Uveitis Flashcards
What is uveitis?
broad term for inflammation of one or all parts of uvea, or vascular area between the retina and sclera of the eye
What is included in uvea?
choroid, ciliary body and iris
What is anterior uveitis?
involves inflammation of the iris and ciliary body
What is intermediate uveitis?
involves the posterior ciliary body and pars plana
What is posterior uveitis?
Inflammation of:
- Retina
- Choroid
- Retinal vasculature
- Optic nerve
What is acute uveitis?
sudden onset (hours or days)
What is recurrent uveitis?
repeated episodes separated by disease inactivity ≥3 months, whether on or off treatment
What is chronic uveitis?
persistent uveitis (>3 months’ duration) characterised by relapse within 3 months of therapy termination.
What are causes for uveitis?
- idiopathic
- associated with human leukocyte antigen-B27-related disease
- viral eye disease
What are RF for uveitis?
- Inflammatory disease
- HLA-B27 positivity
- Ocular trauma
- Immunosuppresion
What type of uveitis is most common?
- Anterior uveitis most common
2. Infectious uveitis common in developing countries
What are symptoms and signs of uveitis?
- Pain (anterior uveitis)
- Decreased vision (intermediate and posterior)
- Synechiae
- Flare: hallmark of anterior uveitis
- Keratic precipitate
- Tearing
- Photophobia
- Eye redness without discharge
What are classic anterior uveitis signs?
- Pain
- Flare
- redness
- photophobia
- tearing
What are possible DDx for uveitis?
- Ocular lymphoma
- Leukaemia
- Intra-ocular solid tumours
- Intra-ocular foreign body
- Ocular ischaemia syndrome
What are investigations for uveitis?
clinical diagnosis
What is the management plan for uveitis?
- Potentially blinding conditions so refer to ophthalmologist
- Corticosteroid eye drops + management of any underlying disease e.g. prednisolone
What are possible complications of uveitis?
- Synechia
- Retinal scarring
- Cataract
- Band keratopathy
- Macular oedema
- Glaucoma
- Choroidal neovascularisation
- Retinal detachement
What are symptoms of posterior uveitis?
- floaters
- decreased vision
- photophobia
- often asymptomatic
What are some common causes for anterior uveitis?
- Ankylosing spondylitis
- Crohn’s disease
- Juvenile idiopathic arthritis
- Psoriatic arthritis
What are some common cause of posterior uveitis?
- HSV
- Herpes Zoster
- TB
What are 4 types of uveitis?
anterior, posterior, complete, intermediate
What are causes of anterior uveitis?
- Idiopthic
2. Associated with non-infectious, autoimmune systemic disease
What non-infectious, autoimmune systemic disease is anterior uveitis associated with?
- seronegative spondyloarthropathies
- RA
- Sarcoidosis
- IBD
- HLA-B27 associated conditions-SLE
- Reactive arthritis
- Behcet’s disease
What are symptoms of anterior uveitis?
- Pain: dull and progressive
- Flares
- Photophobia
- Lacrimation
- Decreased visual acuity
- Eye redness
What is hypopyon?
medical condition involving inflammatory cells in the anterior chamber of the eye – one key thing to look out for during flares
What investigations are done for uveitis?
- slit lamp
- other than slit lamp examination, mostly clinical Dx (don’t need Ix) – can do smear and cytology if infectious cause suspected
What would be found on a slit lamp for anterior uvetitis?
- Keratic precipitates (leukocytes) in anterior chamber
- Protein in aqueous humour
- General signs of inflammation of iris (red eye, hypopyon)
What would be found on posterior uveitis slit lamp?
- Leukocytes in vitreous humour
2. Inflammation of choroid and retina
What is management for uveitis?
- Corticosteroids (drops)
- Cycloplegic eye drops
- Simple analgesia for anterior
- Antibiotic or antiviral therapy if infectious cause
When would you use corticosteroid drops?
- Can use systemic/oral steroids if symptoms persist
2. Treats the underlying inflammatio
When would you use cycloplegic eye drops?
- Relieves pain caused by the spasm of muscles
2. Prevents formation of synechiae
What is synchiea?
Synechiae are at pupil margin where iris is adherent to the anterior lens capsule which prevents dilation and makes cataract surgery harder
