Uveitis Flashcards
Anatomical classification of uveitis
Anterior (iris+ pars plicata) iridocyclitis
Intermediate (para plana) para planitis
Posterior (choroiditis)
Panuveitis (all 3 parts)
Pathological classification of uveitis
Granulomatous and non-granulomatous
D shaped pupil in
Iridocyclitis
Due to disinsertion of iris due to weakening of roof of iris
Anterior uveitis clinical features
Pain Redness Photophobia Blepharospasm Discharge (watery)
Examination findings in anterior uveitis
Just the names briefly
Keratin precipitates Aqueous cells Aqueous flare Muddy iris Bussaca and koeppe’s nodules Miosis Post synechae - secclusio and occlusio pupillae Festooned shaped pupil Peripheral anterior synechae
Iris bombe
What is arlt’s triangle
KPs are maximum in lower part of cornea
Due to convection current in aqueous humour
Why does miosis happen in uveitis
Due to release of toxins from inflamed tissue
What kind of pupil in angle closure glaucoma
Mid dilated pupil
Uveitis pupil shape
Constricted pupil
TOC of anterior uveitis
Topical steroids
Role of cyclopegics in anterior uveitis
Relieves pain and gives rest to the inflamed tissue
Prevents posterior synechae
Break posterior synechae
Relieves spasm (better blood supply and better healing,gives rest to ciliary muscles)
Which drug is ONLY a mydriatic
Phenylephrine
Active mydriasis
Strongest mydriatic
Atropine
Luminate program
Non-steroidal treatment of uveitis
Voclosporin
Intermediate uveitis
Inflammation of vitreous and peripheral retina along with para plana
Etiology of intermediate uveitis
Idiopathic (more than 70%)
Infective – TB, Leprosy, syphilis
Non-infective-sarcoidosis,Multiple sclerosis
Clinical features of intermediate uveitis
Blurred vision
Painless floaters
Examination findings of Intermediate uveitis
Decreased visual acuity Retrolental flare few KP Snowballs Snow banking – fibro vascular and exudative plaque (pathognomic) Periphlebitis (hallmark)
Most complication of pars planitis
Cystoid macular edema
Step ladder approach for intermediate uveitis
Local steroids
Systemic steroids
Immunosuppressive drugs
Para plana vitrectony
Posterior uveitis features
Choroiditis-round yellow patches Vitritis-haziness and flare Papillitis-inflammatory optic neuritis CME Retinal edema Periphlebitis
Some causes of non-granulomatous anterior uveitis
Ankylosis spondylitis
Psoriatic arthritis
Reuter’s syndrome
JRA-juvenile rheumatoid arthritis
Reiter’s syndrome
Arthritis
Conjunctivitis
Urethritis
Still’s disease
Systemic onset JRA (16 yrs)
What is white uveitis
Atypical anterior uveitis (5 features of uveitis absent)
Occurs in early onset pauciarticular seronegative JRA associated with uveitis
Complications of JRA
Complicated cataract
Secondary glaucoma
Band shaped keratopathy
Candle wax dripping present in
Venous sheathing
Occurs in sarcoidosis
Ocular features of sarcoidosis
Sarcoidosis nodules (episclera/sclera)
Interstitial keratitis
Band shaped keratopathy
Granulomatous panuveitis
What is Behçet’s disease
Obliterative vasculitis due to circulating immune complexes
Behçet’s disease genetic predisposition
HLA B5
HLA B51
Transient hypopion syndrome seen in
Behçet’s disease
Non-granulomatous anterior and posterior uveitis
Eeles disease also known as
Periphlebitis retinae
Clinical features of eales disease
(Hypersensitivity reaction of TB antigen) Diminution of vision/floaters Recurrent vitreous haemorrhage Venous sheathing (Non-granulomatous posterior uveitis)
Management of eale’s disease
ATT
management of vitreous haemorrhage
Partial-postural management (propped up position)
Total-pars plana vitrectomy
(Non-granulomatous posterior uveitis)
MC ocular feature in HIV
HIV induced microangiopathy
- haemorrhage
- micro aneurysm
- cotton wool spots
MC opportunistic infection
CMV retinitis
(Sauce and cheese retinopathy)
(Pizza)
Other opportunistic infections and what do they cause
Toxoplasmosis
Pneumocystis carinii
^^ choroiditis
Herpes zoster
^^ acute retinal necrosis
HAART therapy
MC ocular side effect
Immune recovery uveitis
Non-granulomatous/posterior uveitis
Headlight in fog appearance
Toxoplasmosis
Treatment of toxoplasmosis
Clindamycin
Syphilis fundus findings
Salt and pepper fundus (diffuse chorioretinitis)
Juxtapapillary choroiditis
TB ocular manifestation
Granulomatous panuveitis
MC allergic manifestation of TB-phlyctenular keratoconjunctivitis
MC ocular feature of TB-uveitis
VKH syndrome (vogt koyanagi harada)
Granulomatous panuveitis + systemic feature (Encephalitis Vestibular dysfunction Tinnitus Alopecia Poliosis Vitiligo)
Sympathetic ophthalmitis
Perforating injury in one eye(exciting eye) causing uveitis in the other eye (sympathising eye)
Etiology of sympathetic ophthalmitis
Autoimmune reaction towards uveal tissue
Clinical features of sympathetic ophthalmitis
Granulomatous panuveitis Dalen Fuch nodules Retrolental flare Decreased accommodation Photophobia
Where is dalen fuch norules present
Bruchs membrane
First sign on sympathetic ophthalmitis
Retrolental flare
First symptom of sympathetic ophthalmitis
Decreased accommodation
Photophobia
What is the dangerous area of eye
Ciliary body
Any trauma to CB is a big risk of sympathetic ophthalmitis
Fuch’s heterochromic cyclitis type of uveitis + other features
Atypical anterior uveitis Heterochtomia iridis (involved eye-hypochromic)
Type of uveitis in fuch’s heterochromic cyclitis
Non-granulomatous anterior uveitis
Examination findings in fuch’s heterochromic cyclitis
Rubeosis iridis
Stellate KP
Heterochromia iridis
Complications of fuch’s heterochromic cyclitis
Complicated cataract
Secondary glaucoma
Amslers sign
Present in fuch’s heterochromic uveitis
Blood in anterior chamber on paracentesis
Due to rubeosis iridis at angle of AC
Type of uveitis and TOC of onchocerciasis
Non-granulomatous ant/post
TOC-Ivermectin
Opthalmia nodosum
Intense granulomatous inflammation
Caterpillar hair in the eye
