An introduction to uveitis and it's Management

1. UVEITIS
Emmanuel Ali Adamu
February 2022

2. OUTLINE
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Introduction
Definition
Anatomy of the uveal tract
Epidemiology
Risk Factors
Aetiology
Classification
Clinical Presentation
Management
History
Examination
Investigation
Treatment
Complications
Differential Diagnosis

3. Introduction
•Definition : uveitis is the inflammation of the
uveal tract involving either the anterior or
posterior components. In practice, the term
uveitis is applied to any intraocular
inflammation even if the inflammation is not
predominantly in the uvea.

4. Brief Anatomy of the Uveal
tract
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The term uvea is derived from the Latin worduva
meaning grape.
The Uveal tract consists of the pigmented, highly
vascular loose connective tissue that can be
divided into three anatomical regions
Anterior: Iris
Centrally: ciliary body
Posteriorly: choroid
The uvea is firmly adherent to the scleral spur
anteriorly, optic disc posteriorly and to the exit of
the four vortex veins.

5. ANATOMY CON...
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The uvea provides nutrients to the retina, lens
andad as well assists in the refractive function
of the eye.
The uvea receives it's blood supply from the
ophthalmic artery through the anterior and
posterior ciliary branches.
It is innervated by the anterior and posterior
ciliary nerves.

10. EPIDEMIOLOGY
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Uveitis is an important cause of preventable blindness.
Worldwide incidence is 17-52/100,000 and prevalence
of 38-714/100, 000.
Finland has the highest incidence due to HLA
About 2,359,242 people have uveitis globally.
USA have 109,000 cases with 48,000 new cases
annually.
Nigeria has 1.73% of it's population suffering from
uveitis.
Uveitis has no sex predilection worldwide

11. RISK FACTORS
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Inflammatory bowel disease
Rheumatoid arthritis
AIDS
SLE
TB
Syphilis
Sarcoidosis

12. AETIOLOGY
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Idiopathic (34%)
Traumatic
Infectious
Toxoplasmosis
Histoplasmosis
Syphilis
TB
CMV
Lyme disease
Autoimmune
JRA, SLE, IBD

13. CLASSIFICATION
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Many classifications have been proposed bit
the most recent and widely employed is the
one set forth by the Standardization for Uveitis
Nomenclature (SUN) Working Group who
classified uveitis based on:
Clinical presentation
Inflammatory grading
Clinical complications
Clinical outcome.

17. Classification cont...
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Based on clinical activity
Worsening
Improving
In Remission

18. CLINICAL PRESENTATION
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SYMPTOMS
Pain
Redness
Photophobia
Blurred vision
Increased lacrimation
Floaters
SIGNS
Decreased VA
Direct and consensual Photophobia
Miosis

19. MANAGEMENT
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HISTORY
A young adult man with conjunctivitis, urethritis and
arthritis_Reactive cause
Autoimmune dx: IBD, SLE, RA,
STI: Syphilis, Chlamydia
TB, AIDS
EXAMINATION
Lids, lashes and laceimal ducts normal
Conjunctiva: perilimbal injection
Pupils: Photophobia, miosis
Extraocular muscles movement Normal
Anterior chamber examination for WBCs, RBCs
Decreased VA
Fundoscopy
Slit lamp examination
IOP measurement

20. MGT CONT...
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INVESTIGATIONS
CBC+ESR
ANA
RPR, VDRL,
PPD
LYME TITRE
HIV TEST
URINALYSIS
CXR: TB, SARCOID

21. MGT CONT...
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TREATMENT
EMERGENCY
Analgesics
Refer immediately to an ophthalmologist
SPECIALIST
Steroids: dexamethasone, fluocinolone
Cycloplegics: cyclopentolate, homatropine
TNF blockers: infliximab

22. COMPLICATIONS
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Acute rise in IOP
Acute angle closure glaucoma
Optic nerve atrophy
Permanent visual loss
Endophthalmitis

23. DIFFERENTIAL DIAGNOSIS
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Acute angle closure glaucoma
Acute conjunctivitis
Corneal ulcer
Ulcerative keratitis
HSV keratitis
Intraocular foreign body
Scleritis
Ultraviolet keratitis