Anterior Uveitis

Question 1

Anterior Uveitis

Answer 1

inflammation of anterior portion of uveal tract- iris and ant ciliary body

Question 2

Panuveitis

Answer 2

inflammation of all uveal structures

Question 3

Symptoms of Anterior Uveitis

Answer 3

pain
photophobia
tearing
blurred vision

Question 4

Signs of Anterior Uveitis

Answer 4

perilimbal injection
miosis- possible post synechiae
keratic precipitates
hypopyon or cells/flare in AC
iris nodules or atrophy/ heterochromia
high or low IOP

Question 5

Extra testing needed for anterior uveitis when…

Answer 5

recurrent, severe, bilateral
chronic, granulomatous, resistant
suggest an underlying disease

Question 6

Testing for Systemic Disorders Related to Anterior Uveitis

Answer 6

HLA-B27
blood tests
X rays- sacroiliac joint and chest
dilate for post seg inflammation

Question 7

Tx for Anterior Uveitis

Answer 7

topical steroids- prednisone acetate 1%, taper
NSAIDs if long term
anti-metabolites
cycloplegic drops- pain relief and break up post synechiae- homatropine 5%

Question 8

Spondyloarthropathy

Answer 8

joint disease of the vertebral column
HLA-B27 positive
Rheumatoid factor negative

Question 9

Enthesitis

Answer 9

inflammation of ligament insertion into bone

early stage of ankylosing spondylitis

Question 10

Ankylosing Spondylitis

Answer 10

eventual fusion of vertebrae - bamboo spine
starts as lower back stiffness/ pain
radiology shows changes to sacroiliac joint
HHLA B27 +
AAU in 25%

Question 11

Reactive Arthritis

Reiter’s Syndrome

Answer 11

triad of urethritis, conjunctivitis, arthritis
HLA-B27 +
AAU in 20%

Question 12

Psoriatic Arthritis

Answer 12

arthritis developing after psoriasis

AAU in 7%

Question 13

Ulcerative Colitis

Answer 13

age 10- 30
lower abdominal cramps, bloody diarrhea
can evolve into colon cancer
AAU in 5%, esp if HLA-B27 +

Question 14

Crohn’s Disease

Answer 14

granulomatous inflammation of intestinal wall
age 10- 30
abdominal pain and diarrhea
AAU in 3%

Question 15

Tx for chronic AAU from spondyloarthropathies

Answer 15

systemic immunosuppresion

Question 16

Fuch’s Uveitis Syndrome Presentation

Answer 16

chronic unilateral ocular inflammation of unknown cause
hyperemia absent, eye white and quiet
mild AC cells
heterochromia- iris atrophy
cataracts common
develop glaucoma

Question 17

Tx for Fuch’s Uveitis Syndrome

Answer 17

monitor for glaucoma

no steroids

Question 18

Juvenile Idiopathic Arthritis

Answer 18

arthritis of unknown cause before age 16 that lasts more than 6 weeks

Question 19

Ocular Complications of Juvenile Idiopathic Arthritis

Answer 19

band keratopathy
cataracts
glaucoma
maculopathy- CME or ERM
AAU

Question 20

Mx of Juvenile Idiopathic Arthritis

Answer 20

exams every 3-4 months until age 12
topical steroids
oral NSAIDs
systemic immunosuppression if resistance
Mydriasis to prevent post synechiae

Question 21

Signs of AAU with Sarcoidosis

Answer 21

Busacca nodules- granulomatous bumps on iris

“mutton fat” keratitic infiltrates

Question 22

Signs of AAU with Behcet’s Disease

Answer 22

hypopyon forms and dissolves rapidly and shifts with eye movement

Question 23

Signs of AAU with HZV

Answer 23

sectoral iris atrophy- +TID

diffuse keratitic precipitates

Question 24

Signs of AAU of HSV

Answer 24

linear endotheliitis

keratitic precipitates on endothelium