Uveitis

Question 1

Still’s Triad

Answer 1

Cataract, band keratopathy and Uveitis (chronic)

Question 2

Flare is usually more noticeable

Answer 2

in chronic granulomatous uveitis

Question 3

Plasmoid aqueous

Answer 3

3-4+ Grading flare, Aq is thick and white.
can be seen in severe acute uveitis.
Dense accumulation of fibrin cells producing translucent to cloudy strands or sheets with lumps of protein material

Question 4

Iris Membranes

Answer 4

Uveitis sign

Non-fibrous membranes may come off the collaretes

Question 5

3 major types type of KP

Answer 5

Fine (easy to detect, 3d appearance)
Granulomatous (thick, flat and waxy)
Pigmented

Question 6

Fine Keratic Precipitates

Answer 6

Whitish-gray fibrin or epitheloid cells.

very small and adhere to posterior cornea

Question 7

Granulomatous Keratic Precipitates

Answer 7

Greasy, waxy, grainy-appearing surfaces

looks like mutton fat

Question 8

Pigmented Keratic Precipitates

Answer 8

Arlt’s triangle or Krukenberg’s spindle:
deposit in endothelium as well
With base down and apex up

Question 9

Hypopion

Answer 9

Assoc with severe acute anterior uveitis
dense accumulation of white blood cells
usually PolyMorphoNuclear (PMN) cells
More common in Behcet’s, Leprosy, Endopthalmitis, Sarcoid, and post surgical uveitis
(BLES)

Question 10

Anterior Synechiae:

Answer 10

Peripheral Anterior Synechiae or PAS

Fibrous adhesions between peripheral cornea and iris

Question 11

Posterior Synechiae:

Answer 11

More common than anterior synechiae
Adhesions between the pupillary border and the anterior lens capsule
Form readily in all types of uveitis
Especially in the presence of flare
May occur in conjunction with iris nodules
Sometimes mistaken for persistent pupillary membranes

Question 12

Seclusio Pupillae

Answer 12

Immobile pupil with a 360 posterior synechiae

Usually in chronic uveitis

Question 13

Iris Nodules

Answer 13

Koeppe nodules and Busacca nodules

Question 14

Koeppe nodules

Answer 14

Common in uveitis, round or oval tissue
Located at the pupil border
May accumulate pigment over time

Question 15

Busacca Nodules:

Answer 15

Whitish-yellow lumps away from pupil border

In the internal iris stroma

Question 16

Henkind test:

Answer 16

Shining a light in the non-affected pupil will cause pain in the other (consensual) pupil

Question 17

iris bombe

Answer 17

Fluid build up btw lens and iris

Question 18

lower iop in early stages is from

Answer 18

Due to reduced aqueous production of inflamed ciliary body

Question 19

IOP may increase

Answer 19

Trabecular congestion may reduce outflow

Also consider iatrogenic increase in IOP due to steroid response

Question 20

What types of cataracts are associated with uveitis?

Answer 20

Epi-capsular stars
PSC
Mature cataract

Question 21

Cystoid Macular Edema occur if

Answer 21

inflammation is chronic

Question 22

Bilateral uveitis suggests you are dealing with which type of uveitis?

Answer 22

endogenous and chronic types of uveitis, especially if granulomatous

Question 23

Unilateral uveitis is more common in

Answer 23

Sarcoid, Behcet’s, foreign body, post-surgical events

Question 24

When is uveitis considered chronic?

Answer 24

Persistent

Tends to relapse less than three months after discontinuing treatment

Question 25

Which chronic diseases cause non-granulomatous uveitis?

Answer 25

Juvenile Rheumatoid Arthritis | Fuch’s Heterochromic Iridocyclitis

Question 26

Which chronic diseases cause granulomatous uveitis ?

Answer 26

``` Tuberculosis (get granulomatous elsewhere) Sarcoidosis Syphilis Cat scratch fever (comes from kittens) Fungal infections ```

Question 27

What are the three events that occur in uveitis?

Answer 27

inflammation of any of the structures of the uveal tract Disruption of the blood-ocular barrier Infiltration of leukocytes and protein leakage

Question 28

Duration and onset of acute Anterior uveitis.

Answer 28

Sudden onset Moderate to severe pain Duration 6-12 weeks with/without therapy non-granulomatous disease with fine keratic precipitates (precipitate in endothelium)

Question 29

Non-Caseating Granulomatous

Answer 29

hard inside Chalazion Epidermoid/dermois cyst Sarcoidosis

Question 30

Caseating Granulomatous

Answer 30

soft cheesy | TB granuloma

Question 31

What are the characteristics of recurrent uveitis

Answer 31

Third episode reclassifies patient as recurrent Requires complete medical evaluation Repeated episodes with inactivity longer than 3 months

Question 32

Which diseases are heavily associated with males?

Answer 32

trauma ankylosing spondylitis Reiter’s syndrome

Question 33

Which diseases are heavily associated with females?

Answer 33

Granulomatous type double in females due to sarcoidosis Childhood uveitis greater in females due to Still’s Disease:

Question 34

Which type of uveitis is most common by race?

Answer 34

Blacks: sarcoidosis Especially in black females, Southeastern US. Asians: Vogt-Koyanagi-Harada Syndrome, Bechet’s disease. Caucasians: ankylosing spondylitis, Reiter’s syndrome, HLA-B27 diseases

Question 35

Which type of uveitis is associated with Type A personality?

Answer 35

Pars Planitis high stress trauma with CL wear

Question 36

The release of these chemicals cause the breakdown of the blood aqueous barrier. Which ones are they?

Answer 36

Histamine Bradykinin Serotonin

Question 37

Which corneal disease causes severe swelling when the patient also has uveitis?

Answer 37

Fuch’s endothelial dystrophy

Question 38

Give examples of endogenous causes of uveitis?

Answer 38

Pars planitis-Uveitis with snow banks on ora or pars plana. Fuch’s heterochromic iridocyclytis. Posner-Schlossman glaucomatocyclitic crisis

Question 39

What is the hallmark finding of pars planitis?

Answer 39

Cells and opacities in the vitreous base (critical findings)

Question 40

Elevated IOP Uni-ocular Mild idiopathic anterior chamber inflammation

Answer 40

Possner-Schlossman Syndrome/ Glaucomatocyclitic Crisis

Question 41

Pain is most likely associated with chronic or acute uveitis?

Answer 41

Acute uveitis may be severe and debilitating | Chronic uveitis may be asymptomatic ( sometimes)

Question 42

vision symptoms

Answer 42

Acute uveitis: vision is usually normal to hazy | Chronic uveitis: the vision may be worse than the symptoms

Question 43

stromal edema

Answer 43

present in “hot” acute anterior uveitis, present with dense KP Present in advanced and chronic cases

Question 44

Band keratopathy is common in which type of uveitis?

Answer 44

Band Keratopathy may develop in recurrent/ advanced or chronic cases

Question 45

Iris Atrophy

Answer 45

occurs in chronic uveitis May produce decrease in iris pigment Smooth velvety appearance

Question 46

Iris Granulomas

Answer 46

may form on the pupil border, anterior surface of the iris or angle locations. associated with granulomatous disease common in sarcoid