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opthalmology > uveitis > Flashcards

uveitis Flashcards

1
Q

what are the components of the uveal tract ?

A

iris
the ciliary bodies
the choroid

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2
Q

what arethe types of the uveitis ?

A

anterior uveitis - iris and ciliary body
intermediate uveitis - the ciliary body
posterior uveitis - choroid +/- retina
panuveitis - all of the uveal tract

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3
Q

what is thee most common cause of non-infectious uveitis ?

A

idiopathic

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4
Q

what are the non infectious causes of uveitis ?

A

juvenile idiopathic arthritis
sero negative arthritis
IBD
Sarcoidosis
Behcet
VKH

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5
Q

what are the infectious causes of uveitis ?

A

syphillus
HSV
TB
leprosy
Lyme diseasee
Rubella

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6
Q

what are the symptoms of anterior uveitis or iridocyclitis ?

A

severe pain
drop in vision
photophobia

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7
Q

what are the signs associated with anterior uveitis ?

A

aqueous flares
keratic precipitates
posterior synechiae / festooned pupil
fibrinous reactions
hypopyon

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8
Q

what is the initial treatment for anterior uveitis ?

A

cycloplegia : to alleviate the pain along with prevention of posterior synchaecia - atropine
topical corticosteroids : dexamethasone or prednisolone

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9
Q

what is thee triad associated with behcets disease ?

A

aphthous oral ulcers
genital ulcers
uveitis

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10
Q

what is the genetic association in behcet’s disease ?

A

HLA-B51
associated with people originating from the “silk road” route

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11
Q

what are the ocular features associated with Behcet’s ?

A

retinal vasculitis
vitritis
optic neuropathy
Acute anterior uveitis
transient hypopyon

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12
Q

what type of disease is VKH ?

A

idiopathic multi-system autoimmune disease
thought to be autoimmune against melanocytes

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13
Q

what type of uveitis is associatedd with VKH ?

A

granulomatous panuveitis
that is bilateral and shows exudative Retinal detachement and disc oedema
sunset glow fundus

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14
Q

what are the accompanying signs associated with VKH ?

A

neurological symptoms - headache and neck sttiffness
skin manifestations - vitiligo , alopecia, poliosis
auditory disturbances - deafness and tiinnitus

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15
Q

what is JIA ?

A

juvenile idiopathic arthritis is arthritis of unknown aetiology that takes place before the onset of 16 years of age for at least 6 weeks

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16
Q

what is the commonest systemic disease associated with anterior uveitis in children ?

A

JIA

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17
Q

what is the most common form of JIA ?

A

oligoarticular form
affecting 4 joints or less
most commonly the knees followed by the ankles and wrists

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18
Q

whatare the occular manifestayions in JIA ?

A

iritis develops first but is asymptomatic
ocular complications which happen afterward include band keratopathy, cataract and glaucoma if iritis is not recognized

19
Q

what is the management for patients diagnosed with JIA ?

A

need 3 monthly regular follow up by the ophthalmologist
especially those with oligoarticular form ( same as pacuiarticular form)

20
Q

what are the characteristics of Ankylosing spondylitis ?

A

characterized by : inflammation , then calcification and finally ossification of the ligaments and capsules of the bonees of thee axial skeleton

21
Q

what age group is associated with AS ?

A

middle aged men

22
Q

what is the genetic association with ankylosing spondylitis ?

A

HLA-B27

23
Q

what are the bony deformities associated with AS ?

A

sclerosis of the sacroiliac joint
fixed flexion deformity

24
Q

what are the features of psoriatic arthritis ?

A

scaly skin lesions
also HLA-B27 positive
anterior non granulomatous uveitis
recurrent attacks

25
Q

immune mediated scleritis ?

A

think rheumatoid arthritis

26
Q

what are the features of rheumatoid arthritis ?

A

autoimmune joint diseases
affecting small joints of the hand ( hand deformities )
more common in females

27
Q

what are the ocular manifestations associated with RA ?

A

keratoconjunctivitis sicca
marginal corneal ulcers ( collagen affection )
scleritis
episclerits

28
Q

what are the hand deformities associated with RA ?

A

swan neck deformity - PIP flexed
Boutonniere deformity- DIP flexed

29
Q

what type of disease is sarcoidosis ?

A

multisystem non-caseating granulomatous disease

30
Q

what are the systemic manifestations in sarcoidosis ?

A

bilateral hilar lymphadenopathy
lung infiltrates
ereythema nodosum
thoracic lymphadenopathy
occular manifestations

31
Q

what are the occular manifestation in sarcoidosis ?

A

granulomatous anterior uveitis
KP mutton fat
iris nodules
lacrimal gland involvement ( enlargement )- dry eyes
patchy venous sheaths
chorioretinal granuloma
vitritis - vitreous opacities called snowball or pearls on a string

32
Q

what is seen on FFA in cases of sarcoidosis ?

A

sheathing of the retinal veins
leakage and staining at the site of sheathing

33
Q

what are thee findings on chest x ray in sarcoidosis ?

A

pulmonary mottling
bilateral hilar lymphadenopathy

34
Q

what other iinveestigations should be performed in cases of suspected sarcoidosis ?

A

serum ACE levels - elevated
Mantoux test - but may be negative in patients with BCG vaccine
Lung function test
Gallium Scan - increased uptake in the parotid, lacrimal and pulmonary regions

35
Q

what is the treatment for sarcoidosis ?

A

systemic steroids especially in posterior segment disease where vision is threatened

36
Q

what is endophthalmitis ?

A

ocular inflammatory responsee caused by the invasion of intraocular structures by replicating organisms

37
Q

what are the types of acute endophthalmitis ?

A

endogenous - hematogenous spread from the body
exogenous - post-op or blunt/peenetrating occular trauma

38
Q

what is the most common cause of acute endophthalmitis ?

A

post-operative
followed by bleb related causes

39
Q

what is a bleb ?

A

surgically made “door” that allows drainage of fluid from the eye to treat glaucoma

40
Q

what is the most common causative organism associated with endophthalmitis ?

A

staph. epidermidis

41
Q

what is the presentation of acute post operative endophthalmitis ?

A

1-7 days after the surgery
rapid drop in vision
corneal oedema
flare and severe exudation

42
Q

what does ocular adnexa mean ?

A

all the orbital contents except the globe and optic nerve

43
Q

what are the risk factors associated with acute post operative endophthalmitis ?

A

complicated surgery
diabetics
sutureless surgery
suturless dead temporal wounds

44
Q

what is the treatment for acute post operative endophthalmis ?

A

immediate intra-vitreal antibiotics
( vancomycin and ceftazidime)
after a vitreous sample has been taken
vitrectomy in severe cases with vision of hand movement or less

opthalmology (14 decks)

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