Uveitis Flashcards
What is the most common form of uveitis?
Anterior uveitis
What is anterior uveitis?
inflammation of the anterior uvea.
What does the uvea consist of?
The iris, ciliary body and choroid.
What are the 3 types of uveitis?
1) Anterior
2) Intermediate
3) Posterior
What is a hypopyon?
A fluid collection containing inflammatory cells seen at the bottom of the anterior chamber on inspection.
What is the most common cause of anterior uveitis?
Systemic autoimmune disease e.g. IBD, sarcoidosis, reactive arthritis, ankylosing spondylitis & Bechet’s disease
Presentation of anterior uveitis?
- Painful red eye (typically a dull, aching pain)
- Acute onset
- Visual acuity initally normal then progresses to reduced
- Photophobia (due to ciliary muscle spasm)
- Excessive lacrimation (tear production)
Exam findings in anterior uveitis?
1) Ciliary flush (a ring of red spreading from the cornea outwards)
2) Miosis (a constricted pupil due to sphincter muscle contraction)
3) Abnormally shaped pupil due to posterior synechiae (adhesions) pulling the iris into abnormal shapes
4) Hypopyon (inflammatory cells collected as a white fluid in the anterior chamber)
What is a ciliary flush?
A ring of red spreading from the cornea outwards
Why is the pupil abnormally shaped in anterior uveitis?
Due to posterior synechiae (adhesions) pulling the iris into abnormal shapes
Mx of anterior uveitis?
1) Refer for urgent assessment and management by an ophthalmologist.
2) Steroids (eye drops, oral or IV)
3) Cycloplegics (e.g., cyclopentolate or atropine eye drops)
Role of cycloplegics in anterior uveitis?
Dilate pupil & reduce pain associated with ciliary spasm.
What does cycloplegic refer to?
paralysing the ciliary muscles
What class of drugs are cyclopentolate and atropine?
Antimuscarinics (reduce the action of the iris sphincter muscles and ciliary muscles).
What are posterior synechiae?
Adhesions between the iris and lens.
These can lead to pupil distortion, iris bombe, and angle-closure glaucoma.
