Chapter 1

Question 1

What confirms the diagnosis of anterior uveitis?

Answer 1

WBC’s in the anterior chamber

Question 2

Uveitis is caused by the breakdown of…

Answer 2

The blood aqueous barrier (think tight junctions in 3 places…CB, Schelmm’s canal and iris vessels)

Question 3

The tight junctions are where in the AC?

Answer 3

CB, iris vessels, Schelmm’s canal

Question 4

What is posterior synechiae?

Answer 4

Iris sticking to lens

Question 5

What is peripheral anterior synechiae?

Answer 5

Iris sticking to TM

Question 6

What drug used for Uveitis?

Answer 6

Use Pred Forte steroid every hour or Durasol QID

to decrease fatness and stickiness of iris

Question 7

What do you use to treat cystoid macula edema (cme)?

Answer 7

Pred Forte AND an NSAID

Question 8

What are key differences b/w episcleritis and scleritis

Answer 8

Scleritis is more painful, bilateral, associated with systemic condition, bluish, gradual onset

Question 9

What blanches episcleritis (to make dx that it is NOT scleritis)?

Answer 9

2.5% phenylephrine. If doesn’t work use 10%

Question 10

To make a diagnosis of uveitis there must be _____ in the anterior chamber.

Answer 10

White blood cells

Question 11

Keratic precipitates (KP’s) are the most common corneal finding in ________.

Answer 11

Uveitis

Question 12

Stellate KP’s are observed in what 2 conditions?

Answer 12

Fuch’s heterochromic iridocyclitis (more common) and herpetic uveitis.

Question 13

3 things to look for in Uveitis

Answer 13

1. peripheral anterior synechiae (PAS) on TM
2. Posterior synechiae (on lens)
3. CME

Question 14

Most common type of scleritis is

a. diffuse non-necrotizing
b. nodular non-necrotizing
c. necrotizing with inflammation
d. necrotizing without inflammation (scleromalacia perforans)

Answer 14

A.

Question 15

Necrotizing scleritis without inflammation is also called:

Answer 15

Scleromalacia perforans (they have RA)

Question 16

What auto-immune disease does a patient with sleromalacia perforans have?

Answer 16

RA

Question 17

Granulomatous KP’s or mutton fat KP’s are…

Answer 17

macrophages

Question 18

Most common type of Uveitis is non _______

Answer 18

granulomatous

Question 19

Most common cause of non-granulomatous uveitis

Answer 19

Idiopathic 50-70%

Question 20

Three other causes of non-granulomatous uveitis are:

Answer 20

1. Ankyl. spon (back pain)
2. RA (urination pain)
3. inflammatory bowel disease

Question 21

Chronic granulomatous

Answer 21

Sarcoid, TB, syphilis (Arlt’s triangle is the botton triangular shaped area where they form. They are sticky and attach to the bad surface of the cornea)

Question 22

1 most common systemic disease associated with acute anterior uveitis

Answer 22

Ankylosing spondylitis

Question 23

1 symptom patient’s complain of in TB

Answer 23

night sweats

Question 24

Most common cause of posterior uveitis

Answer 24

Toxoplasmosis, unilateral, (vitritis)

Question 25

Leading cause of scleritis

Answer 25

Arthritis (called scleromalacia perfoans)

Question 26

If they show a photo of a granulomatous KP on the test...you would order what test for this patient?

Answer 26

Chest x-ray (suspect sarcoidosis or tb)

Question 27

Anky spond order what test?

Answer 27

Sacroiliac x-ray

Question 28

What do you Rx with uveitis?

Answer 28

Pred forte Q1hr and homatropine 5%BID (or Furezol QID instead of pred forte)

Question 29

Scleritis tx

Answer 29

ORALS (not topicals due thinning) | Oral NSAID, Oral steroids (prednisone QD)

Question 30

Do you give topical steroids to scleritis?

Answer 30

No due to corneal thinning

Question 31

Mr. Fabry Whorl's his Chai-t

Answer 31

``` Fabry's disease cause whorl keratopathy and meds that cause whorl keratopathy: C hlorquine H ydroxycloroquine A mniodirone I ndometicine T imoxifin ```

Question 32

Episcleritis with 3+ hyperemia treat with...

Answer 32

soft steroid like Lotemax and artificial tears

Question 33

Do you Rx steroids for Addison's?

Answer 33

Yes you need to ADD steroids to Addisons. Cushing's disease has a "cushing of steroids"

Question 34

Ocular albinism symptoms

Answer 34

photophobia, deafness,

Question 35

Ocular albinism signs

Answer 35

transillumination of iris, foveal hypoplasia (under-developed fovea), deafness, nystagmus, strabismus, high myopia

Question 36

Why do albinism patient's get nystagmus?

Answer 36

under-developed fovea is "searching" for objects

Question 37

Were is melanin produced?

Answer 37

In a cell called melanocyte

Question 38

What is inside the melanocyte that pumps out melanin cells?

Answer 38

melanosomes

Question 39

What do you worry about happening in ectropian uveae

Answer 39

angle closure glaucoma

Question 40

What drugs can cause the scleral to turn blue?

Answer 40

1. minocycline | 2. topical steroids, oral corticosteroids

Question 41

Iritic =

Answer 41

Inflammation of iris = ant. uveitis

Question 42

Iridocyclitis =

Answer 42

Inflammation of iris and CB

Question 43

Ectropian uveae

Answer 43

eversion of the pigmented posterior epithelium of the iris at the pupillary margin. Worry about angle closure glaucoma