Intermediate Uveitis

Question 1

What is intermediate uveitis?

Answer 1

Inflammation of the anterior vitreous and peripheral retina.

Question 2

What are the signs of intermediate uveitis?

Answer 2

• Inflammatory cells (snowballing)
• Snowbanking
• Mild to moderate cells and flare
• Cystoid macular oedema

Question 3

What are the common symptoms of intermediate uveitis?

Answer 3

• Floaters
• Decreased vision

Question 4

What is posterior uveitis?

Answer 4

Inflammation of the posterior vitreous, retina, and choroid.

Question 5

What are the signs of posterior uveitis?

Answer 5

• Cells and flare
• Posterior vitreous detachment
• Cystoid macular oedema
• Retinitis (white fluffy retinal lesion with unclear borders, BV affected)
• Choroiditis (clear borders, BV not affected)
• Vasculitis (inflamed blood vessels with a white fluffy column along the vessel)

Question 6

What is retinitis in posterior uveitis?

Answer 6

Inflammation of the retina, appearing as a white fluffy lesion with unclear borders and blood vessel involvement.

Question 7

What is choroiditis in posterior uveitis?

Answer 7

Inflammation of the choroid, with clear borders and no blood vessel involvement. Inactive choroiditis has pigment, while active cases show no inflammation at the moment.

Question 8

What is vasculitis in posterior uveitis?

Answer 8

Inflammation of the blood vessels, characterized by a white fluffy column along the vessel.

Question 9

What are the symptoms of posterior uveitis?

Answer 9

• Floaters
• Decreased vision

Question 10

What is the management for all types of uveitis?

Answer 10

• A1/A3 Emergency or urgent referral (emergency for significantly reduced vision, increased IOP, or severe pain)
• Cycloplegia (e.g., cyclopentolate 1%)
• Topical steroid (prednisolone 1% drops, steroidal ointment at night)
• Subconjunctival steroid injection if needed
• Treat any secondary glaucoma or steroid response
• Possible systemic immunosuppression
• Further investigations if recurrent for underlying systemic disease

Question 11

When is emergency referral necessary in uveitis cases?

Answer 11

In cases of significantly reduced vision, increased intraocular pressure (IOP), or severe pain.

Question 12

What topical steroid is commonly used to manage uveitis?

Answer 12

Prednisolone 1% drops, with steroidal ointment at night.

Question 13

When is a subconjunctival steroid injection needed in uveitis?

Answer 13

When topical steroids are not sufficient to control inflammation.

Question 14

How is secondary glaucoma treated in patients with uveitis?

Answer 14

With appropriate glaucoma treatment, especially if there’s a steroid response.

Question 15

What systemic treatment might be required in recurrent uveitis cases?

Answer 15

Systemic immunosuppression may be needed.

Question 16

Why are further investigations required in recurrent uveitis cases?

Answer 16

To check for an underlying systemic disease that might be causing the uveitis.

Question 17

What is the prognosis for uveitis if diagnosed and treated promptly?

Answer 17

The prognosis is good, and patients can expect to recover eventually.

Question 18

What complications can arise if uveitis is left untreated?

Answer 18

Cataract, glaucoma, and permanent loss of vision.

Question 19

What is snowballing in intermediate uveitis?

Answer 19

Inflammatory cells in the anterior vitreous forming snowball-like clumps.

Question 20

What is snowbanking in intermediate uveitis?

Answer 20

Inflammatory exudates that form a snowbank-like appearance along the pars plana or retinal periphery.