Uveitis

Question 1

Name the types of uveitis

Answer 1

anterior- Iris + cillary body
intermediate - Cillary body
Posterior - choroid
pan uveitis - iris to choroid

Question 2

What are the risk factors

15

Answer 2

Autoimmunie conditions:

1) ankylosing spondylitis (spine = inflamed)
2) Reactive arthritis (inflammation of body)
3) Chron’s disease / Ulcerative colitis (bowel inflammation)
4) Behcets disease (ulcer )
6) Sarcoidosis (inflammatory condition, lungs, skin, eyes)
5) juvenile idiopathic arthritis - ( kids)

Infection

1) Toxoplasmosis
2) Herpes simplex virus
3) varicella zoster virus - ( chicken pox)
4) Cytomegalovirus (common infection low immune system px = sight threatening uveitis)

5) Tuberculosis
6) Hiv and Syphilis

other causes

1) trauma / injury eye/ sx
2) cancer - non- hodgkins lymphoma

Gene HLA-B27 - anterior uveitis

Question 3

What are the symptoms of anterior Uveitis (7)

Answer 3

1) Red eye
2) Unilateral (usually)
3) Rapid onsent
4) Pain (behind the eye)
5) reduced vision
6) photophobia
7) Epiphora (watery eyes)

Question 4

What are the signs of anterior Uveitis

Answer 4

1) Hyperaemia ciliary flush
2) Keratic precipitates ( mutton fatts)
3) Cells (WBC active) & Flare ( protein {no cells= not active inflammation})
4) Hypopyon
5) Iris Nodules - Bussca (away from pupil border, yellow lumps) , Koeppe (at pupil border)
6) anterior synechiae- between iris and posterior cornea
7) posterior adhesions - iris and lens

Question 5

Optometrist management of Anterior uveitis

Answer 5

Urgent 1 week

EMERGENCY IF:

1) VA reduced
2) Severe pain
3) Raised IOP

• Advise sun rx (photophobia)
• Cycloplegia = stops synechia + symptom relief
• painkillers

Reoccurring ?
consider near add for cycloplegia ( stops ciliary spasm )

Question 6

Ophthalmologist Management- Anterior uveitis

Answer 6

Cycloplegia
Topical steriods
Treat secondary glaucoma
Systemic immunosuppression

Question 7

Intermediate Uveitis - Symptoms

Answer 7

1)Bilateral
2)Eye - Quiet
3)Hazy Vision
4)Floaters
5) Redcued VA
(Macular oedema)

Question 8

Signs - Intermediate Uveitis

Answer 8

• Yellow exudates (peripheral retina + scleral indentation)
• exudates break off forming snow breaks (inferior)
• exudates break off @ vitreous = floaters

Question 9

Management of Intermediate Uveitis

Answer 9

EMERGENCY

Question 10

HES management-Intermediate Uveitis

Answer 10

Steroid drops
Steroid Injection
Immunosuppressives
Vitrectomy

Question 11

Complications Intermediate Uveitis

Answer 11

2ry glaucoma
PSC
Vitreous detach/ Haemorrhage 
RD/ RT/RB
Macula Oedema
OD Oedema

Question 12

Posterior Uveitis

Answer 12

Retinitis
Choroiditis
Vasculitis
birdshot uveitis