Common Eye Problem

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Common Eye Problem

  1. 1. Common Eye problem
  2. 2. <ul><li>Diseases of uveal tract (Iris, ciliary body, choroid) </li></ul><ul><ul><ul><li>Inflammations (Uveitis) </li></ul></ul></ul><ul><ul><ul><li>Tumors: nevus, hemangioma, </li></ul></ul></ul><ul><li>malignant melanoma, metastatic tumors (breast, lung, GU, GI tract) </li></ul>Common Eye problem Uveal tract
  3. 3. Uveitis : classification <ul><li>Anterior : Inflammation of iris 40-70 % </li></ul><ul><li>Intermediate : Inflammation of ciliary body, </li></ul><ul><li>pars plana, vitreous, </li></ul><ul><li>peripheral retina : 7-15 % </li></ul><ul><li>Posterior: Inflammation of choroid, retina, </li></ul><ul><li>optic N : 15-22 % </li></ul><ul><li>Panuveitis </li></ul>
  4. 4. Anterior uveitis : Iritis <ul><li>Clinical : </li></ul><ul><ul><li>Usually acute, duration < 6 weeks </li></ul></ul><ul><ul><li>Sudden onset of redness, pain, photophobia, </li></ul></ul><ul><ul><li>mild blurring of vision </li></ul></ul><ul><ul><li>PE : Keratic Precipitates(KP), Flare and/or hypopyon </li></ul></ul><ul><li>of anterior chamber, lenticuler precipitates </li></ul><ul><li>Causes : </li></ul><ul><ul><li>Idiopathic : 38-70 % </li></ul></ul><ul><ul><li>Immune: AS, JRA, SNSA, Reiter, UC, Crohn’s disease, </li></ul></ul><ul><li>Sarcoidosis, Psoriasis, Lens-induced, Behcet’s disease </li></ul><ul><ul><li>Vohk-Koyonagi-Harada (VKH) syndrome </li></ul></ul><ul><ul><li>Infection: virus, Tbe, Syphilis </li></ul></ul><ul><ul><li>Malignancy: Leukemia, Lymphoma, Retinoblastoma </li></ul></ul><ul><ul><li>Hyperuricemia and gout </li></ul></ul><ul><ul><li>Fuchs’ Heterochromic Iridocyclitis </li></ul></ul><ul><ul><li>Trauma </li></ul></ul><ul><li>Complication: glaucoma, cataract </li></ul><ul><li>Treatment:Topical : cycloplegia, steroid, aqueous suppressant </li></ul><ul><li> Oral : steroid, aqueous suppressant </li></ul>
  5. 5. Intermediate Uveitis : Cyclitis,Pars planitis, Vitritis <ul><li>Clinical: </li></ul><ul><ul><li>Floating spot in the field of vision blurring of vision </li></ul></ul><ul><ul><li>More likely to have chronic inflammation (months to years) </li></ul></ul><ul><ul><li>PE: vitreous opacities, WBC cells in anterior chamber and retrolental space and/or anterior vitreous, PVD </li></ul></ul><ul><li>Causes: like anterior uveitis </li></ul><ul><li> multiple sclerosis </li></ul><ul><li>Complication: posterior subcapsular cataract (PSC), </li></ul><ul><li>cystoid macular edema (CME) and traction retinal detachment(TRD), choroidal neovascularization (CNV), </li></ul><ul><li>vitrenous hemorrhage, glaucoma </li></ul><ul><li>Treatment: Topical steroid or retrobulba injection </li></ul><ul><li> Px of complication: medication, Laser, surgery </li></ul>
  6. 6. Postrior uveitis: choroiditis, chorioretinitis, retinitis Clinical : Blurred vision, floaters, deep eye pain, scotomata PE : vitreous clouding, CME, geographic or coin-like choroiditis, retinal neovascular membrane and hemorrhage and/or RD : Mostly involve bilaterally, : Chronic course (months-years)
  7. 7. Causes: Infection : Viruses (CMV, HSV, HZV, HIV, EBV,etc), : Bacteria: Tbe, Syphilis, Neisseria menigitidis : Fungus: Candida, Histoplasma, cryptococcus : Parasitic: Toxoplasma, Toxocara, cysticercus Non infection: Immune: Behect’s, VKH, Polyarteritis Nodosa, Sympathetic ophthalmia, Retinal vasculitis, sarcoidosis, multiple sclerosis, SLE : Malignancy: Leukemia, melanoma, reticulum cell sarcoma, metastatic lesions Unknown : 40-60 % Complication: like intermediate uveitis, visual “loss” Treatment: ATB, oral and/or IV steroid, other immunosuppressive drugs. : Treat complication : medication, Laser, Surgery
  8. 8. Disorders of Lens <ul><li>Opacification (Cataract) </li></ul><ul><li>Dislocation : hereditary, traumatic </li></ul><ul><li>Distortion </li></ul>
  9. 9. Cataract <ul><li>Senile cataract most are bilateral </li></ul><ul><li>Childhood cataract </li></ul><ul><ul><li>Congenital or infantile: may be unilateral or bilateral </li></ul></ul><ul><ul><li>Acquired </li></ul></ul><ul><li>Traumatic : penetrating or blunt trauma </li></ul><ul><li>Complicated cataract : 2 nd to intraocular disease: </li></ul><ul><li>uveitis, glaucoma, RD </li></ul><ul><li>Associated with systemic diseases : DM, </li></ul><ul><li>Down syndrome, atopic dermatitis </li></ul><ul><li>Toxic cataract : drug ; steroid, statin, phenothiazine </li></ul><ul><li>After cataract (secondary membrane) </li></ul>
  10. 10. Cataract surgery <ul><li>Terms </li></ul><ul><li>ICCE = Intracapsular Cataract Extraction </li></ul><ul><li>ECCE = Extracapsular cataract Extraction </li></ul><ul><li>Phaco = Phacofragmentation and Phacoemulsification </li></ul><ul><li>IOL = Intraoular Lens </li></ul><ul><li>YAG Laser for after cataract </li></ul>
  11. 11. Complication of cataract surgery <ul><li>Infection </li></ul><ul><li>Uveitis </li></ul><ul><li>Glaucoma </li></ul><ul><li>Vitreous prolapse and RD </li></ul>

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