Uveitis Flashcards
uvea parts
Choroid, iris, ciliary body
Choroid location
from ora serrata to optic disc
Choroid job
vascular supply + absorb reflecting light
Choroid layers
external to interna:
- Hallers layer (large vessels)
- Sattler’s layer (medium vessels)
- Choriocapillaries (capillaries)
- Bruch’s membrane
Iris zones
Pupillary zone - inner most from pupillary margin to collarette. sphincter pupillae (CN3)
Ciliary zone - outer part from collarette to iris origin. dillator pupillae (sympathetic via ciliary nerve)
Ciliary body parts
Pars plicata - anterior, finger like projection. function: accommodation, aqueous humour production and drainage
Pars plana - avascular, between ora serrata and ciliary processes. no function. used for intravitreal injections or pars plana vitrectomy
Parasympathetic nerve supply to ciliary body
Edinger westphal nucleus of CN3 - ciliary ganglion - short ciliary nerve - contraction of ciliary body and laxing of zonular fibres (thick lens)
Sympathetic nerve supply to ciliary body
Hypothalamus - sympathetic chain - superior cervical ganglion - nerves tagging along with ICA or CNV1 - long ciliary nerve - relaxation of ciliary body, tight zonular fibres (lens flat)
Uveitis classification
Anterior - iris and pars plicata
Intermediate - pars plana to vitreus
Posterior - chorioretinitis
Pan uveitis - all
Anterior uveitis
HLA B27 (psoriasis, ankylosing spondylitis etc), sarcoid or infection (TB, syphilis, lyme disease, VZV)
risk of angle closure glaucoma, posterior synechchiea
Fx: acute painful red eye, photophobia, irregularly meiosed pupil.
Anterior uveitis
Granulomatous vs non-granulomatous
Granulomatous - chronic > 3months, mutton fat KP
Non- granulomatous - acute, stellate KP
Intermediate uveitis (pars palan)
painless blurry vision and floaters
Fx:
- snowballs floaters in inferior vitreous
- snowbanking exduates on ora serrata (seen on indirect ophthalmoscopy with scleral depression)
Onchocerciasis (onchocerca volvulous)
- Africa, river blindness
Vectro : simulium black fly
Fx: maculopapular rash, panuveitis, keratitis
Dx: nematodes on retroillumination
Mx: ivermectin
Toxocariasis (toxocara cani)
- Most common cause of childhood leukocoria
host: dog
Fx: endophthalmitis
Diagnosis: ELISA, calcification on CT differentiates from retinoblastoma
Mx: steroids
Toxoplasmosis
Most common cause of childhood chorioretinitis
Host: cats
Fx: congenital toxoplasmosis: hydrocephalus, intraretinal calcium deposits, chorioretinitis
In AIDS - anterior uveitis
mx: Pyrimethamine
Sarcoidosis
black woman.
hilar lymphadenopathy, parotid gland enlargement, CN7 palsy
periretinal granuloma (Lander sign)
raised ACE and hypercalcaemia
Sickle cell retinopathy non-proliferative
Sickle cell retinopathy proliferative
sea fan neovascularisation
vitreous haemorrhage, retinal detachment
Goldberg classification!!
