Anterior Uveitis Flashcards
What is anterior uveitis?
Inflammation in anterior parts of the uvea
What is anterior uveitis sometimes known as?
Iritis
What does the uvea involve?
Iris
Ciliary body
Choroid layer
Immunology of anterior uveitis?
Inflammation and immune cells in anterior chamber of eye
Anterior chamber becomes infiltrated with neutrophils, lymphocytes and macrophages
How is chronic different to acute iritis?
More granulomatous (more macrophages and less severe) Lasts more than 3 months
Cause of anterior uveitis?
Usually an autoimmune response HLA B27 gene -UC -Ankyspo -Sarcoidosis But it can be: -Infection: TB, syphilis -Ischaemia -Malignancy -Trauma -Infection
What is acute anterior uveitis associated with?
HLA B27 related conditions Such as -Ankylosing spondylitis -Inflammatory bowel disease -Reactive arthritis
What is chronic iritis associated with?
Sarcoidosis
TB
Syphilis
Herpes virus
How symptoms of anterior uveitis starts?
Usually unilateral symptoms, start spontaneously without history of trauma etc
Presentation of iritis?
- Dull, aching painful red eye
- Pain on movement
- Ciliary flush
- Reduced visual acuity
- Floaters and flashers
- Sphincter muscles contraction causing miosis
- Photophobia
- Excessive tear production (lacrimation)
- Abnormally shaped pupil due to posterior synechiae pulling iris into unusual shapes
Management of anterior uveitis?
Same day referral to ophtho
- Steroids
- Cycloplegic-mydriatic medications (Cyclopentolate or atropine eye drops)
- Immunosuppressants (DMARDs, TNF inhibitors)
- Laser therapy, cryotherapy or surgery in SEVERE cases
What does cycloplegic mean?
Paralysing ciliary muscles
What does mydriatic mean?
Dilating pupils
What is the action of cycloplegic-mydriatic drugs?
Block action of iris sphincter muscles and ciliary body
Dilate pupil and reduce pain
What is ciliary flush?
Ring of red spreading from cornea outwards
