Uveitis Flashcards
What is Uveitis?
Inflammation of one of all parts of the uvea or the vascular area between the retina + sclera
What is the Uvea composed of?
Iris
Choroid
Ciliary body
List the inflamed areas in the 3 types of uveitis
Anterior: iris + ciliary body
Intermediate: posterior ciliary body + pars plana
Posterior: posterior vitreous, retina, choroid, retinal vasc + optic nerve
Describe 3 aetiological causes of of uveitis with examples. What do these have in common?
Infection (e.g. HSV, CMV, HIV, TB, Toxoplasmosis, syphilis)
Manifestation of systemic inflammatory conditions (e.g. reactive arthritis, ankylosing spondylitis, IBD, sarcoidosis, Behcet’s disease, MS, + eye trauma)
Idiopathic
All due to an inflammatory response within the uvea
Describe the epidemiology of uveitis
Uveitis associated with spondyloarthritis is twice as common in MALES as females
List 3 risk factors for uveitis
Systemic inflammatory diseases
HLA-B27 positive
Hx of ocular trauma
List 4 symptoms of anterior uveitis
Pain due to inflammation
Pain during accommodation
Photophobia
Red eyes: no discharge
List 2 symptoms of posterior or intermediate uveitis
Blurred vision
Floaters
List 7 signs of anterior uveitis
Flare: Hypopyon (fluid level of leukocytes)
Synechia: Adhesions of iris to lens or cornea
Slit Lamp: keratic precipitates (leucocyte deposits on the corneal endothelium)
Ciliary flush: redness in the eye due to dilation of vessels spreading out from the cornea of the eye
Corneal oedema
Signs of underlying aetiology
List 3 signs of posterior or intermediate uveitis
Reduced visual acuity
Constricted/ non-reactive pupil
Decreased IOP
What symptoms are common to all types of uveitis?
Lacrimation: no discharge
Rarely associated with tubulointerstitial nephritis (causing flank pain, haematuria, proteinuria)
How is uveitis diagnosed?
Clinically with fundoscopy + slit lamp exam
What investigations should be considered in uveitis?
FBC: high WBC (infection)
ESR + CRP (inflammation)
Ix for associated systemic conditions (e.g. spondyloarthritides: sacroiliac joint X-ray, HLA-typing, RF etc)
What is sympathetic Ophthalmia?
Inflammation of the contralateral eye weeks/months after penetrating injury
Due to recognition of eye antigens in the contralateral eye by T-cells that were activated by the initial penetrating injury to the opposite eye
What is seen on fundoscopy in posterior or intermediate uveitis?
Retinal exudates + oedema
Optic nerve oedema
Retinal vasc sheathing (acc of inflam cells along vessel walls)
Retinal haemorrhages
