UVEITISUVEITIS

UVEITIS

Inflammation of the middle vascular coat

or

uvea of the eye is called uveitis.

Types of the uveitis

Anterior uveitis–Iritis–Iridocyclitis

Intermediate uveitis Posterior uveitis

–Retinitis–Choroiditis–Retinochoroiditis/ chorioretinitis

Panuveitis

Depending on the location of inflammation

Types

Depending on the onset and duration of the disease.

• Acute• Recurrent• Chronic

Types

Depending on the clinical picture.

» Granulomatous» Non-granulomatous

Etiology of uveitis

Infections• Bacterial • Viral• Fungal• Parasitic• Spirochaetal

Arthritis related Trauma Collagen vascular diseases Idiopathic

Anterior uveitis

» Iritis» Iridocyclitis

Symptoms

» Pain» Redness» Photophobia» Diminution of vision

Examination

– Circum corneal congestion (CCC).– Keratic precipitates (K.P.)– Flare in A/C.– Cells in A/C.– Hypopyon. – Muddy iris.– Iris nodules.– Iris atrophy and loss of pattern.

Circum corneal congestion (CCC)

Hypopyon

Keratic precipitates (KPs)

Fine to medium size KPs Mutton Fat KPs

Pupil

» Usually constricted» May be irregular» Posterior synechiae» Seclusio pupillae» Occlusio pupillae

Pupillary membrane (Occlusio pupillae) with 360 posterior synechia

Seclussio pupillae

Posterior Synechia

Iris atrophy

Iris nodules

Koeppe’s nodules Bussaca’s nodules

Lens

– Pigments on the lens surface.– Cataractous changes in the

lens.

Posterior subcapsular cataract

Vitreous

» Cells» Opacities

Fundus

• Usually unremarkable but macular edema can be present in anterior uveitis too.

Cystoid Macular Edema

Complications

• Band keratopathy• Glaucoma• Cataract• Macular edema• Phthisis bulbi

Band keratopathy

Investigations

• Depending on clinical picture• For infections• Rheumatoid factor• ANA• HLA typing • Tests for syphilis• Screen for HIV in selected cases

Treatment

– Topical Mydriatic- cycloplegic– Topical corticosteroid– Periocular corticosteroid injection– Systemic corticosteroids– Cyclosporins– Cytotoxic agents.– Treatment of the underlying causes

THANK YOU.