eye inflammatory disorders

Question 1

inflammation of any component of the uveal tract
iris (anterior) –> most cases
ciliary body (intermediate)
choroid (posterior)

Answer 1

uveitis

Question 2

uveitis is also called

Answer 2

iritis

Question 3

most uveitis is

Answer 3

anterior

Question 4

uveitis caused by

Answer 4

trauma, inflammation, or infection

Question 5

how do patients present with uveitis

Answer 5

vision changes

Question 6

if uveitis is anterior patients present with

Answer 6

eye pain, redness, tearing, and photophobia

Question 7

iritis –> inflammation is limited to iris

iridocyclitis –> inflammation is of iris and ciliary body

Answer 7

anterior uveitis

Question 7

choroiditis
chorioretenitis

Answer 7

posterior uveitis

Question 8

what should you do with all patients with uveitis

Answer 8

referred to ophthalmologist

Question 9

how many % of cases of uveitis is anterior

Answer 9

73%

Question 9

MC age for uveitis

Answer 9

25-64

Question 10

in children, what is the most common associated systemic disease with uveitis

Answer 10

juvenile rheumatoid arthritis

Question 11

common cause of iritis

Answer 11

trauma

Question 12

less common infections of iritis

Answer 12

herpes
syphilis
TB

Question 13

unilateral eye pain, redness, tearing, photophobia, decreased vision

360-degree perilimbal injection, most

history of eye trauma, an associated systemic disease, or risk factors for infection

Answer 13

anterior acute uveitis

Question 14

severe anterior uveitis may cause a ___________ from layering of leukocytes and fibrous debris in the anterior chamber

Answer 14

hypopyon

Question 15

presents with altered vision or floaters

often there is no pain, redness, tearing, or photophobia

Answer 15

intermediate and posterior uveitis diagnosis

Question 16

panuveitis

gradual and usually a bilateral onset

few vision complaints unless cataracts or glaucoma develop

Answer 16

sarcoid uveitis diagnosis

Question 17

anterior uveitis is unilateral and sarcoid uveitis is typically bilateral

Answer 17

typical distribution diagnosis

Question 18

what to do in uveitis if cause not readily apparent

Answer 18

lab testing
CBC, BMP, UA, ESR

Question 19

what to consider for patients with recurrent anterior uveitis

Answer 19

HLA-B27

Question 20

what to do for syphilis uveitis

Answer 20

serology

Question 21

uveitis treatment

Answer 21

refer patients for any red eye along with loss of vision to an ophthalmologist

Question 22

dilated fundoscopy for other ocular trauma

measurement of intraocular pressure

treatment– steroid and/or cycloplegics for comfort

Answer 22

traumatic uveitis

Question 23

slit lamp exam and lab tests to assist with diagnosis of underlying cause treatment- based on underlying cause but usually topical steroid drops with or without cycloplegia

Answer 23

non traumatic uveitis

Question 24

inflammations of the the deeper layers of the eye, the vascular episclera, and the avascular episclera

Answer 24

episcleritis and scleritis

Question 25

segmental eye redness discomfort but not severe pain no vision loss

Answer 25

episcleritis

Question 26

may have overlying episcleritis violaceous hue to sclera* painful may cause vision loss

Answer 26

scleritis (EMERGENCY)

Question 27

scleritis and episcleritis more common in

Answer 27

women

Question 28

scleritis median age at diagnosis

Answer 28

56

Question 29

episcleritis median age at diagnosis

Answer 29

45

Question 30

scleritis and episcleritis often associated with

Answer 30

systemic illness connective tissue or vasculitic disease

Question 31

scleritis often occurs with

Answer 31

episcleritis

Question 32

episcleritis does not involve the _______ and does not progress to ________

Answer 32

sclera; scleritis

Question 33

causes of scleritis

Answer 33

systemic autoimmune diseases (RA, wegener granulomatosis) infections (pseudomonas, TB, syphillis, herpes zoster) idiopathic

Question 33

causes of episcleritis

Answer 33

idiopathic

Question 33

does episcleritis disrupt vascular architecture and cause vision loss

Answer 33

no, scleritis does

Question 34

segmental or diffuse inflammation of sclera (violaceous, purple, blue) with overlaying episcleral and conjunctival inflammation severe, boring eye pain often radiating to head and neck that worsens with eye movement 20% of patients may not have pain photophobia and vision loss

Answer 34

scleritis

Question 35

why must scleritis be differentiated from episcleritis

Answer 35

scleritis requires treatment and an evaluation for underlying medical conditions

Question 36

segmental or diffuse inflammation of episclera (pink color) and overlying conjunctival vessel injection mild if any discomfort but can be tender to palpation no vision disturbance

Answer 36

episcleritis

Question 37

what blanches inflamed episcleral and conjunctival vessels, but not scleral vessels

Answer 37

10% phenylephrine

Question 38

when to do labs and imaging for scleritis

Answer 38

if associated systemic disease has not been previously diagnosed

Question 39

imaging for scleritis

Answer 39

chest x ray, sinus CT, SI joint x ray

Question 39

labs for scleritis

Answer 39

CBC, metabolic panel, UA, ANCA

Question 40

what imaging for posterior scleritis

Answer 40

ophthalmic ultrasound or orbital CT

Question 41

scleritis management

Answer 41

refer to opthalmologist immediately! initial: systemic NSAIDS and/or topical steroids if no response to above: systemic steroids, subconjunctival steroids, or immune modulators

Question 42

episcleritis management

Answer 42

often resolves spontaneously eye redness and irritation improve by 50% in less than 1 week redness and discomfort may improve with topical NSAIDS or artificial tears