#30. Inflamatory diseases of the whole uvea - tubercular, syphilitic, Toxoplasma, sarcoidosis. Ocular signs in AIDS

Question 1

What is TUBERCULOSIS?

Answer 1

• CHRONIC GRANULOMATOUS Infection
• CAUSED by Bovine / Human Tubercle Bacilli

Question 2

How does TUBERCULOSIS affect the UVEA?

Answer 2

• Accounts for 1% of UVEITIS
• CAUSE Anterior AND Posterior Uveitis

Question 3

What are the 4 TYPES of TUBERCULOSIS?

Answer 3

1) MILIARY
- MULTIPLE Yellow-Whitish Nodules
- Seen in PUPILLARY and CILLIARY Margin

2) CONGLOMERATE TUBERCLE
- Yellow-White Tumour
- Containing GIANT CELL System

3) KOEPPE’s NODULES

4) EXUDATIVE TYPE
- Allergic in Nature
- Recurrent

• TINY Translucent Nodules seen on SURFACE of IRIS at PUPILLARY Margin

Question 4

What is the TREATMENT for TUBERCULOSIS?

Answer 4

• RIFAMPICIN with:

a. ISONIAZID
b. ETHAMBUTOL

** EFFECTIVE when given 6 months - 1 year

Question 5

How does SYPHILIS affect the UVEA?

Answer 5

• It is BILATERAL (Both eyes)

Question 6

What are the CLINICAL FEATURES of SYPHILIS on the Uvea?

Answer 6

1) IRITIS = Plastic & Gummatous Variety in

2) CYLITIS = Associated with IRITIS

3) CHOROIDITIS
- Disseminated
- Anterior AND Diffuse Varieties are seen

Question 7

What is the TREATMENT for SYPHILIS?

Answer 7

SYSTEMIC Course of LONG-ACTING Penicillin

Question 8

What is TOXOPLASMOSIS?

Answer 8

A PROTOZOAN Infection from CATS / RODENTS

Question 9

What are the CLINICAL FEATURES of TOXOPLASMOSIS?

Answer 9

Same as CHOROIDITIS / RETINITIS

Question 10

What is the TREATMENT for TOXOPLASMOSIS?

Answer 10

• Corticosteroids
• Sulphatriad
• Pyrimethamine
• Clindamycin

Question 11

How does SARCOIDOSIS affect the UVEA?

Answer 11

Causes ACUTE / CHRONIC Iridocyclitis

Causes POSTERIOR Uveitis

Uveal Parotid Fever

Question 12

What are the 8 OCULAR Signs in AIDS?

Answer 12

1) EYELIDS
- Those with Herpes Zoster Virus UNDER age 50

• KAPOSI’s Sarcoma = Flat / Slightly raised PURPLE Papules on Eyelid

2) CONJUNCTIVAL LESIONS
- Dry Eye Syndrome
- Toxoplasmosis = Choroiditis

• Dilated Capillary Segments + Sludging in BF in Conjunctiva
• KAPOSI’s Sarcoma = REDDISH Plaque resembling Conjunctival Haemorrhage

3) CORNEA = Fungal Corneal Ulcers

4) ANTERIOR UVEITIS = Associated with HYPOPYON

5) LENS
- INCREASED Myopia
- PREMATURE Presbyopia

6) RETINA / VITREOUS
- Cotton Wool Spots in Retina
- Intra-retinal Haemorrhage resembling Roth’s Spots
- Cytomegalovirus, Syphilis,

7) CHOROID
- Choroid Infiltrates are DEEP Yellow / White Lesions
- Tuberculosis, Syphilis

8) ORBIT
- UNILATERAL Painless + PROGRESSIVE Propotosis
- PERIORBITAL Lymphoedema