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Uvea Pathologies Flashcards

(51 cards)

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1
Q

Iris Naevi: Aetiology (1)

A

Physiological change in pigmentation composed of small spindle and dendritic naeval cells

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2
Q

Iris Naevi: Signs (4)

A

Can be flat or raised

Avascular

Superficial layers only

Rarely distorts surroundings

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3
Q

Iris Naevi: Management (1)

A

Monitor for changes

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4
Q

Iris Naevi: Symptoms (1)

A

Cosmetic only

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5
Q

Iris Melanoma: Aetiology (4)

A

Can be primary from a secondary metastasis

Accounts for 5-10% of uveal tract melanoma

Ask history & family history

Primary tumours have low metastasis risk

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6
Q

Iris Melanoma: Signs (6)

A

Raised

Replaces Iris stroma

Variable pigmentation- frequently dark brown

Visible intrinsic tumour vessels

Commonly located at pupil margin

Distorts pupil

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7
Q

Iris Melanoma: Symptoms (4)

A

Usually none

May affect vision if interacts with pupil or cross visual axis

Can shed pigment

Block anterior angle - causing secondary glaucoma

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8
Q

Iris Melanoma: Management (3)

A

Refer within 2/52

Long-standing can be routinely referred

Urgent if increases IOPs

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9
Q

Iris Coloboma: Aetiology (1)

A

Congenital abnormalities associated with poor macula development

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10
Q

Iris Coloboma: Signs (1)

A

Part of the Iris missing

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11
Q

Iris Coloboma: CL related management (2)

A

Cosmetic

Hand painted lens with opaque backing

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12
Q

Aniridia: Aetiology (2)

A

Congenital

Traumatic

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13
Q

Aniridia: Signs (3)

A

Majority or entire Iris is missing

Nystagmus may be present

Amblyopia

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14
Q

Aniridia: CL related Management (3)

A

Cosmetic

Hand painted lens with Iris and opaque backing (prevents light scatter)

Scleral lenses may be fitted

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15
Q

Albinism: Aetiology (2)

A

Congenital

Can be just ocular of full albinism

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16
Q

Albinism: Signs/Symptoms (6)

A

High refractive error

Associated with high astigmatism

Nystagmus

Reduced VAs

Photophobia

Pale skin, hair, iris due to lack of pigment

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17
Q

Albinism: CL related management (5)

A

Cosmetic contact lens

Hand painted with opaque backing

Nystagmus can reduce with improved VAs and feedback loop

Magnification can be lost with contact lenses

UV block important

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18
Q

Fixed Dilated Pupil: Aetiology (4)

A

Unilateral or bilateral

Many causes, including blunt trauma and anterior uveitis

Neurological causes usually involve CNIII and accompany ptosis

Acute glaucoma may cause mydriasis

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19
Q

Fixed Dilated Pupil: Signs/Symptoms/Management (1)

A

Will vary depending on the cause

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20
Q

Choroid Naevi: Aetiology (2)

A

Often congenital

Pigment changes in the choroid

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21
Q

Choroid Naevi: Signs (2)

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A

Always flat

Slate grey in colour

22
Q

Choroid Naevi: Symptoms (1)

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A

Typically asymptomatic

23
Q

Choroid Naevi: Management (2)

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A

Monitor for changes (growth and visual symptoms)

Can develop into malignant melanoma

24
Q

Choroid Melanoma: Aetiology (3)

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A

Most common primary malignant intraocular tumour

More common in caucasians ages 55-75

Systemic metastasis occurs in 40% of patients

25
Choroid Melanoma: Signs (3)
Slate grey in colour (similar to Naevi) Concerning when raised Overlaying vessels are pushed forward
26
Choroid Melanoma: Symptoms (4)
Can be asymptomatic Can experience photopsia (flashes) as neural retina is pulled Metamorphopsia (distorted vision) as retina pulled out of place Vision loss if more severe
27
Choroid Melanoma: Management (2)
Consider retinal detachment first with symptoms - refer for dilated examination same day or next Once ruled out retinal detachment, refer routinely
28
Uveitis: Structures it involves (4)
Iritis (anterior uveitis) - iris Iridocycitis (intermediate uveitis) - iris and ciliary body Choroiditis (posterior uveitis) - choroid at the back of the eye Panuveitis - inflammation of the entire uveal tract
29
Uveitis: Further classifications (based on source) (2)
Exogenic Endogenic
30
Exogenic
External disease/microbial infection or trauma has caused the inflammation
31
Endogenic
Internal disease/microbial infection or systemic (often inflammatory) disease has caused the inflammation.
32
Panuveitis: Inflammation of...
Entire uveal tract
33
Choroiditis: Inflammation of...
Choroid
34
Iridocycitis: Inflammation of...
Iris and ciliary body
35
Iritis: Inflammation of...
Iris
36
Uveitis: Signs (6)
Perilimbal/circumlimbal injection with deep redness Anterior chamber flare Keratic precipitates (in severe cases) Hypopyon and iris abnormalities Iris Nodules (koeppe nodules – small and situated at pupil border and busacca nodules – situated on iris away from pupil margin) Posterior Synechiae – adhesions between lens and iris
37
Uveitis: Symptoms (5)
Photophobia Pain Reduced VAs Lacrimation (Chronic can be asymptomatic)
38
Uveitis: Management (2)
Initially can refer to optom for cyclopentolate to relax the iris and relieve pain Emergency referral with acute will then be treated with steroid drops (or treatment/management of the underlying autoimmune condition)
39
Choroiditis (4)
Inflammation of choroid & surrounding tissue Reasons include toxoplasmsis & or other systemic inflammatory diseases Likely to scar and reduce acuity Corticosteroids to manage and/or treat underlying condition
40
Choroidal Detachment (3)
Associated with raised IOPs and fluid accumulation in suprachoroidal space Can be cause by trauma, poor surgical outcome and haemorrhage Symptoms same as retinal detachment
41
Glaucoma: Classifications (2)
Open angle Closed angle
42
Open Angle Glaucoma
Where the anterior angle opening is not obstructed
43
Closed Angle Glaucoma (2)
When the anterior angle opening is compromised Can be primary (no other factors) or secondary, following an associated predisposing condition/disease (e.g. Uveitis).
44
Acute Closed Angle Glaucoma: Risk Factors
Hyperopic Female 50+ in age
45
Acute Angle Closure Glaucoma: Lens changes
Lens increase in size with age, gradually reduces chamber angle and depth Results in intermitted angle closure and intermittent symptoms
46
Acute Angle Closure Glaucoma: Signs
Reduced Van Herick’s Measurement / Angle Closure Iris Bombe Hazy Cornea Perilimbal injection
47
Acute Angle Closure Glaucoma: Symptoms
Haloes around lights in evening/morning/night Aching of the browline Pain Blurred vision Symptoms may be intermittent initially
48
Secondary Glaucoma: Pigment Dispersion Syndrome (4)
Predominantly myopic Caused by anterior lens rubbing on posterior iris epithelium which sheds pigment into aqueous and anterior chamber Seen as Krukenberg's syndrome due to aqueous convention currents Retro illumination of the iris can identify iris transillumination in those with PDS where pigment is lost
49
Secondary Glaucoma: Pseudo Exfoliative Glaucoma (4)
Grey flecks of amyloid-like fibrillar material seen on lens capsule More prevalent with increasing age Flaking material occludes the trabecular meshwork as with PDS Iris transillumination may also be seen
50
Secondary Glaucoma: Neovascular Glaucoma (3)
Neovascularisation of the iris (in advanced diabetic eye disease) can invade the anterior angle and prevent the outflow of aqueous increasing the IOP Slit lamp exam will show dilated capillary tufts at the pupil margin Note it is normal to see highly visible blood vessels in lighter irides.
51
Secondary Glaucoma - Neovascular Glaucoma: Management (2)
Can improve the opening of the anterior angle with bypass of any pupil block with iridectomy Can improve outflow of aqueous by laser treatment on trabecular meshwork or trabeculectomy which allows outflow of aqueous into surrounding conjunctival tissue

CLO (13 decks)

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