Anterior Uveitis Flashcards
1
Q
What is anterior uveitis?
A
- This is inflammation in the anterior part of the uvea
2
Q
What is the Uvea?
A
- Iris
- Ciliary body
- Choroid
3
Q
What is the Choroid?
A
- This is the layer between the retina and the sclera
4
Q
What is the pathophysiology of Anterior Uveitis?
A
- It involves the infiltration of neutrophils, lymphocytes and macrophages
- These immune cells cause inflammation in the anterior chamber of the eye
- The inflammatory cells cause floaters in the patients vision
5
Q
What are the causes of Anterior Uveitis?
A
- Infection
- Trauma
- Ischaemia
- Malignancy
- Autoimmune
6
Q
What gene is Acute Anterior Uveitis associated with?
A
- HLA B27
7
Q
What Rheumatological conditions are associated with HLA B27?
A
- Ankylosing Spondylitis
- Inflammatory Bowel Disease
- Reactive Arthritis
8
Q
What is Chronic Anterior Uveitis associated with?
A
- Sarcoidosis
- Syphilis
- Lyme Disease
- TB
- Herpes Virus
9
Q
How does Anterior Uveitis present?
A
- Dull, aching, painful red eye
- Ciliary flush ( a ring of red spreading from the cornea outwards)
- Reduced Visual Acuity
- Floaters and flashes
- Sphincter muscle contraction causing miosis
- Photophobia - ciliary muscle spasm
- Pain on movement
- Lacrimation (excessive tear production)
- Posterior Synechiae (adhesions causing an abnormally shaped pupil by pulling the iris into abnormal shapes)
- Hypopyon - collection of WBC in the anterior chamber a yellowish fluid collection is seen settled in front of the lower iris
10
Q
What is the managment of Anterior Uveitis?
A
- Refer to Ophthalmology
- Steroids (oral, topical or IV)
- Cycloplegic-mydriatic medications ( cyclopentolate/ atropine) eye drops
- Cycloplegic = paralysing ciliary muscles
- Mydriatic = dilating the pupils
- Cyclophentolate and atropine are antimuscarinic medications that block the ciliary body and the iris sphincter muscles and reduce ciliary spasm and dilate the pupil
-Immunosuppresents - DMARDS and TNF inhibitors - Laser therapy, cryotherapy or surgery
