Dr. Anupama Karanth
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http://www.djo.harvard.edu/site.php?url=/physicians/gr/1134
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Idiopathic Infectious Immune related
• After ruling out • Tuberculosis, • Sarcoidosis
other causes syphilis • Vogt – Kayanagi
• Lyme disease – Harada
• Leptospirosis syndrome
• Infectious • Sympathetic
endophthalmitis ophthalmitis
• Beh et
syndrome
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 Anatomical diagnosis – Panuveitis
 Infectious causes –negative tests
 Penetrating injury to the other eye
 Is this the sympathizing eye ?
 SYMPATHETIC OPHTHALMITIS
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http://www.aao.org/publications/eyenet/200804/am_rounds.cfm
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 Panuveitis
 Bilateral, granulomatous uveitis
 Chronic and recurrent
 Shallow detachments and depigmentation
 Dark skinned individual
 VOGT-KOYANAGI-HARADA SYNDROME
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Idiopathic Infectious Immune related
• Most common • Herpes simplex • HLA B27+/
• Diagnosis only • Herpes zoster seronegative
after other • Tuberculosis spondylo-
causes are ruled arthropathies
• Syphilis
out • Juvenile
rheumatoid
arthritis (JRA)
• Lens or IOL
related
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 Seronegative spondyloarthropathies
◦ Ankylosing spondylitis
◦ Psoariatic arthritis
◦ Reiter syndrome
◦ Inflammatory bowel disease
 Usually associated with HLA B27 positivity
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 Young adult male with classic triad of
◦ Nonspecific urethritis
◦ Polyarthritis
◦ Conjunctivitis and iritis
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 Young adult male with classic triad of
◦ Hypopyon iritis
◦ Genital ulcers
◦ Oral ulcers
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Idiopathic Infectious Immune related
• Less common • Toxoplasmosis • Sarcoidosis
• Toxocariasis • Collagen vascular
• Herpes diseases
(ARN/PORN/CMV) • Retinochoroidop
• Tuberculosis, athies
syphilis
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