Overview of uveitis - Part2 Clinical features

8,793 views

Published on

www.ophthalclass.blogspot.com has the complete class on uveitis for undergraduate medical students. This presentation is the second part of the introductory class in the series and deals with the clinical features of uveitis.

Published in: Health & Medicine
4 Comments
26 Likes
Statistics
Notes
No Downloads
Views
Total views
8,793
On SlideShare
0
From Embeds
0
Number of Embeds
282
Actions
Shares
0
Downloads
0
Comments
4
Likes
26
Embeds 0
No embeds

No notes for slide

Overview of uveitis - Part2 Clinical features

  1. 1. D r. A n u p a m a K a r a n t h www.ophthalclass.blogspot.com www.ophthalclass.blogspot.com
  2. 2.  Symptoms: Classical triad of acute onset  Pain  Redness  Photophobia  With or without diminished vision Chronic iridocyclitis – variable presentation www.ophthalclass.blogspot.com
  3. 3. 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
  4. 4.  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
  5. 5. 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
  6. 6. Corneal Aqueous endothelium • Keratic precipitates • Aqueous cells • Aqueous flare • (Leucocytes on sticky endothelium) www.ophthalclass.blogspot.com
  7. 7. www.ophthalclass.blogspot.com
  8. 8.  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
  9. 9. cells flare www.ophthalclass.blogspot.com
  10. 10. Pupil Iris • Miosis • Muddy iris • Sluggish reaction • Iris nodules • Posterior synechiae www.ophthalclass.blogspot.com
  11. 11. Festooned pupil – multiple posterior synechiae seen on pupillary dilatation www.ophthalclass.blogspot.com
  12. 12. Posterior synechiae Posterior synechiae with cataract in a child with blunt injury www.ophthalclass.blogspot.com
  13. 13.  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
  14. 14.  Symptoms  Insiduous onset  Floaters  Opacities in the anterior vitreous  Diminished vision www.ophthalclass.blogspot.com
  15. 15. 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
  16. 16. Pars plana Anterior vitreous • Snowballs • Snow banking www.ophthalclass.blogspot.com
  17. 17. Peripheral Anterior retina chamber • Periphlebitis • Spill over aqueous cells, flare and KPs www.ophthalclass.blogspot.com
  18. 18.  Symptoms  Painless  Visual disturbances  Floaters  Metamorphopsia  Macropsia / Micropsia  Photopsia  Blurring of vision www.ophthalclass.blogspot.com
  19. 19. 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
  20. 20. Choroid Vitreous • Vitritis • Yellow white infiltrates Optic nerve Retina • Infiltrates • Papillitis • Perivascular cuffing www.ophthalclass.blogspot.com
  21. 21. Cells and exudates seen in the anterior vitreous www.ophthalclass.blogspot.com
  22. 22. 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

×