D r. A n u p a m a K a r a n t h
www.ophthalclass.blogspot.com
www.ophthalclass.blogspot.com

 Symptoms: Classical triad of acute onset
 Pain
 Redness
 Photophobia
 With or without diminished vision
Chronic iridocyclitis – variable presentation
www.ophthalclass.blogspot.com

Pain V nerve, ophthalmic division, due to ciliary spasm
Photophobia Abnormal sensitivity to light due to pain from ciliary
spasm and miosis
Redness Ciliary congestion / ciliary flush
3600 perilimbal / circumcorneal violaceous hue
(vs. red in conjunctivitis or purplish in scleritis)
www.ophthalclass.blogspot.com

 Redness can result from any inflammation in anterior
segment
 Conjunctivitis
 Keratitis / Episcleritis / Anterior scleritis
 Iritis / Iridocyclitis / Cyclitis
 Angle closure glaucoma
Clues: type of congestion and associated features
www.ophthalclass.blogspot.com

Inflammation in iris and ciliary body
Dilated vessels and
exudation of fluid/cells
Cornea Aqueous Pupil Iris
Signs seen by slit lamp
www.ophthalclass.blogspot.com

Corneal
Aqueous
endothelium
• Keratic precipitates • Aqueous cells
• Aqueous flare
• (Leucocytes on
sticky endothelium)
www.ophthalclass.blogspot.com

www.ophthalclass.blogspot.com

 Keratic precipitates (KPs) vary in size, shape, number
 Base down triangle inferiorly – Arlt’s
 Granulomatous / non granulomatous
 Proteinaceous influx gives rise to aqueous flare
(Tyndall effect)
 Aqueous cells are always a sign of activity
www.ophthalclass.blogspot.com

cells
flare www.ophthalclass.blogspot.com

Pupil Iris
• Miosis • Muddy iris
• Sluggish reaction • Iris nodules
• Posterior synechiae
www.ophthalclass.blogspot.com

Festooned pupil – multiple posterior synechiae
seen on pupillary dilatation
www.ophthalclass.blogspot.com

Posterior synechiae
Posterior synechiae with cataract in a child with blunt injury
www.ophthalclass.blogspot.com

 Pupillary constriction is an important sign in D/D of
red eye
 Risk of pupil block glaucoma exists with extensive
posterior synechiae
 Iris nodules are characteristic of granulomatous uveitis
Iris nodules
www.ophthalclass.blogspot.com

 Symptoms
 Insiduous onset
 Floaters
 Opacities in the anterior vitreous
 Diminished vision
www.ophthalclass.blogspot.com

Inflammation in vitreous base - pars plana -
peripheral retina complex
WBCs aggregate and
form clumps
Anterior Peripheral Anterior
Pars plana
vitreous retina chamber
Signs seen by slit lamp & indirect ophthalmoscopy
www.ophthalclass.blogspot.com

Pars plana
Anterior vitreous
• Snowballs • Snow banking
www.ophthalclass.blogspot.com

Peripheral Anterior
retina chamber
• Periphlebitis • Spill over aqueous
cells, flare and KPs
www.ophthalclass.blogspot.com

 Symptoms
 Painless
 Visual disturbances
 Floaters
 Metamorphopsia
 Macropsia / Micropsia
 Photopsia
 Blurring of vision
www.ophthalclass.blogspot.com

Inflammation in choroid or
retina or both
Focal / Multifocal /
Diffuse
Vitreous Choroid Retina Optic nerve
Signs seen by slit lamp & indirect ophthalmoscopy
www.ophthalclass.blogspot.com

Choroid
Vitreous
• Vitritis • Yellow white
infiltrates
Optic nerve
Retina
• Infiltrates • Papillitis
• Perivascular cuffing
www.ophthalclass.blogspot.com

Cells and exudates seen in the anterior vitreous
www.ophthalclass.blogspot.com

Diseases of the uveal tract. In: Parsons’ Diseases of the eye. 20th ed.
1.
Sihota R, Tandon R eds. Elsevier; 2007
Basic and Clinical Science Course. Intraocular inflammation and
2.
uveitis. American Academy of Ophthalmology. 2006-2007
Nussenblatt RB, Whilcup SM, Palestine AG. Uveitis: Fundamentals
3.
and Clinical Practice. 2nd ed. St. Louis: Mosby; 1996
Duane’s Ophthalmology 1997. CD-ROM Edition.
4.
www.ophthalclass.blogspot.com