Summary about Disease
Synechiae refers to adhesions or scar tissue that cause the iris (the colored part of the eye) to stick to either the lens of the eye (posterior synechiae) or the cornea (anterior synechiae). These adhesions can distort the pupil shape, impede fluid flow within the eye, and potentially lead to glaucoma or vision loss.
Symptoms
Symptoms of synechiae can vary depending on the severity and location of the adhesions. Common symptoms include:
Irregularly shaped pupil
Blurred vision
Eye pain or discomfort
Headache
Light sensitivity (photophobia)
Elevated intraocular pressure (in cases of glaucoma secondary to synechiae)
Causes
Synechiae can be caused by various factors, including:
Uveitis: Inflammation of the uvea (the middle layer of the eye) is the most common cause.
Eye trauma: Injury to the eye can lead to inflammation and scarring.
Eye surgery: Post-surgical inflammation can cause adhesions to form.
Certain medications: Some medications may rarely contribute to inflammation and synechiae formation.
Congenital: Rarely, synechiae can be present at birth.
Medicine Used
Treatment focuses on addressing the underlying cause and preventing further adhesion formation. Medications commonly used include:
Corticosteroid eye drops: To reduce inflammation. Examples: prednisolone, dexamethasone.
Cycloplegic eye drops: To dilate the pupil and prevent further adhesions. Examples: atropine, cyclopentolate.
Non-steroidal anti-inflammatory drugs (NSAIDs): In some cases, oral or topical NSAIDs may be used for pain and inflammation.
Glaucoma medications: If synechiae cause elevated intraocular pressure.
Mydriatic agents: to dilate the pupil.
Is Communicable
Synechiae itself is not communicable (not contagious). The underlying cause, such as uveitis caused by an infectious agent, might be communicable in some cases, but the synechiae is a consequence, not the primary infection.
Precautions
Precautions depend on the underlying cause. For uveitis:
Follow the prescribed medication regimen.
Attend all follow-up appointments with the ophthalmologist.
Protect your eyes from further injury.
If the uveitis is related to a systemic condition, manage the underlying condition.
Wear sunglasses.
How long does an outbreak last?
Synechiae is not an "outbreak" in the infectious sense. The duration depends on the underlying condition and the effectiveness of treatment. Uveitis episodes can last from weeks to months. Synechiae can persist even after the inflammation resolves, requiring ongoing management.
How is it diagnosed?
Diagnosis is made through a comprehensive eye examination by an ophthalmologist. The examination typically includes:
Slit-lamp examination: Allows detailed visualization of the iris, lens, and anterior chamber.
Pupil dilation: To better visualize the posterior structures of the eye.
Intraocular pressure measurement: To check for glaucoma.
Gonioscopy: To examine the drainage angle of the eye.
Visual acuity testing: to see level of vision
Timeline of Symptoms
The timeline of symptoms varies depending on the underlying cause and the speed of synechiae formation.
Acute Uveitis: Symptoms can develop rapidly, over days to weeks.
Chronic Uveitis: Symptoms may develop gradually over weeks to months.
Post-Surgery: Synechiae may develop within days to weeks after eye surgery.
In general, pain, redness, and blurred vision appear relatively quickly after the initial trigger.
Important Considerations
Early diagnosis and treatment of the underlying cause are crucial to prevent permanent vision loss.
Synechiae can lead to secondary glaucoma, requiring long-term management.
Regular follow-up appointments with an ophthalmologist are essential to monitor the condition and adjust treatment as needed.
Surgery may be necessary in severe cases to break adhesions or manage glaucoma.
If you have a history of uveitis or eye trauma, be vigilant for symptoms of synechiae.