Meybomit - it is the inflammation of meybomiyevy glands which is shown hyperaemia, hypostasis, morbidity in a zone of defeat and availability of purulent infiltrate. This pathology is followed by allocation of a "foamy" secret, dense yellow or grayish masses with the subsequent formation of dry crusts. Diagnostics is based on results of biomicroscopy, a microscopic and cultural research of a secret, PTsR, the analysis of scrape. At bacterial genesis of a meybomit purpose of ftorkhinolon of the 3rd generation is recommended, at defeat by a tick of a sort of Demodeks – antiparasitic means. Perhaps surgical opening of infiltrate and application of hardware methods of treatment.
Meybomit or internal barley represents a polietiologichesky disease of which development the purulent inflammation of meybomiyevy glands is the cornerstone. At 41,6% of patients the activator is S. epidermidermitis. In 65,9% of cases meybomit, Demodeks caused by a tick of a sort, is combined with accession of bacterial microflora. Pathology is widespread everywhere. Most often occurs at females that is connected with use of someone else's or low-quality cosmetics. In children's ophthalmology it is observed against the background of decrease in immunity or at a hormonal imbalance in a puberty. Meybomit it is inclined to a frequent retsidivirovaniye and an aggravation at people of advanced age.
Reasons of a meybomit
The activator of a meybomit in most cases is pathogenic microflora. S. epidermidermitis, S. ureus, Propionibacterium acnes, Corynebacterium xerosis at a long bakterionositelstvo synthesize the lipases splitting lipids of a mucous and liquid part of plaintive liquid. Violation of structure of a conjunctival secret belongs to the main triggers of a meybomit. Presence of pathogenic bacteria on a conjunctiva leads to development of inflammatory process, promotes growth of other microorganisms and increases tendency to the heavy course of a disease. Less often this pathology is provoked by mushrooms, viruses or pincers of a sort of Demodeks. At long parasitizing of a tick in channels of meybomiyevy glands the qualitative structure of their secret with the subsequent insufficiency of a lipidic layer of a plaintive film changes.
As a rule, infection at a meybomita happens at friction a century the polluted hands, long stay in the dirty, dusty room. Development of this pathology is promoted by decrease in resistance of an organism against the background of overcooling or acute infectious diseases in the anamnesis. Non-compliance with rules of personal hygiene, use of someone else's cosmetics can be the cause of development of a meybomit. Carrying contact lenses is more than the term of their validity, long irritation of eyes a smog or smoke are also triggers of this disease.
Etiologichesky communication between development of a meybomit and a hormonal imbalance (is more often in the pubertatny period), diabetes, diseases of digestive tract and gepatobiliarny system is proved. Persons with an acne, a rozatsea, seboreyny dermatitis, keratokonjyunktivity in the anamnesis since these pathologies are followed by hyper secretion and dysfunction of meybomiyevy glands that in the subsequent leads to a meybomit enter into risk group.
Symptoms of a meybomit
From the clinical point of view allocate sharp and chronic meybomit. Pathological process can be localized both on top, and on a lower eyelid. The combined defeat is less often observed both century. At a sharp current meybomit it is shown by hyperaemia, the hypostasis expressed by a pain syndrome in a defeat zone, feeling of a foreign matter in an eye. Inflammatory infiltrate settles down from the inside of a century therefore puffiness is outside visible. At spontaneous opening of infiltrate patients show complaints to allocation of purulent masses. On the place of break the small involved hem is formed. The heavy course of inflammatory process at a meybomita is followed by temperature increase of a body to 38-39 degrees of Page. At the same time development of abscess of a century and purulent fusion of tissues of cartilage is possible.
Chronic meybomit arises in that case when there is no opening of infiltrate at the sharp course of a disease. At process synchronization the affected eyelid looks reinforced, a little hyperemic. Distinctive symptoms are the itch and burning. At a reversing of a century consolidation of yellow color is visualized. Chronic meybomit often is complicated by secondary conjunctivitis because of long irritation of a conjunctiva a secret of meybomiyevy glands. From channels the dense secret of grayish color which leads to formation of dry crusts at external openings is allocated. On the party of defeat cervical, submaxillary, podborodochny groups of lymph nodes can increase. Decrease in visual acuity at a meybomita is possible against the background of secondary conjunctivitis.
At a meybomita of a lower eyelid patients show complaints to "foamy" allocations which emergence is caused by change of qualitative structure of a secret of glands. The zone of growth of eyelashes is often covered with crusts of yellow or grayish color. Degree of dysfunction of meybomiyevy glands at a meybomita is defined depending on expressiveness of stagnation. The result of 0 points indicates lack of developments of stagnation, 1 point – the third part of glands is corked, 2 points – are struck 50% of all channels, 3 points – all channels are corked, 4 points – stagnation of glands, expansion of mouths of output channels, hyperaemia and an inflammation of surrounding fabrics.
Diagnostics of a meybomit
The diagnosis meybomit is established on the basis of anamnestichesky yielded, results of external examination, biomicroscopy, a microscopic and cultural research of pathological allocations, the polymerase chain reaction (PCR), a research of eyelashes regarding identification of a tick of Demodeks. To all patients with meybomity the standard diagnostics including a viziometriya, a tonometriya and an oftalmoskopiya is without fail carried out. Can point such anamnestichesky data to this pathology as professional harm (work in the dusty room, long contact with smoke, a smog), use of others means of decorative cosmetics, recent visit of beauty shops, a recurrence of a meybomit.
At external examination of eyes of the patient with meybomity yellow or grayish consolidation on an internal surface of a century, existence of dry crusts near mouths of output channels, in corners a century and at the basis of eyelashes, hyperaemia and hypostasis of surrounding fabrics comes to light. Expansion of mouths of output channels of meybomiyevy glands, their thickening and a yellowish shade is defined by method of biomicroscopy. The microscopic and cultural research is conducted for the purpose of allocation of the activator with the subsequent crops for definition of sensitivity to antibiotics. PTsR at a meybomita allows to reveal activator DNA in short terms and is more informative test. For detection of a tick of Demodeks, provocative meybomit, scrape from an affected area with a further microscopic research of material and calculation of individuals of a tick in case of his identification is in vitro carried out.
Results of primary diagnostics (oftalmoskopiya and tonometriya) at a meybomita, as a rule, are normal. At development of secondary complications perhaps insignificant decrease in visual acuity found when carrying out a viziometriya.
Treatment of a meybomit
Conservative therapy of a meybomit consists in purpose of etiotropny medicines taking into account yielded antibiotikogramma or results of a microscopic and cultural research. At bacterial genesis of a disease activators are most sensitive to ftorkhinolona of the 3rd generation. For treatment of the meybomit provoked demodekozy purpose of antiparasitic means is recommended. Often at demodekozny defeat bacterial flora therefore expediently combined purpose of antiparasitic means and antibiotics joins. At a meybomita it is necessary to carry out hygienic processing a century by disinfecting solutions 2-3 times a day for the purpose of removal of dry crusts.
The indication to expeditious opening of infiltrate is inefficiency of conservative therapy, growth of granulations and development of abscess of a century. Hardware treatment of a meybomit is the auxiliary method promoting spontaneous opening of infiltrate. UVCh, magnetotherapy and helium - neon laser stimulation are applied. It is recommended to carry out thermal procedures from defeat. Only dry heat is used. For the entire period of treatment use of slezozamestitelny medicines is contraindicated. The recurrence of a disease is the indication to early purpose of antibacterial means from group of ftorkhinolon of the 3rd generation.
Forecast and prevention of a meybomit
Specific prevention of a meybomit it is not developed. Nonspecific preventive measures consist in respect for hygiene a century and increase in resistance of an organism. At the first displays of a disease it is recommended to address the ophthalmologist. A frequent recurrence of a meybomit in the anamnesis with the accompanying development of secondary conjunctivitis demands the special leaving excluding use of medicines of an artificial tear for the entire period of treatment until a full eradikation of the activator.
The forecast at timely diagnostics and treatment of a meybomit for life and working capacity favorable. Development of secondary complications in the form of abscess of a century and purulent fusion of tissues of cartilage is characterized as predictively adverse.