DIS - Uveitis Management I - Week 5 Flashcards
What four things can untreated uveitis lead to?
Glaucoma
Cataract
Macular damage
Blindness
What kinds of uveitis are treatable by optometrists (3)?
Anterior uveitis
-iritis
-iridocyclitis
Acute
-not chronic
What eye segment are optical agents only effective in?
Only effective in anterior segment
What does posterior segment inflammation typically require for management (5)?
Careful diagnosis
Injection of anti-inflammatories
Oral anti-inflammatories
Systemic antibiotics
Systemic immunosuppressants
What is the role of optometrists in acute anterior uveitis (3)?
Detecting and delivering primary care
Differentiating AAU to other causes
Detecting systemic associations
What is the role of optometrists in chronic anterior uveitis and posterior uveitis (2)?
Detecting and referring both
Co-management when appropriate
What must be excluded if you suspect anterior uveitis for it to be considered anterior uveitis?
Anterior uveitis is only anterior uveitis when you have excluded the possibility of posterior uveitis
What must you be sure of before considering topical steroid for an eye you suspect has anterior uveitis?
No infection in anterior uveitis
Look for infection in:
-anterior segment
-posterior segment
-careful history
-especially rule out HSV keratitis
What structure of the eye must be intact before you consider topical steroid for an eye you suspect has anterior uveitis?
corneal epithelium
If you suspect anterior uveitis and there is high IOP, what does this suggest of aetiology?
Viral aetiology
What must be done before topical steroids in suspected infectious uveitis? Does this apply to both anterior and posterior, or just one?
No steroids without antibiotic control
-applies to both anterior and posterior uveitis
What is the level of primary care for acute vs chronic anterior uveitis in optometric practice?
Acute - significant primary care role
-because AAU generally requires only short-term therapy
Chronic - limited primary care role
What question should be asked after you detect uveitis?
Why do they have it
-i.e. is a systemic condition also present
What aspect of history should be reviewed if you detect uveitis? What questions specifically?
Return to history taking
-medical systems review
Specific and directed questions on systemic diseases
-do so even if you have already asked
List 8 medical systems that are typically associated with uveitis.
Rheumatological
Respiratory
Dermatological
Genito-urinary
Gastro-intestinal
ENT
Constitutional
Immunological
List four spondylo-arthropy conditions associated with uveitis.
Ankylosing spondylitis
Juvenile idiopathic arthritis
Reactive arthritis
Psoriatic arthritis
List four targeted history questions to ask if you suspect spondylo-arthropathy for a case of uveitis.
Pain/stiffness in joints
-which joints
-how many joints
-onset/duration
-age of patient
List four targeted history questions to ask if you suspect a respiratory/pulmonary disease for a case of uveitis.
Shortness of breath - dyspnoea
Chest pain
Cough
-duration
-phlegm/sputum
List four pulmonary/respiratory conditions associated with uveitis.
Sarcoidosis
TB
HIV
-pneumocystis carinni - pneumonia
List three genito-urinary conditions associated with uveitis.
Syphilis
Reactive arthritis
Behcets disease
What five things would you be on the lookout for if you suspect a genito-urinary cause for a case of uveitis.
Urethritis
Gonnococcal vs non-gonnococcal
Discharge
-milky/puslike
Stinging/burning on urination
Painful/difficult urination
-dysuria
What three things would you be on the lookout for if you suspect a gastro-intestinal cause for a case of uveitis.
Diarrhoea
Jaundice
Hepato-splenomegaly
List five gastro-intestinal conditions associated with uveitis.
Sarcoidosis
Crohns disease
Ulcerative colitis
Hepatitis
CMV
What six things would you be on the lookout for if you suspect a dermatological cause for a case of uveitis.
Rash
-pain/distribution
Alopecia
Vitiligo
Keratoderma blennorrhagica
-pustules/crusts/hyperkeratosis
White/scaly skin
Nodules
List five dermatological conditions associated with uveitis.
Sarcoidosis
Psoriasis
Zoster
Reactive arthritis
VKH
What four things would you be on the lookout for if you suspect an ENT cause for a case of uveitis.
Oral ulcers
Impaired immunity
Salivary/lacrimal gland dysfunction
Sinusitis
What uveitis associated ENT disease is indicated for ulcers with and without pain?
Painful
-behcets disease
Painless
-reactive arthritis
List three constitutional syptoms that can indicate uveitis.
Fever
Night sweats
Flu-like symptoms
List three diseases associated with fever indicating uveitis.
Reactive arthritis
Inflammatory bowel disease
HIV
List three diseases associated with night sweats indicating uveitis.
TB
Malignancy
Sarcoidosis
List a disease associated with fever-like symptoms indicating uveitis.
AMPPPE