Cognition & Senses 2: Anterior Uvea Flashcards
FUNCTIONS of the CILIARY BODY?
what KIND of muscle is this?
where is it located?
- helps with LENS POSITION via ZONULAR LIGAMENTS
- PRODUCE AQUEOUS HUMOR and allows it to DRAIN
this is a SMOOTH muscle
located at the ANTERIOR & POSTERIOR chamber
what are the 3 COMPONENTS of the UVEAL TRACT?
blood supply?
- IRIS
- CILIARY BODY
- CHOROID
THIS IS VASCULAR
location of the POSTERIOR & ANTERIOR chambers?
BOTH are filled with…
ANTERIOR chamber = between the CORNEA & IRIS
POSTERIOR chamber = between IRIS & LENS
BOTH are filled with AQUEOUS HUMOR
UVEITIS..
= general definition?
2 sub-categories & what they mean?
what is PANUVEITIS?
= INFLAMMATION of the UVEAL TRACT
2 subs?
1. ANTERIOR uveitis = inflammation of the IRIS & CILIARY BODY
- POSTERIOR uveitis = inflammation of the CHOROID
PANUVEITIS = inflammation of ENTIRE UVEAL TRACT
the BLOOD-OCULAR barrier..
= function
what 2 compartments does it separate in the FRONT & BACK of the eye?
when UVEITIS…
= PREVENT LARGE PARTICLES from FREELY FLOWING BACK & FORTH via INTERCELLULAR JUNCTIONS
2 compartments?
1. FRONT = between ANTERIOR UVEAL TRACT & AQUEOUS HUMOR
2. BACK = between CHOROID & RETINA
when UVEITIS occurs, then this BARRIER IS DISRUPTED and so PROTEINS & BIG MOLECULES CAN GET THROUGH TO either AQUEOUS HUMOR or CHOROID
how does CORNEAL EDEMA occur from the…
OUTSIDE of the eye?
INSIDE of the eye?
OUTSIDE of the eye = CORNEAL ULCER causes TEAR FILM to SOAK INTO CORNEA
INSIDE of the eye = CORNEAL ENDOTHELIUM is DYSFUNCTIONAL so Na/K cannot PUMP OUT FLUID
if we see RED in a NORMALLY BLUE IRIS, then what should we suspect?
what’s another term for this?
suspect IRIS HEMORRHAGE
aka RUBIOSIS IRIDIS
what is OCULAR HYPOTANY?
it’s LOW INTRAOCULAR PRESSURE
UVEITIS CLINICAL SIGNS? (7)
which is PATHOGNOMONIC? (2)
- AQUEOUS FLARE (PROTEIN in FREE ANTERIOR CHAMBER)
–> PATHOGNOMONIC - HYPOPYON (WBCs in FREE ANTERIOR CHAMBER)
–> PATHOGNOMONIC - PHOTOPHOBIA
- EPIPHORA
- KERATIC PRECIPITATES
- LOW IOP
- MIOSIS (constricted pupils)
= what are KERATIC PRECIPITATES?
what DZ is this often seen in?
= WHITE BLOOD CELLS that are ADHERED TO THE CORNEAL ENDOTHELIUM from the AQUEOUS HUMOR
often seen in UVEITIS
HYPOPYON definition
this is PATHOGNOMONIC for ___ because…
FREE WBCs settled out in the ANTERIOR CHAMBER
this is PATHOGNOMONIC for UVEITIS because it indicates LEAKY BLOOD VESSELS
AQUEOUS FLARE definition
PATHOGNOMONIC for…
= PROTEIN present in the AQUEOUS HUMOR and therefore ANTERIOR CHAMBER
PATHOGNOMONIC for UVEITIS
why is this ABNORMAL?
what is it? what’s the DZ?
we see CORNEAL REFLECTION, LENS REFLECTION & REFLECTION BETWEEN THEM
this is AQUEOUS FLARE, so likely UVEITIS
why do we have LOW IOP in UVEITIS?
- the CILIARY BODY MUSCLE is INFLAMED and NOT MAKING AS MUCH AQUEOUS HUMOR, causing LOWER IOP
- VASCULATURE is LEAKY so AQUEOUS HUMOR ESCAPING THROUGH UVEO-SCLERAL OUTFLOW
how does AQUEOUS HUMOR drain from the EYE? (2)
- drains through the IRIDO-CORNEAL ANGLE via HOLES between IRIS & CORNEA
- through VASCULATURE via UVEO-SCLERAL OUTFLOW
why do we see MIOSIS in UVEITIS?
INFLAMMATION of CILIARY MUSCLE causes CRAMPING, so CONSTRUCTION OF PUPIL
SEQUELAE of UVEITIS if it goes UNTREATED LONG-TERM (give five)
- POSTERIOR SYNECHIAE = ADHESIONS between IRIS & LENS
- CATARACTS
- GLAUCOMA
- RETINAL DETACHMENT
- CILIARY BODY ATROPHY –> PHTHISIS BULBI
ID & DEFINE LESION
POSTERIOR SYNECHIAE
the IRIS will form ADHESIONS TO THE LENS because of LEAKY VESSELS causing IRIS TO BECOME STICKY
PHTHISIS BULBI definition
when the eye SHRINKS secondarily to END-STAGE DZ
what is the MOST COMMON CAUSE OF CATARACTS?
UVEITIS
how can UVEITIS cause BLINDNESS?
AQUEOUS HUMOR PRODUCTION gets altered, causing METABOLISM OF THE LENS to be altered and therefore VISUAL IMPAIRMENT
why can UVEITIS cause GLAUCOMA when UVEITIS is normally associated with LOW IOP? (2)
what 2 findings on PE would we expect to find if UVEITIS caused GLAUCOMA?
why..?
- when vessels are LEAKY due to INFLAMMATION, then CELLS/PROTEIN will SPILL OUT OF VESSELS –> AQUEOUS HUMOR
- these materials can PLUG THE IRIDO-CORNEAL ANGLE and PREVENT AQUEOUS HUMOR FROM DRAINING –> GLAUCOMA
on exam…
1. HIGH IOP
2. AQUEOUS FLARE
how can UVEITIS cause RETINAL DETACHMENT?
this usually occurs in ___ disease
- if the CHOROID VESSELS are LEAKY, then SERUM with BIG CELLS will GO INTO RETINAL
- cause SEROUS RETINAL DETACHMENT
this usually occurs in CHRONIC disease
TREATMENT of UVEITIS? (3)
overall, MAINSTAY of Tx for UVEITIS is…
TOPICAL vs. SYSTEMIC route for medication?
- CORTICOSTEROIDS (topical, systemic, sub-conjunctival)
- NSAIDs (topical or systemic)
- ATROPINE
overall, MAINSTAY of Tx for UVEITIS is ANTI-INFLAMMATORIES!
do TOPICAL if INFLAMMATION IS JUST ANTERIOR (up to the lens), but if FURTHER BACK then we need SYSTEMIC
ATROPINE..
what KIND of drug is this?
what does it do in UVEITIS?
what are LONG-TERM advantages? (2)
contraindication?
drug type = MYDRIATIC-CYCLOPLEGIC
in UVEITIS, will PARALYZE CILIARY MUSCLE, PUPIL/IRIS can DILATE, & help with OCULAR PAIN
LONG-TERM advantages?
1. can help PREVENT FORMATION OF SYNECHIAE
- PREVENTS or SLOWS DOWN deposition of PROTEIN & WBCs into ANTERIOR CHAMBER
contraindication? = DO NOT USE ATROPINE IN CATS!
–> because EYES ARE CLOSE TO NOSE, so if it GETS ONTO NOSE & they lick it, it can cause SPASMING & FOAMING AT MOUTH
all MYDRIATIC DRUGS have a ___ top tube
all MIOTIC DRUGS have a ___ top tube
all OCULAR ANTI-INFLAMMATORIES have a ____ top tube
all GLAUCOMA drugs have a ___ top tube
RED = MYDRIASIS
GREEN = MIOSIS
GRAY = ANTI-INFLAMMATORIES
ORANGE = GLAUCOMA
what is the MOST COMMON ETIOLOGY of UVEITIS in DOGS?
give 2 other possible etiologies & specific examples in them
IDIOPATHIC/IMMUNE-MEDIATED, generally WE DO NOT KNOW
2 others?
1. INFECTIOUS = EHRLICHIA CANIS common
2. NEOPLASTIC = LYMPHOMA
when are TOPICAL CORTICOSTEROIDS/NSAIDs CONTRAINDICATED for OCULAR USE?
when there’s CORNEAL ULCERS
what is the MOST COMMON INTRAOCULAR NEOPLASTIC TUMOR that AFFECTS UVEAL TRACT?
LYMPHOMA
INFECTIOUS UVEITIS…
= definition
treatment is GENERALLY… & give ETIOLOGIC AGENT
= UVEITIS caused by EYE INFECTION, RESPONSE to BACTERIAL TOXIN or IMMUNE RESPONSE to INFECTION
treatment is GENERALLY DOXYCYCLINE for E. CANIS
dog comes in with RED LEFT EYE & 2 wk history of SYSTEMIC ILLNESS
DZ? etiology?
INFECTIOUS UVEITIS caused by E. CANIS
if we see that the RIGHT EYE looks diseased in a patient, but when we shine a light on it the LEFT EYE still constricts (POSITIVE INDIRECT PLR), what does this mean? (2)
- the RETINA in the RIGHT EYE is STILL FUNCTIONAL
- instead, the IRIS is LIKELY PROBLEMATIC
if the IRIS is clear, what OTHER 2 parts of the EYE are ALSO CLEAR?
if there’s still OPACITY in the eye, WHAT PART is OPAQUE?
- CORNEA
- AQUEOUS HUMOR
OPACITY is in the LENS
UVEODERMATOLOGIC SYNDROME…
= definition
clinical signs? (2)
treatment? (2)
prognosis?
= SPONTANEOUS AUTOIMMUNE DZ targeting MELANIN-CONTAINING TISSUE
clinical signs?
1. UVEITIS signs causing PANUVEITIS
2. DEPIGMENTATION on NOSE & other MUCOCUTANEOUS JUNCTIONS –> LIPS & EYES WHITE
treatment?
1. SYSTEMIC IMMUNOSUPPRESSIVE DRUGS like AZATHIOPRINE or CYCLOSPORINE
prognosis? = POOR FOR VISION
LENS-INDUCED UVEITIS…
= definition
PHACOLYTIC vs. PHACOCLASTIC type?
prognosis for both types?
= IMMUNE RESPONSE to LENS PROTEINS leaking through a CATARACT
PHACOLYTIC = INFLAMMATION causing leakage of PROTEINS through HYPERMATURE CATARACT
PHACOCLASTIC = LENS CAPSULE RUPTURE causing UVEITIS
prognosis…
PHACOLYTIC = GOOD
PHAGOCLASTIC = POOR
ID DZ & ETIOLOGY
UVEODERMATOLOGIC SYNDROME
etiology = AUTOIMMUNE
GOLDEN RETRIEVER PIGMENTARY UVEITIS…
= definition
clinical signs? (3)
prognosis?
= UVEITIS caused by INTRAOCULAR CYST formation & PIGMENT DISPERSION
clinical signs?
1. UVEAL CYSTS
2. PIGMENT on CORNEAL ENDOTHELIUM
3. RADIATING PIGMENT STREAKS on ANTERIOR LENS CAPSULE
prognosis? = POOR FOR VISION
UVEITIS in CATS…
is often a result of ___ DISEASE
5 common causes?
prognosis?
is often a result of SYSTEMIC DISEASE
5 common causes?
1. FIP
2. FeLV
3. FIV
4. TOXO
5. CRYPTO
prognosis? = POOR for VISION & LIFE
