Uveitis

Question 1

Describe the different types of classifications of uveitis.

Answer 1

TAPE:

T - Temporal (time)
A - Anatomical
P - Pathological
E - Etiological

Question 2

Subdivide the Temporal (time) classification of uveitis.

Answer 2

Acute (less than 6 weeks), chronic (more than 6 weeks), or recurrent.

Question 3

Subdivide the Anatomical classification of uveitis.

Answer 3

Anterior - Iritis/ iridocyclitis
Intermediate - Pars plantis (pars plana of ciliary body)
Posterior - Posterior vitreous base
Pan-uveitis - Everything

Question 4

Subdivide the Pathological classification of uveitis.

Answer 4

Granulomatous/ Non-Granulomatous

Question 5

Subdivide the Etiological classification of uveitis.

Answer 5

Exogenous/Endogenous/Idiopathic

Question 6

Etiology of Anterior uveitis?

Answer 6

Sickness Of I’s (2 Eyes)

S- Systemic
O - Ocular problems
I - Idiopathic
I - Infections

Question 7

Etiology of Anterior uveitis - elaborate on systemic causes.

Answer 7

27 JoBS
27 - HLA 27 - PAIR (Psoriatic arthritis, Ankylosing Spondylitis, IBD, Reiter)
J - JRA
o
B -Bechet (lesions in genitalia, Uveitis, lesions in mouth)
S - Sarcoidosis

Question 8

Etiology of Anterior uveitis - elaborate on Ocular problems.

Answer 8

“Fuck the eyes upfront”- Fuchs heterochromatic iridocyclitis

Question 9

Etiology of Anterior uveitis - elaborate on Infections.

Answer 9

TB, HSV, VZV, Syphilis

Question 10

Anterior Uveitis findings:

Answer 10

Anterior Uveitis loves KFC’S Nodules!

K - Keratopercipitants (on the endothelium)
F - Flare and cells
C - Ciliary injection
S - Synechea (posterior - flower pupil in kids)

Nodules - on the Iris (Sarcoidosis)

Question 11

Anterior Uveitis findings - Ciliary injection not affected with

Answer 11

Phenylephrine. Ciliary injection manifested from deep vessels, and Phenylephrine superficial vessels.

Question 12

Anterior Uveitis symptoms:

Answer 12

PR VAT

P - Photophobia
R - Redness

V - Vision decreased
A - Algia (pain)
T - Tears (lacrimaion)

Question 13

Keratopercipitants (on the endothelium) due to VZV are_____.

Answer 13

small.

Question 14

Keratopercipitants (on the endothelium) due to granulomatous disease are_____.

Answer 14

Big (mutton fat)

Question 15

Fresh vs Old Keratopercipitants (on the endothelium) visual characteristics:

Answer 15

Fresh - white and rouns

Old - dark and shriveled.

Question 16

Nodules on the Iris cause____, which leads to____, and relieved with____.

Answer 16

inflammation of the pupillary muscle, photophobia, cyclopentolate,

Question 17

Flare and cells are ranked by_____.

Answer 17

The number of cells.

Ranks are 1-4 (above 50 cells= rank 4)

Question 18

Dilating the pupil of a patient with posterior synechea may lead to ____.

Answer 18

Rupture of the Iris and pigment stuck on the lens.

Question 19

Intermediate (Pars plantis) Uveitis pathophysiology:

Answer 19

Ciliary body inflammation -> cytokines and inflammation factors -> Cystoid macular edema.

Question 20

Intermediate (Pars plantis) Uveitis symptoms:

Answer 20

Sudden vision loss and/or floaters (vitreous full of percipitans)

Question 21

Intermediate (Pars plantis) Uveitis findings:

Answer 21

The anterior segment is fine, CME with snow banking (white parts), Vitrits (cells in the vitreous)

Question 22

Intermediate (Pars plantis) Uveitis treatment:

Answer 22

Posterior sub-tenon steroids.

Question 23

Posterior Uveitis findings:

Answer 23

CV3R:

C - Choroid lesion (elevated lesions on the retina)
V - Vasculitis
V - Vitreous has cells
V - Vitreous has snowballs
R - Retinitis

Question 24

Posterior Uveitis symptoms:

Answer 24

Sudden vision (fovea/papilomacular bundle) loss and/or floaters.

Question 25

Posterior Uveitis etiology:

Answer 25

I SIN I - Idiopathic S - Sympathetic ophthalmia I - Infections N - Non-infectious

Question 26

Etiology of Posterior uveitis - elaborate on Infections.

Answer 26

T3H2C2S1 (THC'S) T - Toxocara, Toxoplamosis, TB H - HSV, Histoplamosis C - CMV, Candida S - Syphilis

Question 27

Posterior Uveitis findings - elaborate on shapes.

Answer 27

THC Toxoplamosis - unifocal Histoplasmosis - multifocal CMV - geografic

Question 28

Uveitis workup:

Answer 28

``` IMP(EACH)2 Syphilis: I - IM rheumatology consult M - Mantoux (and acid fast bacili sputum) for TB P - PCR for HSV E - ESR/ELISA (Toxocara and Toxoplamosis - "Elisa has TT's") A - ACE (sarcoid)/ ANA,ANCA (Wegner) C - CT (sarcoid/TB)/ CBC H - HLA (B27/29)/HIV Syphilis - VDRL/TPHA ```

Question 29

Uveitis treatment:

Answer 29

CC'S S - Steroids EARLY (topical, ocular injections, systemic) with antibiotic\antivirals. C - Cyclopegics for pain and photophobia C - Cytotoxics (Cyclosporis, Cyclophosphamide, MTX, Azathioprine), for non-reacting posterior uveitis.

Question 30

Chronic Uveitis complications:

Answer 30

RV SCuMBaG! ``` R - Retinal neovascularization V - Vitreous opacities S - Synechiae C - Cataract M - Macular edema B - Band keratopathy G - Glaucoma ```

Question 31

Retinal neovascularization treatment:

Answer 31

Bevacizumab=Avastin

Question 32

Band keratopathy treatment:

Answer 32

EDTA

Question 33

Band keratopathy pathophysiology:

Answer 33

Calcium precipitates