MDT EYE Uveitis/Iritis

Question 1

_______ is inflammation of the anterior segment of the uveal tract. Usually immunologic but possibly infective or neoplastic.

Answer 1

Iritis

Question 2

What is the middle layer of the eyeball?

Answer 2

vascular tunic or uvea

Question 3

Iritis is Classified as what according to the clinical signs…….

Answer 3

• acute or chronic

- nongranulomatous or granulomatous

Question 4

The common types are

Answer 4

• acute nongranulomatous anterior,

- granulomatous anterior, and posterior

Question 5

What are some infectious etiologies for Iritis?

Answer 5

Herpes virus, 
Cytomegalovirus, 
Toxoplasmosis, 
Syphilis, 
West Nile Virus

Question 6

What are some Systemic inflammatory diseases that cause Iritis?

Answer 6

Spondyloarthritis,
Sarcoidosis,
SLE,
Multiple sclerosis

Question 7

PT has these issues what would you suspect?
Signs:
-Inflammatory cells and flare within the aqueous (WBC released from vessels appear as snowflakes)
-Blurred vision in a mildly painful and mildly inflamed eye
-Hypopyon (WBC pool) and fibrin within the anterior chamber.
-Keratic precipitates (KPs) (cells seen on the corneal endothelium)

Answer 7

Iritis

Question 8

PT has these issues what Meds would you give?
Signs:
-Inflammatory cells and flare within the aqueous (WBC released from vessels appear as snowflakes)
-Blurred vision in a mildly painful and mildly inflamed eye
-Hypopyon (WBC pool) and fibrin within the anterior chamber.
-Keratic precipitates (KPs) (cells seen on the corneal endothelium)

Answer 8

!!!Only to be initiated by or under the direction of Ophthalmologist!!!
Cycloplegic (for pain and inflammation)
1) Mild to moderate: Cyclopentolate 1% t.i.d.
2) Severe: Atropine 1% b.i.d. to q.i.d.
(b) Topical steroid
1) Prednisolone acetate 1% q1-6h

Question 9

Differential Diagnosis for Iritis?

Answer 9

(1) Keratitis
(2) Conjunctivitis
(3) Hypopyon due to bacterial keratitis
(a) Leukocytes in anterior chamber are a characteristic of anterior uveitis
(b) Hypopyon is differentiated from uveitis by slit lamp
(4) Intraocular tumors

Question 10

What labs/studies would you do for a pt with iritis?

Answer 10

• Complete ocular examination

- Labs (if required) are targeted for suspected etiology (e.g. sarcoidosis, syphilis, and TB in at-risk patients)

Question 11

Complications for Iritis

Answer 11

(1) Loss of vision

(2) Retinal necrosis