Anterior Uveitis

Question 1

Ant. Uveitis Symptoms

Answer 1

Pain
Redness 
Watering
Photophobia
Blurring
Ocular discomfort

Question 2

Signs Ant.uveitis

Answer 2

VA- variable- severity
Conj- ciliary injection- deep vessels
Cornea- kp’s
AC- cells, flare, hypochondriac,fibrin
Pupil- miosis.- spasm of pupil sphincter- post. Synechiae
Iris- heterochromia,nodules,atrophy, neovas.

Question 3

KP’s

Answer 3

1. Stellate:
   - ( LMP- lymphocytes,macrophages,plasma cells)
   - arlt tri. Apex up, infe. D/t gravity& at.convection currents
   - non granulomatous
   - FUS
2. Mutton fat:
   -(ME- multinucleated cells, epitheliopathy cells)
   -

Question 4

AAU investigations
( when not to be done)

Answer 4

• single
• unilateral
• no hypopyon
• mild mod
• non granulomatous

Question 5

AAU when to investigate?

Answer 5

Bilateral 
Severe
Recurrent
Granulomatous
Persistent
Chronic
Recurrent
Intermediate
Posterior
Ocular/sys. C/f suggesting underlying disease

Question 6

AAU systemic investigations?

Answer 6

1. Haematology
2. serology
3. radiology
4. CSF study
5. urine
6. stool
7. intraocular fluid& tissue biopsy

Question 7

Hematological tests uveitis

Answer 7

1.CBC : leucocytosis -infection,
Eosinophilia-parasitic ,
IMT,leukaemia , lymphoma,neutropenia

2. ESR& CRP: sys. Inflammatory disorder, giant cell arteritis.
3. Interferon gamma release assay :Quantiferon TB gold- TB

Question 8

Uveitis Serological tests

Answer 8

1. LFT :ALT,AST- sarcoidosis
2. Serum urea creatinine nitrogen :: glomerulonephritis

3.ACE:➕granulomatous dis.
( sarcoidosis,Tb,leprosy), non spec8fic, exercise may raise ace levels.
Serum lysozyme ( sarcoidosis)

4. calcium: sarcoidosis
5. ANA: idiopathic juvenile arthritis
6. Antiphospholipid antibody:Vascular occlusion
7. Rh factor- rheumatoid

8.HLA ::
( A29 - birdshot)
(B5- behcets)
(B7- histoplasmosis ‘
(B27-recurren5 Ant.uveitis)
(B51 behcets)
(DR2- histoplasmosis)
(DR4- VKH , SYMP. OPHTHALMITIS)

9.antineutrophilic cytoplasmic antibody ANCA: cANCA Wegener, sys. Vasculitis
10. Syphilis specific: ELISA
SYPHILIS NONSPECIFIC : VDRL ,RPR

11. Bartonella,Brucella,CMV,EBV,FUN*AL,HIV,HSV,LYME,T.gondii,VZV

Question 9

Uveitis intraocular fluid analysis & tissue biopsy

Answer 9

1. Aq./ vitreous tap :PCR
   ( herpes,CMV, rubella,propionibacter for in&lamer pseudophaki. Eyes, unexplained hypertensive uveitis,unresponsive to steroids.
2. Endoretinal subretinal choroidopathy biopsy- ( neoplasia, necrotising retinitis)
3. Skin conj. Lacr8mal biopsy:: sarcoidosis

Question 10

CSF study in uveitis

Answer 10

Protein, glucose, VDRL, GRAM STAIN :: VKH ,APMPPE,malignancy, syphilis

Question 11

Ocular imaging in uveitis

Answer 11

Bscan. :: small pupil, opaque media

OCT: CME, ERM

FAF: MEWDS

FA: VASCULITIS,WDS,MACULAR ISCHEMIA

ICGA: choroid always pathology

UBM :: hypotony,choroidopathy effusion,cyclodialysis cleft,cycllitic membrane

Question 12

Sys. Radiological tests for uveitis

Answer 12

Chest X-ray- ( TB ,sarcoidosis,granulomatosis with polyangiitis)

Sacroiliac joint Xray: ankylosis gets spondylitis

CT chest : sarcoidosis

CT MRI brain : MS,Sarcoidosis,Toxoplasmosis,CNS lymphoma