Clinical Traditional Chinese and Western Medicine Treatment for Uveitis
Uveitis is one of the common ophthalmic diseases in clinical practice. Improper treatment often leads to blindness. Its etiology is complex, with various types and a high recurrence rate, making prevention and control challenging. Combined traditional Chinese and Western medicine therapy can shorten the course of disease and reduce recurrence, especially in patients who have long-term or excessive use of hormones, where this approach is more effective in maintaining the body's yin-yang balance.
Due to differences in etiology and lesion location, clinical manifestations of uveitis vary. Anterior lesions mainly present as pain, photophobia, lacrimation, eye redness, blurred vision, ciliary tenderness, posterior corneal precipitates, turbid aqueous humor, and small or deformed pupils. Posterior lesions manifest as decreased vision accompanied by floating shadows in front of the eyes, vitreous opacities, and pathological changes in the fundus. When caused by or associated with systemic diseases, systemic symptoms may also occur.
In traditional Chinese medicine (TCM), treating uveitis emphasizes syndrome differentiation and individualized treatment. A combination of local and systemic syndrome differentiation is used. In early stages, most cases are real syndromes, treated by dispelling wind, clearing heat, detoxifying, and removing blood stasis using Modified Formula I for Uveitis: Scutellaria root, honeysuckle, Schizonepeta, Salvia, stir-fried coix seed, etc. For wind-heat type, add Vitex fruit, chrysanthemum, mulberry leaf; for liver-gallbladder fire excess type, add Gentiana root, prunella; for damp-heat type, add talc, cardamom; for wind-damp-heat type, add rhizoma angelicae pubescentis and rhizoma diphasiae. In chronic stages, mixed deficiency and excess prevail, requiring tonifying the body and expelling pathogens. Use Modified Formula II for Uveitis: Chrysanthemum, raw and cooked rehmannia, ophiopogon, wolfberry, etc. For yin deficiency, add Anemarrhena rhizome, Phellodendron bark; for yang deficiency, add epimedium, cinnamon twig; for qi-yin deficiency, add ginseng, schisandra. Using the residue of these herbal medicines for fumigation and warm compress on the affected eye, three times daily, yields significant efficacy.
Western medicine uses 1% atropine or compound tropicamide to dilate the pupil. Pupil dilation prevents posterior synechiae and reduces glaucoma risk while relieving spasm of the iris sphincter and ciliary muscle, thus alleviating stimulation symptoms.
Depending on the location and severity of inflammation, glucocorticoids, immunosuppressants, nonsteroidal anti-inflammatory drugs such as indomethacin, and antibiotics are selected. For severe anterior lesions, topical steroid eye drops may be used; for posterior lesions, systemic glucocorticoids and other immunosuppressants are administered based on condition.