Vitreous inflammation is a disease in which inflammatory processes develop in the area of the vitreous humor on the eye. Vitreous inflammation is acute or chronic and is also known by the synonym vitritis. Vitreous inflammation usually affects only one eye, as simultaneous infection of both eyes is comparatively rare.
What is vitreous inflammation?
Vitreous inflammation occurs in numerous cases in conjunction with other diseases or inflammations in the eye area. In addition, isolated occurrences of vitreous inflammation are possible, with only the vitreous itself affected by the inflammatory processes. However, since different tissues inside the eye are very close to each other, the inflammation quickly spreads to other areas. For this reason, pure vitreous inflammation is less common than inflammation associated with other conditions. Basically, isolated vitreous inflammation is a disease that occurs with low frequency. More often it presents in association with endophthalmitis. The reasons for its development are often trauma to the bulb, whereby germs of disease penetrate into the area. Surgical interventions on the eye also sometimes cause vitreous inflammation. If the causes of vitreous inflammation are found in microbial pathogens and the inflammation spreads to other areas of the eye, endophthalmitis is present.
Causes
Vitreous inflammation is usually caused by bacterial or viral pathogens that enter the vitreous, for example, through surgery or trauma. People with generally good health are more likely to develop vitreous inflammation caused by bacteria. On the other hand, people with a weakened body defense system more often develop vitreous body inflammation as a result of fungal infections. These patient groups suffer, for example, from AIDS, tumors or carry a donor organ. In these cases, vitreous inflammation is often caused by fungi of the Candida species. The structure of the vitreous body allows inflammation only when germs enter the area from the outside. For example, the pathogens enter the vitreous body from neighboring areas inside the eye. In addition, various microbial germs are capable of triggering vitreous inflammation. These include bacteria, viruses and fungi. The pathogens are transmitted either directly through injuries to the bulb or indirectly through sepsis or other pathological phenomena. Depending on the responsible pathogen as well as the defense system of the affected individual, vitreous inflammation develops with a chronic, acute, or subacute course.
Symptoms, complaints, and signs
In acute vitreous inflammation, patients first notice that their vision deteriorates. Also, pain usually develops inside the eye, which patients experience as dull. Pain-relieving medications usually have little effect in this case. In addition, redness forms on the conjunctiva of the diseased eye. The chronic form of vitreous inflammation is accompanied by far fewer symptoms, so that it often goes unnoticed by the affected person for a long time. In this case, deterioration of visual acuity is also possible, but it is less noticeable than in the acute form of progression.
Diagnosis and course
Patients with acute vitreous inflammation consult a physician significantly more often than people suffering from the chronic course form. The acute symptoms provide the treating ophthalmologist with the first important clues to a possibly present vitreous inflammation. In addition to the individual symptoms, the doctor will discuss possible triggers of the vitreous inflammation. In doing so, he finds out whether the patient has recently suffered injuries to the bulb or undergone surgical procedures on the eye. The analysis of existing, possibly chronic underlying diseases also plays an important role in the anamnesis. Diseases such as tumors or AIDS indicate a weakened immune system that makes one more susceptible to vitreous inflammation. The ophthalmologist examines the affected eye clinically using a slit lamp. In addition, he usually uses ultrasound techniques to image the inside of the eye and gather clues about the inflammation of the vitreous.A swab of the diseased eye with subsequent laboratory evaluation is usually essential to reliably diagnose vitreous inflammation and identify the responsible pathogens.
Complications
In most cases, vitreous inflammation occurs in only one of the two eyes, so the symptoms and complications also often affect only one of the two eyes. Severe pain inside the eye and decreased visual performance occur. Likewise, the patient not infrequently suffers from veil vision and double vision, which complicate everyday life and no longer allow various activities. The conjunctiva is also often reddened. Unfortunately, pain in the eye usually cannot be relieved with the help of painkillers, so that the quality of life is extremely reduced. In the worst case, the vitreous inflammation leads to complete blindness of the patient. This condition is irreversible and cannot be reversed. The treatment itself always depends on the causes of the vitreous inflammation and the underlying disease. In severe cases, the loss of vision can also occur within a few hours, leading to a panic attack. In the case of tumors or AIDS, no specific treatment can be given in most cases. The patient’s life expectancy is not reduced by vitreous inflammation.
When should you see a doctor?
Visual complaints should always be clarified by a physician. If they persist unabated for several days, this is considered unusual and should be investigated. If there is a decrease in vision or if the affected person reacts more sensitively to various light influences, a doctor is needed. If the change in vision increases the general risk of accidents, a check-up should be initiated as soon as possible. If pain of the eyes occurs, this is a warning sign that should be followed up. Consultation with a physician is required before taking any pain medication. If the discomfort increases or if further problems occur, a physician should be contacted. If there is redness of the conjunctiva, changes in the tear fluid, an itching or burning sensation in the eye, a doctor should be consulted. If the affected person wears visual aids, it is advisable to contact a doctor as soon as possible, otherwise further complications may occur. If anxiety sets in or other psychological complaints occur, a doctor should be consulted. If there is palpitations, increased blood pressure, sweating or increased irritability, help should be sought. If there is a fever or decreased performance, a doctor should be consulted. Behavioral abnormalities, sleep disorders, an inner restlessness or concentration as well as attention deficits should also be examined and treated.
Treatment and therapy
The treatment of vitreous inflammation depends in each case on the individual reasons for its development, especially on the causative pathogens. This is because bacterial or viral germs usually require a different therapy than infections caused by fungi. In this case, a so-called antibiogram is used to treat the germs specifically. Rapid treatment of vitreous inflammation is of immense importance, since various complications are possible. If endophthalmitis is present, there is a risk that the affected person will go blind after a short time. The loss of visual acuity develops in severe cases in the course of a few hours. Timely diagnosis with subsequent therapy of vitreous inflammation precisely tailored to the pathogen is therefore of considerable importance.
Outlook and prognosis
The prognosis of vitreous inflammation is generally considered good. The course of the disease varies depending on the cause and the general health of the affected person. Acute as well as chronic developments may occur. In patients with a stable immune system, vitreous inflammation is usually completely cured within a few days or weeks. As soon as the causative pathogens have been identified, medical care begins that is tailored to the individual needs of the organism. Significant improvements and relief of symptoms are seen after only a short time. With a weak immune system, there is an overall delay in the healing process. In addition, there are often other diseases that need to be treated in parallel.The immune system can stop the multiplication of pathogens only with difficulty or not at all. Therefore, an individual therapy as well as a strengthening of the immune system are needed. Without medical support, no quick healing or relief can be expected. The well-being continues to decrease and the ability to see remains diminished. A chronic course of the disease is considered likely. Despite a good chance of cure if treatment is sought, vitreous inflammation can recur at any time over the lifespan. The prognosis remains positive if the symptoms recur. Which eye is affected is unaffected by the prospect of cure.
Prevention
Effective preventive measures for vitreous inflammation have hardly been developed. It is particularly important to maintain meticulous hygiene during surgical procedures on the eye to reduce the risk of invading germs. Even after surgical intervention, patients should keep the operated eye away from possible sources of infection. In cases of underlying immunocompromising diseases, regular check-ups with the physician are recommended to quickly diagnose possible vitreous inflammation.
Follow-up care
In the case of vitreous inflammation, affected individuals have very limited options for follow-up care. First and foremost, the cause of this disease must be identified and treated to prevent complete blindness in the affected individual. Unfortunately, a positive course of the disease cannot always be guaranteed. In most cases, vitreous inflammation is treated with the help of medications or creams. In this case, the affected person must always ensure that the medication is taken or applied regularly in order to prevent complications. A very early diagnosis of vitreous inflammation is also important, as this is the only way to prevent blindness. Since vitreous inflammation can also spread to other parts of the body or even to the internal organs, early treatment is necessary to prevent this. Therefore, even after successful treatment, regular examinations should be performed to detect inflammation in other parts of the body. Furthermore, the eyes should always be spared and not unnecessarily strained in the case of vitreous inflammation. If the affected person is taking antibiotics, these should not be taken together with alcohol, as their effect will be reduced. The patient’s life expectancy is usually not reduced by vitreous inflammation.
What you can do yourself
There are no self-help options available to the affected person for vitreous inflammation. However, patients must maintain strict hygiene during all eye procedures to avoid possible infections. If the patient suffers from immunodeficiency, he should undergo regular examinations and check-ups with a council in order to detect the symptoms of vitreous inflammation at an early stage. The earlier the disease is detected, the higher the chances of a complete cure of the disease. Since the treatment itself takes place with the help of medications or antibiotics, the affected person should also take them according to strict instructions. Especially the side effects or interactions with other medications should be taken into account, so as not to reduce the effectiveness of the medications being treated. However, any changes in the medication taken may only be made after consultation with a physician. In severe cases or if treatment is delayed, vitreous inflammation can also lead to vision loss. In these cases, the patient is dependent on the support of friends and family, who can make everyday life much easier. Contact with other patients can also have a positive effect on the psyche of the affected person.
