Uveitis

Question 1

uvea

Answer 1

vascular middle coat of the eye made of the

• iris
• choroid
• ciliary body

Question 2

what makes up the anterior uvea?

Answer 2

iris

ciliary body

Question 3

What makes up the blood aqueous barrier?

Answer 3

Tight junctions b/w

1. endothelial cells of iris vasculature
2. nonpigmented epithelium of ciliary body

Question 4

what is the term for inflammation of the iris?

Answer 4

iritis

Question 5

Inflammation of iris and ciliary body

Answer 5

Iridocyclitis

Question 6

inflammation of the whole uvea

Answer 6

Panuveitis

Question 7

Inflammation of uveal tract and ocular cavities

Answer 7

Endophthalmitis

Question 8

inflammation of all 3 tunics of the eye (nervous, vascular, fibrous)

Answer 8

Panophthalmitis

Question 9

What are three effects of inflammation on the uveal tract?

Answer 9

vessels dilate
vessels leak
breakdown of BAB

Question 10

What are important inflammatory mediator involved in uveitis? What is caused?

Answer 10

PG (especially PGF2alpha)

• Hyperemia
• Decreased IOP
• Miosis
• Pain (squinting, tearing, photophobic)

Leukotrienes: chemotactic

Question 11

What is the hallmark of uveitis?

Answer 11

Aqueous flare

Question 12

What is aqueous flare?

Answer 12

Increased protein in anterior chamber (proteins from vessel damage)

Question 13

Term for pus in the eye

Answer 13

Hypopyon

Question 14

Term for blood in the eye

Answer 14

Hyphema

Question 15

What are keratic precipitates?

Answer 15

inflammatory cells stuck in the cornea

Question 16

What are some chronic signs of inflammation?

Answer 16

• cataracts
• posterior synechia
• deep corneal vascularization
• iris bombe
• lens luxation
• secondary glaucoma
• phthisis bulbi

Question 17

what is posterior synechia?

Answer 17

iris adherent to anterior lens capsule

Looks like iris has been smeared on lens

Question 18

what is the #1 cause of cataracts in horses and cats?

Answer 18

Uveitis

Question 19

What is rubeosis irididis?

Answer 19

A preiridal fibrovascular membrane formation due to chronic inflammation

Question 20

Describe deep corneal vascluarization

Answer 20

small, straight, deep vessels coming from the limbus

Question 21

What is iris bombe?

Answer 21

360 degree posterior synechia
traps aqueous humor
iris bows forward

Question 22

What makes the aqueous humor?

Answer 22

ciliary body

Question 23

What can cause secondary glaucoma with uveitis?

Answer 23

• iris bombe
• lens luxation
• scarring of ICA

Question 24

How does uveitis cause lens luxation?

Answer 24

Inflammatory mediators and byproducts breakdown the zonular fibers

Question 25

What is the last thing to happen with chronic uveitis?

Answer 25

Phthisis bulbi

Question 26

What would cause you to worry about secondary glaucoma due to uveitis?

Answer 26

Aqueous flare + miosis with elevated IOP If IOP is within normal limit -- in danger of secondary glaucoma

Question 27

Why is there a decrease IOP with uveitis?

Answer 27

Draining angle is working properly Ciliary body isn't producing aqueous humor like it should

Question 28

What two topical steroids are used for anterior uveitis? Why are these used?

Answer 28

1. Neomycin + Polymyxin B + Dexamethasone 2. Prednisolone Acetate both penetrate the eye

Question 29

What is the term for paralysis of the ciliary body?

Answer 29

Cycloplegia

Question 30

What are two topicals that dilate the pupil? Hint: one is used for eye exams, the other is used for therapy

Answer 30

Tropicamide | Atropine

Question 31

Causes of uveitis

Answer 31

- idiopathic - lens induced - neoplasia - infectious causes

Question 32

What are the big 4 infectious causes of uveitis in cats?

Answer 32

1. FeLV 2. FIV 3. FIP 4. Toxoplasmosis

Question 33

Name two lens induced causes of uveitis

Answer 33

1. Phacolytic - leaking of lens proteins through capsule | 2. Phacoclastic - drastic: lens capsule ruptured and large amounts of lens protein exposed

Question 34

What are some neoplasia that can cause uveitis?

Answer 34

1. Uveal melanoma 2. Ciliary body adenoma 3. Metastatic (often lymphoma)

Question 35

The uvea is responsible for what 3 things?

Answer 35

1. regulating and controlling scatter of light 2. providing nourishment to interior of eye 3. removing waste products

Question 36

What are the two muscles of the iris?

Answer 36

``` Iris dilator (longitudinal muscle) Iris constrictor (circular muscle located in pupillary zone) ```

Question 37

What are the two layers of the ciliary body?

Answer 37

Nonpigmented outer layer - produces aqueous humor | Pigmented inner layer - continuous with pigmented outer layer of iris

Question 38

Trace the flow of aqueous humor

Answer 38

produced by ciliary body --> posterior chamber --> pupil --> anterior chamber --> exits through iridocorneal angle

Question 39

What two parts make up the ciliary body?

Answer 39

1. pars plicata (produces aqueous humor) - base of iris | 2. pars plana - extends from pars plicata to retina

Question 40

What attaches to the ciliary body?

Answer 40

zonular fibers of the lens

Question 41

What is the general treatment for uveitis?

Answer 41

1. Topical Steroids (neopolydex, or prednisolone acetate) 2. Topical NSAID (flurbiprofen) 3. Systemic NSAID 4. +/- systemic corticosteroids 5. Topical atropine

Question 42

How are we controlling inflammation in uveitis?

Answer 42

Topical steroid and NSAID only works for anterior uveitis because it is topical systemic medications will help get the posterior segment

Question 43

Why are we giving atropine for treatment of uveitis?

Answer 43

relieves ciliary spasm that causes significant amount of discomfort minimizes chance of posterior synechia