Anterior/intermediate uveitis

Question 1

Most common cause of noninfectious anterior uveitis without hypopyon

With hypopyon?

Answer 1

idiopathic (then HLA B27)

HLA B27

Question 2

Differential Dx for anterior uvietis in children

Answer 2

JRA, anklyosing spondylitis, psoritatic arthritis, TINU, toxoplasmosis, sarcoidosis, post viral, lyme disease, HSV, Kawasaki’s disease, trauma

Question 3

Differential diagnosis of anterior uveitis in adults

Answer 3

HLA-B27, sarcoidosis, syphilis, Fuch’s hererochromatic iridocyclitis, behcet’s, HZO, masquerade syndromes, JXG, MS, malignancies

Question 4

Differential diagnosis for nongranulomatouns uveitis?

Granulomatous uveitis?

Answer 4

HLA-B27, idiopathic, bechet’s, Lyme, Posner-Schlossman syndrome, HSV, Kawaskai, traumatic, TINU, Lupus, JRA, Fuch’s

Sarcoidosis, VKH, SO, syphilis, TB, toxoplasma, brucellosis, Fungal, HIV

Question 5

nongranulomatous KP vs Granulomatous KP composition

Answer 5

Nongranulomatous - lymphocytes and PMNs

Granulomatous - macrophages, epithelioid cells, and multinucleated giant cells

Question 6

DDx for hypopyon

Answer 6

HLA-B27

infectious (keratitis/endophthalmitis)

IOFB

behcet’s

VKH

malignancy

toxic

Question 7

DDx for diffuse KP

Answer 7

Fuchs’ heterocromic iridocyclitis

syphilis

sarcoidosis

Question 8

DDx for uvetic glaucoma

Answer 8

HSV

VZV

Posner-schlossman

Fuchs’

Sarcoid

Syphilis

SO

Question 9

Ankylosing Spondylitis

Answer 9

90% are HLA-B27 positive

30% will have anterior uveitis (40% of these will have recurrent uveitis)

Question 10

Reiter’s Syndrome

Triad?

% b27 positive?

associated infectious?

Answer 10

classic triad: Conjunctivitis, urethritis, arthritis

75% HLA-B27 positive

Salmonella, Shigella, Chlamydia, Ureaplasma, Yersinia,

Question 11

Fuch’s Heterochromic Iridocyclitis

Answer 11

Young adults

Unilateral

involved iris is paler

60% have glaucoma, 50% PSC cataract

white stellate KP, min AC rxn, fine angle vessels that bleed, no PS

Question 12

DDx for iris heterochromia

Answer 12

Fuchs’ heterochromic iridocyclitis

congenital horner’s

IOFB (trauma)

Posner Schlossman

topical prostaglandins

Nevus of ota

iris melanoma

Question 13

Lyme disease

Answer 13

often bilateral

Spirochete infection - borrelia burgdorferi

stage 2/3 disease: bell’s palsy, orbital myositits, follicular conjnctivitis, episcleritis, keratitis, granulomatous iridocyclitis with PS and vitreous cell, Exudative RD, opctic neuritis, optic atrophy, CME, BRAO

Question 14

Posner Schlossman syndrome

Answer 14

recurrent anterior uveitis with increased IOP

self limited

unilateral eye pain

Question 15

DDx for intermediate uveitis

Answer 15

Pars planitis (80-90% of intermediate uveitis)

MS (25% with periphebitis)

sarcoidosis

lyme disease

Fuchs’ heterochromic iridocyclitis

Question 16

Pars planitis

Answer 16

diagnosis of exclusion

in females > males

75% bilateral

Snowballs (epitheliod cells/multinucleated giant cells)

Snowbanks (preretinal membrane of fibroglial elements)