Red Eye 3

Question 1

Uveitis”

Answer 1

•   Inflammation of the uveal tract”
•   Anterior uveitis”
•   Accompanies many autoimmune diseases “

Question 2

•  Inflammation of the uveal tract”

Answer 2

– Uveal tract composed of the iris, ciliary body,
and choroid”
– Middle vascular layer of the eye, protected
externally by the cornea and sclera”
– Contributes to the blood supply of the retina”

Question 3

•  Anterior uveitis”

Answer 3

– Preferred term for iritis and iridocyclitis"
–  Most common form of uveitis"
– Symptoms:"
•  Usually unilateral"
•  Hx of pain"
•  Photophobia"
•  Blurring of vision"
•  Red eye (circumcorneal flush)"
•  Small pupil"
–  Tx: dialate pupil to prevent posterior synechiae (adhesion of 
posterior iris to lens"

•  The uveal tract. So iritis, iridocyclitis and anterior
uveitis are synonyms.
•  At risk: HLA-B27, CT diseases, past attacks,
juvenile arthritis, sarcoid.
•  PAIN, then photophobia then visual loss.
•  Ciliary flush. As it gets worse the pupil gets small
and reactions get sluggish, hypopyon, keratitis
(back of cornea). These are markers of progress &
are bad news.
•  Refer all.

Question 4

•  Accompanies many autoimmune diseases “

Answer 4

–  There is often no correlation between ocular & systemic
inflammatory activity.”
–  Uveitis in 25% of pt with ankylosing spondylosis”
–  Uveitis or conjunctivitis in all cases of Reiter’
s”
–  Anterior uveitis develops in 2-12% of pts with IBS and pts with
psoriatic arthritis (not with psoriasis alone”
–  Symptoms:”
•  Decreased vision and photophobia”

Question 5

Posterior Uveitis”

Answer 5

•    Preferred term for choriditis or chorioretinitis”

*   Retina almost always secondarily affected

Question 6

Anterior Uveitis”

Answer 6

•  Two types of uveitis based on clinical and
pathologic basis: – Non-granulomatous (Anterior)”
– Granulomatous (Posterior)”

Question 7

– Non-granulomatous (Anterior)”

Answer 7

•   More common”
•   Pathologic organisms not been demonstrated”
•   Responds to corticosteroid therapy”

•  Mainly occurs in anterior uveal tract (iris & ciliary
body)”
•  Severe cases may see hyphema or hypopyon”

Question 8

– Granulomatous (Posterior)”

Answer 8

•  Follow invasion by M. tuberculosis or Toxoplasma
gondii, T. pallidum, sarcoidosis”

•  May involve any part of uveal tract but has a
predilction for the posterior uvea

Question 9

Anterior Uveitis”

Answer 9

Inflammation of the iris or ciliary body can
lead to closure of the Canal of Schlemm
and result in closed angle glaucoma”

Question 10

Cataracts”

Answer 10

•  Opacification of the lens”
–  Leading cause of blindness in the world”
–  Leading cause of vision loss in Americans over 40”
–  Majority of cases represent normal aging changes”
•  Progressive yellowing of the lens nucleus”
•  Hydration of the lens cortex”
– Prolonged exposure to uv radiation shown to be
cataractogenic

•  Mature swollen cataracts may narrow anterior
chamber angle leading to glaucoma”

•  About half of Americans older than 65 have some degree
of clouding of the lens”
•  According to one study, after age 75, 39% of men, and
46% percent of women in the U.S. have visually
significant cataracts

•  Cataracts produce a gradual, painless, progressive loss
of vision, and many patients are unaware of vision
problems”
•  Generally do not cause pain, or abnormal tearing”
•  But as the clouding progresses, the cataract eventually
interferes with your vision

•  Commonly affect distance vision”
•  Cause problems with glare”
•  In the early stages, stronger lighting and
eyeglasses can help deal with the vision
problems”
•  If impaired vision jeopardizes your normal
lifestyle, you might need surgery

•  Patients often 
describe trying to 
look through a 
fogged-up window "
•  Clouded vision can 
make it more difficult 
to drive a car, read, 
or see details"

Question 11

Symptoms of Cataracts

Answer 11

•   Blurred vision “
•   Increasing difficulty with vision at night “
•   Glare, especially at night “
•   Halos around lights “
•   The need for brighter light for reading”
•   Double vision in a single eye”
•   Fading or yellowing of colors

Question 12

Cataracts

Answer 12

Due to increase of 
yellow-brown 
pigment in the lens, 
color perception also 
is affected

•  These may also be symptoms of other eye
conditions, therefore it is important to see
your ophthalmologist annually, or if there is
a persistent change in vision “

Question 13

Hypermature Cataract”

Answer 13

•  A cataract isn't 
dangerous to the eye 
unless the cataract 
becomes completely 
white, a condition 
known as an overripe 
(hypermature) cataract "
•  This can cause 
inflammation, eye pain 
and headache "
•  A hypermature cataract 
is extremely rare and 
needs removal"