Ocular Inflammation Flashcards
what is Iritis/Anterior Uveitis?
Inflammation of the uveal tract (the iris, ciliary body and choroid)
what is the main cause of Anterior Uveitis?
Idiopathic
what are the seronegative arthropathic causes of Anterior Uveitis?
Ankylosing spondylitis, Inflammatory bowel disease, Psoriatic arthritis, Reiter’s syndrome
what are the infective causes of Anterior Uveitis?
TB, Syphilis, HIV, Herpes zoster, Toxoplasmosis, Toxocariasis
what are the autoimmune causes of Anterior Uveitis?
Sarcoidosis, Behcets
what are the malignant causes of Anterior Uveitis?
Non-Hodgkin’s lymphoma, Leukaemia, Retinoblastoma, Ocular melanoma
what are the clinical features of anterior uveitis?
- Ocular pain
- Photophobia
- Blurring of vision
- Redness –
- Cells/flare in anterior chamber
- Hypopyon
- Reduced visual acuity
- Small pupil – iris spasms and adhesions
- Posterior synechiae – pupil stuck to lens surface
- Posterior Uveitis – floaters, scotomas
what are the systemic symptoms associated with anterior uveitis?
Systemic symptoms depending on cough – respiratory symptoms, skin problems, joint disease, bowel disease, infectious disease
how is anterior uveitis diagnosed?
- Positive Talbots test – pain increases as eyes converge
* Investigate for underlying cause if bilateral or highly recurrent
what is management of anterior uveitis?
- Topical Steroids
* Topical Mydriatic
what is the cause of episcleritis?
Idiopathic
• Underlying systemic vascular disease – polyarteritis nodosa, granulomatosis
• Connective tissue disease – RA, rosacesa, atopy, GOUT, UC
what is episcleritis?
Benign engorgement of blood vessels
what are clinical features of episcleritis?
- Red eyes
- Nodules may occur/diffuse
- No discharge, less photophobia, then uveitis, gritty feeling
- Localised patch of injected sclera which blanches on application of phenylephrine
what is the management of episcleritis?
- Self limiting
- Topical lubricants or NSAIDs
- Topical prednisolone acetate
what are the causes of scleritis?
- Idiopathic
- Inflammatory
- Infectious - Herpes Zoster, syphilis, varicella
- Gout
- Other – surgery/trauma
what are the inflammatory causes of scleritits?
Collagen vascular disease (Rheumatoid Arthritis, Ankylosing Spondylitis, Systemic Lupus Erythematosus, Wegener’s granulomatosis, Polyarteritis nodosa), IBD, sarcoidosis
what is scleritis?
Inflammation of the sclera
what is the pathophysiology of scleritis?
- T cell driven inflammation
- Granulomatous disorder – fibroid necrosis with infiltration from macrophages
- Both inflammatory and ischaemic scleral lesions occur
what are the macroscopic features of scleritis?
Anteriorly the sclera may show diffuse or nodular swelling bt less commony a necrotising form occurs with full thickness tissue loss, uveal exposure and the risk of perforation
what are the two types of scleritis?
- Anterior – diffuse, nodular or necrotising
* Posterior
what are the clinical features of scleritis?
- Red eye
- Painful!!! – wake patient up at night, deep boring, radiate to jaw
- Lacrimation
- Photophobia
- Reduced visual acquity
- Injection of deep vascular plexus – vidaceous hue – blue/purple
- Posterior –
what are the complications of scleritis?
- Scleromalacia perforans
- Keratitis
- Uveitis
- Cataract Formation
- Glaucoma
what is the management of scleritis?
- NSAID
* Corticosteroids – oral prednisolone (if severe)
