Lecture 8: Uveitis and Floaters Flashcards
What is uveitis?
Inflamation of the uveal tissue;
- Iris
- Ciliary body
- Choroid tissue
What the classification of uveitis?
o Anterior - iris
o Intermediate – ciliary body
o Posterior – choroid
o Panuveitis
What can cause uveitis?
Idiopathic
Autoimmune:
- HLAB27 +ve
- Sarcoidosis
- Idiopathic juvenile athritis
- SLE
Infective:
- TB
- Syphyilis
- Toxoplasmosis
What are the symptoms of anterior uveitis?
- Aching pain
- Redness
- Photophobia
- Blurred vision
What are the signs of anterior uveitis?
- Decreased VA
- Circum ciliary conjucteval injection
- Small or irregular pupil
- keratic precipitates
- Iris nodules
How are keratic precipitates divided?
Granulamotous or non
What is it called when white cell layer is seen in the anterior chamber?
Hypopyon
What is the sequale of anterior uveitis?
- Posterior synechiae
- Seclusio pupillae
- Occlusio pupillae
- Iris bombè
- Sectoral iris atrophy - HZO
- Low IOP - hypotony
- Glaucoma
- Cataract
- Cystoid macular oedema
- Neovascularisation
What are the symptoms of posterior uveitis?
- Floaters
- Blurred vision
What are the signs of posterior uveitis?
- Inflammatory products ‘Vitritis’
- Visible focus of chorioretinal inflammation
- Inflammatory sequelae
o Macular oedema
o Vascular sheathing / occlusions
o Optic disc swelling
How do you manage anterior uveitis?
- Topical steroids (intensive and early)
- Cycloplegics (pain relief and prevent
posterior synechiae) - Topical / oral Antivirals (aciclovir) –
HSV, HZO - Local steroid injections
(subconjunctival / sub tenons) - Systemic steroids
How do you manage posterior uveitis?
- Orbital floor / posterior subtenons
Steroid injection - Systemic steroids
- Antibiotics, anti-TB therapy
- Antivirals – oral (HZO, CMV, HIV),
intravitreal ganciclovir (CMV) - Immunosuppresion
What are the causes of floaters?
- Posterior vitreous detachment - commonest
- Blood
o Neovascularisation e.g. diabetes
o Torn peripheral retina - Inflammatory products – intermediate / posterior uveitis
Whats important to ask about floaters and why?
- Onset
- Flashing lights (Traction at edge of retinal tear)
- Vision loss
- Field loss (retinal detatchment)
- Occular hx
- Systemic hx
How is a retinal detachment commonly described?
Curtain effect
