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    Uveitis: by Karen Lynn Atuel

    Uploaded by

    Marian Joyce Princess Yuque
    Uveitis refers to inflammation of the uvea, which includes the iris, ciliary body, and choroid. It can be caused by infections like herpes or toxoplasmosis, autoimmune diseases, or unknown causes. There are four main types based on location: anterior, intermediate, posterior, and panuveitis. Symptoms vary depending on location but may include eye pain, blurred vision, and photophobia. Treatment involves topical corticosteroids, cycloplegics, or systemic corticosteroids depending on severity. Complications can include glaucoma, cataracts, and vision loss if not well controlled. Prognosis depends on severity and location, with anterior uveitis

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    Uveitis: by Karen Lynn Atuel

    Uploaded by

    Marian Joyce Princess Yuque
    76 views21 pages
    Uveitis refers to inflammation of the uvea, which includes the iris, ciliary body, and choroid. It can be caused by infections like herpes or toxoplasmosis, autoimmune diseases, or unknown causes. There are four main types based on location: anterior, intermediate, posterior, and panuveitis. Symptoms vary depending on location but may include eye pain, blurred vision, and photophobia. Treatment involves topical corticosteroids, cycloplegics, or systemic corticosteroids depending on severity. Complications can include glaucoma, cataracts, and vision loss if not well controlled. Prognosis depends on severity and location, with anterior uveitis

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    Uveitis refers to inflammation of the uvea, which includes the iris, ciliary body, and choroid. It can be caused by infections like herpes or toxoplasmosis, autoimmune diseases, or unknown causes. There are four main types based on location: anterior, intermediate, posterior, and panuveitis. Symptoms vary depending on location but may include eye pain, blurred vision, and photophobia. Treatment involves topical corticosteroids, cycloplegics, or systemic corticosteroids depending on severity. Complications can include glaucoma, cataracts, and vision loss if not well controlled. Prognosis depends on severity and location, with anterior uveitis

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    76 views21 pages

    Uveitis: by Karen Lynn Atuel

    Uploaded by

    Marian Joyce Princess Yuque
    Uveitis refers to inflammation of the uvea, which includes the iris, ciliary body, and choroid. It can be caused by infections like herpes or toxoplasmosis, autoimmune diseases, or unknown causes. There are four main types based on location: anterior, intermediate, posterior, and panuveitis. Symptoms vary depending on location but may include eye pain, blurred vision, and photophobia. Treatment involves topical corticosteroids, cycloplegics, or systemic corticosteroids depending on severity. Complications can include glaucoma, cataracts, and vision loss if not well controlled. Prognosis depends on severity and location, with anterior uveitis

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    © All Rights Reserved
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    of 21

    UVEITIS

    By Karen Lynn Atuel


    What is Uveitis?

    Clinical Findings

    Laboratory Testing

    Differential Diagnosis

    Complication & Sequelae

    Treatment and Complication

    Course and Prognosis


    WHAT IS UVEITIS?
    inflammation of the iris, ciliary body and choroid

    may occur secondary to keratitis, scleritis, or


    sclerokeratitis

    affects 20-50 yo

    10-20% of cases of legal blindess in developed


    countries
    Anterior Uveitis Intermediate Uveitis Posterior Uveitis Panuveitis

    CLINICAL FINDINGS
    most common type

    unilateral and acute in onset

    pain, photophobia, and blurred vision

    circumcorneal redness with minimal injection

    ANTERIOR
    of palpebral conjunctiva or discharge

    UVEITIS
    pupil: small or irregular
    decrease corneal sensation: herpetic uveitis 

    increase intraocular pressure: HSV, VZV, CMV,


    toxoplasmosis, syphilis, sarcoidosis or
    glaucomatocyclitic crisis

    keratic precipitate: clumps of white cells and


    inflammation debris on corneal endothelium

    iris nodule: Koeppe nodules, Busacca nodule, Berlin nodules

    iris atrophy or transillumination- sectoral or patchy pattern ANTERIOR


    anterior or posterior synechiae- predispose to ocular
    hypertension or glaucoma
    UVEITIS
    Nongranulomatous Granulomatous
    Ag-Ab reaction organismal invasion
    acute onset insidious onset
    pain: marked none or minimal
    photophobia: marked  slight
    blurred vision: moderate marked
    circumcorneal flush: marked slight
    keratic precipitates: small white large gray (mutton fat)
    pupil: small and irregular  small and irregular (variable)
    posterior synechiae: sometimes sometimes
    iris nodule: none sometimes
    site: anterior anterior, posterior, or panuveitis
    course: acute chronic
    recurrence: common sometimes
    Uveitis Associated
    with Joint Disease

    Fuchs
    Heterochromic Lens-induced

    ANTERIOR
    Iridocyclitis Uveitis

    UVEITIS
    ANTERIOR
    UVEITIS
    aka cyclitis, peripheral uveitis or pars planitis

    second most common type of intraocular


    inflammation

    bilateral, affects late teens or early adults

    floaters and blurred vision

    minimal or absent pain, photophobia, and redness

    most striking: vitritis often accompanied by vitreous


    condensates as "snowballs" or "snowbanking"

    cause is unknown in majority of cases INTERMEDIATE


    UVEITIS
    MC complication: cystoid macular edema, retinal
    vasculitis and neovascularization of optic disk and
    retina
    includes retinitis, choroiditis, retinal vasculitis,
    and papillitis

    occur alone or in combination

    floaters, loss of visual field or scotomas,


    decreased vision, retinal detachment

    POSTERIOR
    UVEITIS
    MORPHOLOGY OF SIGNS AND
    MODE OF ONSET
    THE LESION SYMPTOMS

    POSTERIOR UVEITIS
    POSTERIOR
    UVEITIS
    Tuberculosis Sarcoidosis Syphilis

    PANUVEITIS
    NOT REQUIRED: mild and recent history of trauma or
    surgery or with clear evidence of herpes simplex or
    herpes zoster infection

    DEFERRED: healthy, asymptomatic young to middle-aged


    patients with first episode of mild to mod severe acute,
    unilateral, nongranulomatous iritis or iridocyclitis that
    responds to topical corticosteroid and
    cyclopegic/mydriatic agents

    LABORATORY SHOULD BE TESTED: recurrent, severe, bilateral,


    granulomatous, intermediate, posterior, or panuveitis;

    TESTING
    fails to respond to standard therapy

    test for syphilis, sarcoidosis, TB

    based on history and PE: Juvenile idiopathic arthritis,


    psoriasis, urethritis, IBD, toxoplasmosis
    Keratitis- presence of epithelial staining or defects or by
    stromal thickening or infiltrate

    Conjunctivitis- presence of redness and discharge in both


    palpebral and bulbar conjuctiva

    Acute angle-closure glaucoma- markedly raised intraocular

    DIFFERENTIAL
    pressure, corneal haziness and edema, narrow anterior
    chamber angle

    DIAGNOSIS
    Anterior synechiae- impede aqueous outflow at the
    chamber angle and cause ocular hypertension or
    glaucoma

    Posterior synechiae- produce pupillary seclusion an


    forward bulging of the iris (iris bombe) and cause
    secondary angle-closure glaucoma

    Lens thickening and opacification-(early) shift in

    COMPLICATIONS
    refractive error towards myopia, (later) cataract

    Visual loss

    AND SEQUELAE Retinal detachment


    1% prednisolone acetate- 1-2 drops every 1-2 hrs while
    awake

    2% or 5% homatropine- 2-4 times daily

    noninfectious, intermediate, posterior and panuveitis:


    triamcinolone acetonide- sub-Tenon injection,
    1mL superotemporal
    intraocular triamcinolone acetonide- 0.05-0.1 mL
    oral prednisone- 0.5-1.5 mg/kg/d

    TREATMENT
    severe or chronic noninfectious inflammation:
    corticosteroid-sparing agents or TNF-alpha
    inhibitors
    Corticosteroid therapy: cataract and
    glaucoma

    Cyclopegic/mydriatic agents: weaken


    accomodation

    TREATMENT
    COMPLICATION
    depends on severity, location, and cause of
    inflammation

    severe inflammation takes longer to treat and more


    likely to cause intraocular damage and loss of vision

    COURSE AND
    anterior uveitis responds more promptly to
    treatment

    PROGNOSIS
    retinal, choroidal or optic nerve involvement
    associated with poorer prognosis

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