissue with a clear delineation of the above. The surface of the blood vessels of the nodules from the top. nodules may be single or multiple. nodules can be invasive and spread around the cornea phase, the formation of ring scleritis. At this time all eyes are dark purple, gray nodules between the absorption thin scar left by cyanosis. Shorter course of several weeks or months, the elderly up to several years. infiltration gradually absorbed without rupture, scleral thinning dark purple or magnetic white. Since losing to the formation of high-pressure part of the eye, or staphyloma Scleral ectasia were. Episcleral vascular plexus congestion was deep purple, blood vessels can not be moved. Scleral surface and deep vascular network, distortion aberration, in the deep vascular anastomosis between the larger, and thus shows the expansion of blood vessels was beaded with filling. In case of photophobia, tearing symptoms, should consider merging keratitis and uveitis, the results of a very serious damage to eyesight.

necrotizing anterior scleritis (necrotizing anterior scleritis): The disease is also known as inflammatory necrotizing scleritis, although this type of clinical relatively rare, but the most damage This is also a harbinger of serious systemic collagen disease. Prolonged course slow. About half of patients with complications and decreased vision.

early manifestation of clinical symptoms of disease is limited to Board of inflammatory infiltration, congestion dramatically lesions, vascular tortuosity and obstruction. Performance limitations of typical sheet avascular zone. avascular zone in the vicinity of the sclera below or edema, scleral forward displacement of shallow blood vessels (red light with no easy to find the signs). The development of disease may be limited to a small area, but also developing into big area of ​​necrosis, or from the original lesion development around both sides of the eye, and finally loss of the eye and the whole front. disease where the prognosis for continued thinning of the sclera, uveal pigment can see through the blue-purple, unless the intraocular pressure continued up to 4.0kpa (30mmHg), generally do not form a staphyloma. If the necrotic area is small, new collagen fibers can be repaired. As it will damage the top of the conjunctiva have depressed scar. About half of eye tenderness.

Ye Linan et al (1980) report 2 cases of nodular necrotizing scleritis, scleral necrosis of both the yellow nodules, there is significant inflammation and pain, the lesion sclera meager were blue-violet. biopsy was diagnostic. Two cases in the general treatment ineffective, were carried out excision and lamellar keratoplasty. Results of one case improved recurrence. Li, Zhan (1980) reported that immunosuppressive therapy nodular necrotizing scleritis in 1 case. In this case eye disease, ulcerative stage for the right eye, left eye as nodules period. Limitations of the right eye and left eye depressed ulcer lesions of yellow nodules were elevated from the limbus 4mm, purple lesions around the scleral hyperemia, local refused to press. The immunosuppressive treatment of patients with remission.

⑷ penetrating the sclera softening (scleromalacia perforans): also known as non-inflammatory necrotizing scleritis is a rare special type of scleritis, the condition hidden, almost no symptoms, about half of patients with rheumatoid arthritis or ankylosing polyarthritis related. eye may precede the arthritis disease. Patients are women aged over 50. A bilateral lesion, but its performance in varying degrees. slow progression, but there are performance dramatically, leading to blindness in a few weeks.

the disease rarely associated with inflammation or pain response. Characterized by lesions in the limbus and the equator between the sclera, yellow or gray spots. In the most severe cases, the sclera become increasingly localized into a carrion-like and necrotic changes, necrotic tissue, once off the sclera can completely disappear. In the remaining scleral tissue was significantly reduced in the blood vessels, from the appearance of white enamel-like. About half of patients have one or more of the necrotic lesions. As a result of necrosis of the sclera defect, can be derived from the conjunctiva, the thin layer of connective tissue may be covered, unless the increased intraocular pressure, usually not seen staphyloma. None of the ocular tenderness. A cornea is not affected.

defect no repair tissue regeneration, ultimately leading to perforation, uveal prolapse.

Gongchun Hui (1985) reported 1 case of perforation of the sclera osteomalacia. Patients have a history of 5 to 6 years of arthritis, the left middle finger proximal soft tissue spindle knuckle swelling, local tenderness without swelling. No x-ray bone thinning and joint space narrowing and so on. Left eye redness secondary to corneal opacity, ulceration inside was purple blue sclera, no significant irritation. After 6 months, including the rectus muscle just above the end of 5mm away from the cornea at the scleral a 4 × 5mm round ulcer, visible through the conjunctiva and sclera blue purple choroidal tissue. cornea from 12 to 5:00 at the edge of the ulceration, fundus normal. By corticosteroids and repair lamellar corneal transplant, the disease under control.

2. posterior scleritis

posterior scleritis (Posterior scleritis) refers to occurred in the rear of the equator and the sclera around the optic nerve of inflammation. The back of the eye of sufficient severity to cause tissue damage, due to the diversity of disease manifestations and is rarely taken into account in the diagnosis of it, this disease is not associated anterior scleritis, no obvious signs of external eye, so this eye disease is most likely missed one of the diseases can be cured. But the check was pick out a lot of attention, we found that patients had primary posterior scleritis or scleritis back before the expansion of the eye are not uncommon, that posterior scleritis in clinical covert. The disease is more common in men, women, and common in middle-aged.

⑴ clinical symptoms: posterior scleritis are the most common symptoms of varying degrees of pain, vision loss, red eyes, but there are some people no obvious symptoms, or only those symptoms one. Severe cases have eyelid edema, conjunctival edema, proptosis or diplopia, or both. Difficult to distinguish symptoms of orbital cellulitis. The point is to identify the degree of edema of the disease is significantly higher than cellulitis, and cellulitis of the exophthalmos, then again later scleritis is significant. pain severity varies from very light, and some extreme pain, often associated with anterior scleritis is proportional to the severity of involvement. Patients may complain of pain or pain related to the eye itself, eyebrow, temporal or zygomatic temporal.

vision loss are common symptoms, the reason is associated with optic retinopathy. Some take charge of the complaint as to reduce myopia or hyperopia caused by increased eye fatigue, which is diffuse thickening of the posterior axial shortening lead to the replacement lenses can alleviate the symptoms.

clinical and pathological aspects can be seen, after the patients had anterior scleritis scleral involvement, the performance of fornix superficial scleral blood vessels to dilate, patchy anterior scleritis, nodular anterior scleritis. No eye can also be congestion. But a history of pain and eye congestion, or may have been partially used corticosteroid therapy.

proptosis, ptosis, and eyelid edema, seen in severe inflammation around the sclera, the inflammation often spread to the extraocular muscles or orbital. extraocular muscle inflammation due to eye movements may have pain or diplopia. These symptoms combined are called scleral inflammation around the sclera front of the ball fasciitis and acute inflammatory pseudotumor.

In addition there is a more superficial lesions, showed a clear eye fasciitis, and no significant inflammation of the sclera, james jelly of the eye called the fascia inflammation of. conjunctival edema was half orange jelly, such as fish-like, touch the slightly harder, mild depression, oppression, disease can be extended to the limbus, and the eye is still normal. However, some severe cases, lesions can invade and become jelly sclera scleritis.

⑵ retinopathy:

① circumscribed fundus mass: area can cause swelling of the limitations of the sclera choroid uplift. Usually enclosed by a concentric stripes of choroidal or retinal folds. Such inflammatory nodules often accompanied by pain around the orbit, but can also be ill without obvious symptoms found in a routine examination.

choroidal folds, retinal and optic disc edema stripes: This is the main retinal scleritis performance. Patients often accompanied by mild eye pain or fornix surface of vascular congestion. inflammation of the sclera near the optic disc, optic disc edema can cause even.

③ annular choroidal detachment: Some cases of scleritis lesions adjacent spherical slightly visible choroidal detachment, but the circular ciliary body choroidal detachment is more common.

④ exudative macular detachment: young women can be caused by posterior scleritis posterior pole blood - retinal detachment, which is limited from the posterior pole. fundus fluorescein angiography shows multiple pinpoint areas of leakage. ultrasound scan showed thickening layers of the posterior pole of the eye and tenon edema.

above, Benson (1982) pointed out that, for reasons unknown angle-closure glaucoma, choroidal folds, optic disc edema, circumscribed fundus mass, choroidal detachment, and

[Diff]

scleral edema What are the symptoms easily confused?

scleral edema and symptoms of the following symptoms require mutual authentication.

bureau of scleral ectasia limit tumor: posterior staphyloma: When the ball back degeneration myopia significant growth, followed by pole limit of Office can produce bulging to form scleral staphyloma, the edge shape for the slopes, but also showed a steep shape.

scleral staphyloma: staphyloma is the sclera with uveal together like a purple grape bulging outward. The reason is due to the sclera of birth defects or pathological damage to weakened immunity, in the normal intraocular pressure or high intraocular pressure, the sclera and uveal bulging outward. The range is divided into parts according to bulging staphyloma scleral staphyloma and all.

inflammation infringement under the surface of the sclera, or scleral tissue site, symptoms and prognosis, generally accepted to be divided into such types of scleritis is more reasonable.

(a) episcleritis

episcleritis (episcleritis) the scleral surface (or shallow) organization inflammation, and more at the limbus to the equator between the rectus muscle attached to the front line. There are periodic episodes of history, prognosis does not leave traces. Adult prevalence of both men and women, but women are more common, most patients as unilateral disease.

often unknown reasons, more common in foreign immunogenicity of antigen-antibody-induced allergenic responses, other systemic diseases such as metabolic diseases - gout. The disease mostly occurs in women, menstrual period, also with endocrine disorders. prone to allergic reactions scleral surface of the front, which is organized mainly by the surface of the sclera collagen fibers and elastic fibers composed of a rich network of blood vessels and lymphatic vessels, suitable for a variety of immune components on the accumulation of calm.

episcleritis clinically divided into two types:

1. Simple episcleritis (simple episcleritis) : also known as a transient recurrent episcleritis (episcleritis periodica fugax).

clinical symptoms of the lesion on the surface of the sclera and conjunctiva, sudden diffuse congestion and edema, color red, congestion or limited fan-shaped, the majority of lesions confined to a quadrant, a wide range are rare. Tortuous blood vessels on the scleral surface of the expansion, but still remain radial, non-vascular congestion of the deep purple tone, nor the limitations of nodules.

periodic recurrence of the disease, sudden onset, onset time is short, a few days Jiyu features. Accounted for half of patients have mild pain, but often burning, tingling discomfort. Occasionally due to the iris sphincter and ciliary muscle spasm caused the temporary miosis and myopia. Attack may be eyelid edema and neurovascular reactivity. In severe cases, may be associated with migraine headaches, vision is generally not affected.

2. nodular episcleritis (nodular episcleritis) nodular episcleritis to limit the Board characterized as a nodular episcleritis. Often acute disease, there is redness, pain, photophobia, tearing, tenderness and other symptoms. At the surface of the sclera at the limbus edema and infiltration on the soon to form a light red to fire red limitations nodules. nodules from small and large diameter ranging from a few millimeters. nodules at the top of the bulbar conjunctiva free promotion, and tenderness.

pink color conjunctival vascular plexus lesion site congestion, red is the fire department on the scleral surface of vascular plexus congestion. With anterior segment fluorescein angiography can be distinguished.

nodules were round or oval-shaped, mostly solitary, sometimes up to pea size. nodules located on the scleral tissue, the nodules in the sclera can be driven, that has nothing to do with the deep sclera. vascular plexus in the lower part of the scleral nodules remain normal.

duration of about 2 weeks or so self-limiting, nodules from the fire red to pink, round or oval shape but also by the deformation of the flat, the last can be completely absorbed, leaving the surface with schungite tone marks. The more inflammation can be here in his office after the secondary, a nodule subsided after a nodule appeared, Peter recurrence can stretch for more than a few months. As many times in different parts of the attack, which may eventually form a ring around the cornea sclera around the ring pigment. eye pain at night is even, there are not significant pain. vision generally unaffected. episcleritis with mild keratitis is the only complications. If photophobia, tearing indicates the mild keratitis, and to near the limbus at the Department of nodules more common.

(b) scleritis

scleritis (scleritis) or known deep scleritis. episcleritis more rare, but the incidence of acute and often accompanied by the cornea and uveitis, it is more severe than episcleritis, the prognosis is poor. General episcleritis rarely violated scleral tissue, scleritis violates the sclera itself. scleritis occurs in blood vessels than the front of the sclera through the sclera, while the rear of the equator with scleritis, and because they can not directly see small blood vessels, the incidence is also less likely to be ignored. scleritis can be divided into parts according to anterior scleritis and posterior scleritis. scleritis anterior scleritis is common. More often in young people or adults, more women than men, the incidence of both eyes can be successively or simultaneously.

scleritis for the endogenous antigen primary antibody caused by immune complexes, and more associated with systemic collagen disease, it is collagen disease areas, and autoimmunity. Benson (1988) attributed to the immunogenicity: a direct violation of inflammation itself or scleral collagen matrix (amino glucan). primary necrotizing anterior scleritis patient tolerance of the sclera-specific antigen may have a change, and the sclera soluble antigen delayed-type hypersensitivity. Found in rheumatoid arthritis immune complexes is support for this theory. But difficult to be found but the reasons most of scleritis.

1. anterior scleritis

⑴ diffuse anterior scleritis (diffuse anterior scleritis): This disease is scleritis The most benign and rarely associated with severe systemic disease.

clinical symptoms of sudden diffuse congestion and tissue swelling on the sclera, the sclera can not identify the case, for severe cases can be a high degree of conjunctival edema, and thus need to drop 1:1000 adrenaline in the conjunctival sac in order to confirm whether the deep vascular congestion and nodules. Diffuse more easily than the nodular proliferation. lesions can be limited to one quadrant or occupy the whole front of the eye, and more inflammation associated with scleral surface.

⑵ nodular anterior scleritis (nodular anterior scleritis): clinical symptoms of eye pain is quite intense and consciously, and radiation to the eyes around. Accounted for half of the patients eye tenderness. Inflammatory nodules were dark red can not activities, but above the scleral tissue with a clear delineation of the above. The surface of the blood vessels of the nodules from the top. nodules may be single or multiple. nodules can be invasive and spread around the cornea phase, the formation of ring scleritis. At this time all eyes are dark purple, gray nodules between the absorption thin scar left by cyanosis. Shorter course of several weeks or months, the elderly up to several years. infiltration gradually absorbed without rupture, scleral thinning dark purple or magnetic white. Since losing to the formation of high-pressure part of the eye, or staphyloma Scleral ectasia were. Episcleral vascular plexus congestion was deep purple, blood vessels can not be moved. Scleral surface and deep vascular network, distortion aberration, in the deep vascular anastomosis between the larger, and thus shows the expansion of blood vessels was beaded with filling. In case of photophobia, tearing symptoms, should consider merging keratitis and uveitis, the results of a very serious damage to eyesight.

necrotizing anterior scleritis (necrotizing anterior scleritis): The disease is also known as inflammatory necrotizing scleritis, although this type of clinical relatively rare, but the most damage This is also a harbinger of serious systemic collagen disease. Prolonged course slow. About half of patients with complications and decreased vision.

early manifestation of clinical symptoms of disease is limited to Board of inflammatory infiltration, congestion dramatically lesions, vascular tortuosity and obstruction. Performance limitations of typical sheet avascular zone. avascular zone in the vicinity of the sclera below or edema, scleral forward displacement of shallow blood vessels (red light with no easy to find the signs). The development of disease may be limited to a small area, but also developing into big area of ​​necrosis, or from the original lesion development around both sides of the eye, and finally loss of the eye and the whole front. disease where the prognosis for continued thinning of the sclera, uveal pigment can see through the blue-purple, unless the intraocular pressure continued up to 4.0kpa (30mmHg), generally do not form a staphyloma. If the necrotic area is small, new collagen fibers can be repaired. As it will damage the top of the conjunctiva have depressed scar. About half of eye tenderness.

Ye Linan et al (1980) report 2 cases of nodular necrotizing scleritis, scleral necrosis of both the yellow nodules, there is significant inflammation and pain, the lesion sclera meager were blue-violet. biopsy was diagnostic. Two cases in the general treatment ineffective, were carried out excision and lamellar keratoplasty. Results of one case improved recurrence. Li, Zhan (1980) reported that immunosuppressive therapy nodular necrotizing scleritis in 1 case. In this case eye disease, ulcerative stage for the right eye, left eye as nodules period. Limitations of the right eye and left eye depressed ulcer lesions of yellow nodules were elevated from the limbus 4mm, purple lesions around the scleral hyperemia, local refused to press. The immunosuppressive treatment of patients with remission.

⑷ penetrating the sclera softening (scleromalacia perforans): also known as non-inflammatory necrotizing scleritis is a rare special type of scleritis, the condition hidden, almost no symptoms, about half of patients with rheumatoid arthritis or ankylosing polyarthritis related. eye may precede the arthritis disease. Patients are women aged over 50. A bilateral lesion, but its performance in varying degrees. slow progression, but there are performance dramatically, leading to blindness in a few weeks.

the disease rarely associated with inflammation or pain response. Characterized by lesions in the limbus and the equator between the sclera, yellow or gray spots. In the most severe cases, the sclera become increasingly localized into a carrion-like and necrotic changes, necrotic tissue, once off the sclera can completely disappear. In the remaining scleral tissue was significantly reduced in the blood vessels, from the appearance of white enamel-like. About half of patients have one or more of the necrotic lesions. As a result of necrosis of the sclera defect, can be derived from the conjunctiva, the thin layer of connective tissue may be covered, unless the increased intraocular pressure, usually not seen staphyloma. None of the ocular tenderness. A cornea is not affected.

defect no repair tissue regeneration, ultimately leading to perforation, uveal prolapse.

Gongchun Hui (1985) reported 1 case of perforation of the sclera osteomalacia. Patients have a history of 5 to 6 years of arthritis, the left middle finger proximal soft tissue spindle knuckle swelling, local tenderness without swelling. No x-ray bone thinning and joint space narrowing and so on. Left eye redness secondary to corneal opacity, ulceration inside was purple blue sclera, no significant irritation. After 6 months, including the rectus muscle just above the end of 5mm away from the cornea at the scleral a 4 × 5mm round ulcer, visible through the conjunctiva and sclera blue purple choroidal tissue. cornea from 12 to 5:00 at the edge of the ulceration, fundus normal. By corticosteroids and repair lamellar corneal transplant, the disease under control.

2. posterior scleritis

posterior scleritis (Posterior scleritis) refers to occurred in the rear of the equator and the sclera around the optic nerve of inflammation. The back of the eye of sufficient severity to cause tissue damage, due to the diversity of disease manifestations and is rarely taken into account in the diagnosis of it, this disease is not associated anterior scleritis, no obvious signs of external eye, so this eye disease is most likely missed one of the diseases can be cured. But the check was pick out a lot of attention, we found that patients had primary posterior scleritis or scleritis back before the expansion of the eye are not uncommon, that posterior scleritis in clinical covert. The disease is more common in men, women, and common in middle-aged.

⑴ clinical symptoms: posterior scleritis are the most common symptoms of varying degrees of pain, vision loss, red eyes, but there are some people no obvious symptoms, or only those symptoms one. Severe cases have eyelid edema, conjunctival edema, proptosis or diplopia, or both. Difficult to distinguish symptoms of orbital cellulitis. The point is to identify the degree of edema of the disease is significantly higher than cellulitis, and cellulitis of the exophthalmos, then again later scleritis is significant. pain severity varies from very light, and some extreme pain, often associated with anterior scleritis is proportional to the severity of involvement. Patients may complain of pain or pain related to the eye itself, eyebrow, temporal or zygomatic temporal.

vision loss are common symptoms, the reason is associated with optic retinopathy. Some take charge of the complaint as to reduce myopia or hyperopia caused by increased eye fatigue, which is diffuse thickening of the posterior axial shortening lead to the replacement lenses can alleviate the symptoms.

clinical and pathological aspects can be seen, after the patients had anterior scleritis scleral involvement, the performance of fornix superficial scleral blood vessels to dilate, patchy anterior scleritis, nodular anterior scleritis. No eye can also be congestion. But a history of pain and eye congestion, or may have been partially used corticosteroid therapy.

proptosis, ptosis, and eyelid edema, seen in severe inflammation around the sclera, the inflammation often spread to the extraocular muscles or orbital. extraocular muscle inflammation due to eye movements may have pain or diplopia. These symptoms combined are called scleral inflammation around the sclera front of the ball fasciitis and acute inflammatory pseudotumor.

In addition there is a more superficial lesions, showed a clear eye fasciitis, and no significant inflammation of the sclera, james jelly of the eye called the fascia inflammation of. conjunctival edema was half orange jelly, such as fish-like, touch the slightly harder, mild depression, oppression, disease can be extended to the limbus, and the eye is still normal. However, some severe cases, lesions can invade and become jelly sclera scleritis.

⑵ retinopathy:

① circumscribed fundus mass: area can cause swelling of the limitations of the sclera choroid uplift. Usually enclosed by a concentric stripes of choroidal or retinal folds. Such inflammatory nodules often accompanied by pain around the orbit, but can also be ill without obvious symptoms found in a routine examination.

choroidal folds, retinal and optic disc edema stripes: This is the main retinal scleritis performance. Patients often accompanied by mild eye pain or fornix surface of vascular congestion. inflammation of the sclera near the optic disc, optic disc edema can cause even.

③ annular choroidal detachment: Some cases of scleritis lesions adjacent spherical slightly visible choroidal detachment, but the circular ciliary body choroidal detachment is more common.

④ exudative macular detachment: young women can be caused by posterior scleritis posterior pole blood - retinal detachment, which is limited from the posterior pole. fundus fluorescein angiography shows multiple pinpoint areas of leakage. ultrasound scan showed thickening layers of the posterior pole of the eye and tenon edema.

above, Benson (1982) pointed out that, for reasons unknown angle-closure glaucoma, choroidal folds, optic disc edema, circumscribed fundus mass, choroidal detachment, and

[Disease]

scleral edema-related diseases

syphilitic scleritis relapsing polychondritis Wegener granulomatous inflammatory nodular scleritis scleritis multiple arterial inflammatory nature of atypical mycobacterial scleritis spine A Miba of scleritis Gram-positive cocci and Gram-negative bacilli of nocardia scleritis scleritis of scleral inflammation of Behcet's disease of adult rheumatoid arthritis, Lyme disease, scleritis scleritis scleritis of herpes zoster viral fungal scleritis scleritis scleritis herpes simplex virus allergic granulomatous vasculitis associated scleritis toxoplasmosis of tuberculous scleritis scleritis episcleritis

More eye symptoms

"chicken blindness" or "bird blind XV-XA-phenomenon phenomenon phenomenon of X-Y-diamond phenomenon and the phenomenon of visual field defects in white pupil white Arrow halo leopard-like edge of ulcerative keratitis eyes pathological myopia the vitreous body visible through the pupil to move the glass spherical vitreous blood deprivation amblyopia can not be sustained constantly blinking eyes can not blink early morning fat skin swollen cornea


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