UVEAL TRACT

Question 1

1.Uveal layer provides nutrition to the outer part of retina upto the _____ layer.

2. Uveitis classification!

Answer 1

1. Outer plexiform layer.

2.Anterior uveitis(iris + pars plicata)
Iritis
Iridocyclitis
Anterior cyclitis

Intermediate uveitis(pars plana+vitreous)
Pars planitis
Posterior cyclitis
Hyalitis

Posterior uveitis(choroid +retina)
Choroiditis
Retinochoroiditis
Chorioretinitis

Question 2

1. Which form of uveitis is the most common?
2. A 38 years old female presented with sudden onset of pain,decreased vision, photophobia and lacrimation. On examining the eye you noticed marked ciliary congestion,miotic pupil and keratic ppt. The iris is muddy . Red reflex is poor and there is posterior synechiae formation. What is your dx And how would you treat this patient?

Answer 2

1. Anterior uveitis
2. Acute iridocyclitis (acute inflammation of iris and ciliary body)

3.Topical cycloplegics e g atropine
Steroids
NSAIDS
antimetabolites
Cyclosporins (in behcet disease)
Antibiotics
Intravitreal steroid injection

Question 3

1. Chronic iridocyclitis is characterized by persistent inflammation that relapses in ______ months.

2.which type of keratic ppt are present in chronic iridocyclitis?

3. Which type of iris nodules are present in chronic iridocyclitis?
4. Complications of iridocyclitis?

Answer 3

1. Less than 3 months.

2.mutton fat KP.

3.koeppe nodules…. at pupillary margin
Busacca nodules…on iris surface

4. Cataract
   Secondary glaucoma
   CME
   RD
   Hypotony
   Vitreous opacities

Question 4

1.What are s/s of intermediate uveitis?

2.vitritis characteristics in intermediate uveitis?

3. Retinal findings?
4. Treatment of intermediate uveitis?

Answer 4

1. Inflammation of pars plana and vitreous.
   Slow onset of floaters and reduced vision occurs .

2.snowballs..agg of inflammatory cells
Snowbanking … accumulation of inflammatory exudate

3.peripheral periphlebitis and optic disc swelling .
Retinal neovascularization ,CME,RD may occur as complications.

4.periocular/ intravitreal steroid injection
Systemic immunosuppressants
Intra vitreal VEGF
Surgery
Laser photocoagulation
Cryotherapy
Pars plana vitrectomy

Question 5

A 45 years old man presented to opd with chief complaints of gradual visual loss for last 3 months. He also complains of metamorphopsia and macropsia. He has positive hx of sarcoidosis.What is your dx?

2. In which infection does retina show satellite lesions(active disease) and healed punched out pigmented scars(inactive lesion) in retina?
   How would you treat such patient?
3. What is the feature of tuberculous uveitis?

Answer 5

1.Posterior uveitis.

2. Toxoplasmosis.
   TTT….active lesion is treated by combination of Prednisone, pyrimethamine and sulfadiazine

3.mutton fat KP
Vitritis
Disseminated choroiditis is shown as tubercles(yellow lesions) and tuberculoma(whitish lesion)
RD.

Question 6

Difference bw endopthalmitis and panopthalmitis

Answer 6

Endopthalmitis is inflammation of intraocular structures. Panopthalmitis is inflammation of whole eyeball including tenon’s capsule

Endopthalmitis is caused by trauma,perforating injury, intraocular surgery.Panopthalmitis is caused by uncontrolled endopthalmitis.

In endopthalmitis,ocular pain, congestion,swollen eyelids,hazy cornea and hypopyon are present. In panopthalmitis above features are pronounced along with restriction of extra ocular movements.

Endopthalmitis is treated by intra vitreal antibiotics and lastly pars plana vitrectomy.
Panopthalmitis is TTT by antiinflammatory and topical ND systemic antibiotics. At end evisceration operation

Question 7

Difference bw
Evisceration
Enucleation
Eccentration

Answer 7

In evisceration,all contents of eyeball are removed leaving behind sclera and muscles.

In enucleation we remove everything except extraocular muscles.

In eccentration we remove everything including muscles

Question 8

1.What is sympathetic ophthalmitis?

2.what is Fuchs uveitis syndrome?

3. What are ocular findings in AIDS ?

Answer 8

1. It is a bilateral granulomatous panuveitis occuring after penetrating ocular injury . The traumatizing eye is called exciting eye and the fellow eye which develops uveitis is called sympathizing eye.

2.it is a non granulomatous low grade iridocyclitis characterized by
Diffuse distribution of KPs
Absence of synechiae
and heterochromic of iris.

3.Iritis is the most common presentation on AIDS.
Characterized by cotton wool spots,Roth spots and retinal micro aneurysms and hemorrhage.