3.1.8 Flashcards
What is uveitis?
Uveitis is an inflammation of the uvea, the middle layer of the eye that includes the iris, ciliary body, and choroid.
What are cells in the anterior chamber?
Cells are inflammatory white blood cells (usually lymphocytes or neutrophils) that accumulate in the anterior chamber due to inflammation.
How do cells appear under a slit-lamp examination?
Cells can appear as tiny, moving specks or ‘dust-like’ particles.
What does a higher number of cells in the anterior chamber indicate?
A higher number of cells indicates more active inflammation.
What does flare refer to in the context of uveitis?
Flare refers to the increased light scattering caused by protein exudates in the aqueous humor due to inflammation.
How is flare evaluated?
Flare is evaluated using a slit-lamp with the direct illumination technique.
What does the presence of cells and flare indicate in uveitis?
The presence of both cells and flare indicates active inflammation in the anterior chamber.
What are synechiae?
Synechiae are abnormal adhesions between the iris and other structures in the eye.
What are anterior synechiae?
Anterior synechiae are adhesions between the iris and the cornea.
What complications can anterior synechiae cause?
Anterior synechiae can obstruct the drainage angle, potentially leading to increased intraocular pressure and glaucoma.
What are posterior synechiae?
Posterior synechiae are adhesions between the iris and the lens.
What can posterior synechiae cause?
Posterior synechiae can cause irregular pupil shapes and interfere with normal pupillary response.
How do synechiae relate to chronic inflammation in uveitis?
Synechiae often indicate that the uveitis is persistent or poorly controlled.
What is the goal of treating synechiae in uveitis?
The goal is to treat the underlying inflammation and address the synechiae themselves.
What treatments are commonly used for uveitis?
- Corticosteroids (topical, oral, or injected)
- Immunosuppressive therapy (e.g., methotrexate, cyclosporine)
- Mydriatic agents (e.g., atropine, cyclopentolate)
What technique is used to visualize the corneal endothelium?
The retro-illumination technique with a narrow slit beam.
What does assessing the aqueous humor involve?
Examining changes in the anterior chamber, such as flare and cells.
What is the purpose of assessing the iris?
To evaluate signs of inflammation, posterior synechiae, irregularities, or color changes.
What technique is used to assess the anterior lens surface?
Retro-illumination using a narrow slit beam.
What is the SUN grading system used for?
The SUN grading system is used for assessing cells and flare in the anterior chamber.
What is the grading for cells in the anterior chamber?
- Grade 0+: No cells
- Grade 1+: Few cells (1–5 cells)
- Grade 2+: Moderate (6–15 cells)
- Grade 3+: Many cells (16–25 cells)
- Grade 4+: Very many cells (>25 cells)
What does flare grading assess?
Flare grading assesses the presence of protein or fibrin in the aqueous humor.
What is the grading for flare in the anterior chamber?
- Grade 0+: No flare
- Grade 1+: Mild flare
- Grade 2+: Moderate flare
- Grade 3+: Severe flare
- Grade 4+: Very severe flare
True or False: A higher flare score suggests a more severe inflammatory reaction.
True
What is the primary focus of treatment for anterior uveitis?
Controlling inflammation, relieving symptoms, and preventing complications
What are the cornerstone treatments for anterior uveitis?
Corticosteroids
What are topical steroids used for in the treatment of anterior uveitis?
Reduce inflammation in the anterior chamber and control symptoms like redness and pain
Name two examples of topical steroids used in anterior uveitis
- Prednisolone acetate 1% (Pred Forte)
- Dexamethasone 0.1% (Maxidex)
When are systemic steroids prescribed for anterior uveitis?
In cases of more severe or refractory uveitis
What is an example of a systemic steroid used in anterior uveitis treatment?
Prednisolone (oral tablets)
What is the purpose of sub-Tenon or intravitreal steroid injections?
Deliver steroids directly to the site of inflammation
What are cycloplegics used for in anterior uveitis treatment?
Reduce pain, prevent posterior synechiae, and manage inflammation
Name two cycloplegic agents used in anterior uveitis treatment
- Atropine 1%
- Cyclopentolate 1%
How often are cycloplegic agents typically applied?
2-3 times per day, depending on severity
What is the purpose of mydriatics in anterior uveitis treatment?
Widen the pupil and prevent the iris from sticking to the lens
Name an example of a mydriatic agent used in anterior uveitis treatment
Tropicamide 1%
How do corticosteroids work in treating anterior uveitis?
By blocking chemicals that cause swelling and immune reactions
What is the result of using corticosteroids in anterior uveitis?
Calm inflammation, reduce pain, and prevent further tissue damage
What is the mechanism of action of cycloplegics like atropine?
They relax the muscles in the eye that cause focusing and pupil constriction
What is the result of using cycloplegics in anterior uveitis treatment?
Reduces eye pain and helps prevent the iris from sticking to the lens
How do mydriatics like tropicamide function?
They block the muscles that constrict the pupil, widening it
True or False: Cycloplegics can help prevent the formation of synechiae
True
