The document summarizes uveal tract disorders and classifications of uveitis. The uveal tract includes the iris, ciliary body, and choroid. Uveitis is inflammation of the uveal tract and can be classified anatomically by the specific structure inflamed or clinically by duration. Etiological classifications include infections, systemic diseases, and trauma. Clinical features vary by location but may include pain, redness, decreased vision, and cellular deposits in the eye. Complications can include glaucoma, cataracts, retinal issues. Treatment involves steroids, antibiotics, immunosuppressants depending on cause and severity.

1. UVEAL TRACT DISORDERS
• The uveal tract comprises of iris, ciliary body and the
choroid.
• The outer layers of the retina derive their blood supply from
the choroid
• Uveitis is the inflammation of uveal tract

2. CLASSIFICATION OF UVEITIS
Anatomical classification
• Iritis is inflammation of iris.
• Iridocyclitis is inflammation of iris and anterior part of the
ciliary body.
• Intermediate uveitis - inflammation of the posterior part of
the ciliary body and peripheral choroid.

3. • Posterior uveitis/chorioretinitis - inflammation of the
choroid and the retina posterior to vitreous base
• Panuveitis – inflammation of the entire uveal tract
Clinical classification of uveitis
• Acute uveits – sudden onset and up to 3 months
• Chronic uveitis persists for more than 3 months and it’s of
gradual on set and may be asymptomatic.

4. Aetiological classification
Classification according to causes
Infections
• Bacterial - include T.B, leprosy, syphilis, pyogenic bacteria
• Fungal infection – candidiasis, cryptococcus, histoplasmosis,
aspergillus.
• Parasites - Toxoplasma gondii, Toxoplasma canis, Pneumocystis carina,
onchocerciasis, cysticercosis.
• Viral - HZ/Varicella, CMV, Herpes simplex, congenital rubella.

5. Uveitis associated with systemic diseases or non
infective/immunological.
• Sarcoidosis
• Ankylosing spondylitis
• Ulcerative colitis
• Reiter's syndrome
• Juvenile arthritis
• Bahcet disease
• Traumatic: penetrating/surgical trauma, lens induced

6. Clinical features of uveitis
Anterior uveitis
Symptoms
• Photophobia, pain, redness, decreased vision, and
lacrimation.
Signs
• Decreased visual acuity
• Circumcorneal/ciliary injection
• Keratic precipitates are cellular deposits on corneal
endothelium

8. Signs cont’d
• Small irregular pupil that adheres to lens or cornea
• Aqueous flare is due to scattering of light by proteins that
are released in aqueous by damaged iris vessels.
• Aqueous cells are indicative of active inflammation, the cells
can be the observed with a slit lamp
• Hypopyon-pus in anterior chamber
• Iris nodules are features of granulomatous inflammation
- Koeppe nodules are small and are seen at pupil border
- Busacca nodules are located a way from pupil

9. Complications of uveitis
• Synechiae are adhesions between iris and lens
• Secondary glaucoma/inflammatory exudates clogging the
trabecular meshwork.
• Pupil block glaucoma/iris bombe bowing forward of the iris
• Phthisis bulbi - lowering of intraocular pressure due to decreased
production of aqueous
• Cataract
• Retinal membrane formation
• Retinal detachment/tractional RD
• Band keratopathy

12. Intermediate uveitis
• Symptoms: floaters and impaired visual acuity
• Signs: cells in vitreous and few in anterior chamber
• Absence of inflammatory lesion in the posterior fundus

13. • Posterior uveitis may be asymptomatic, mild redness and perception of
floaters.
• Signs: vitreous cells, flare and opacities
- Choroiditis: there are deep yellow or grey patches with fairly well
demarcated borders
- Inactive lesions are white well defined areas with pigmented borders
• Retinitis: retina is white, cloudy and retinal vessels are not seen clearly
• Vascularitis frequently affects retinal veins, white haziness surrounding
vessels

14. • Choroiditis - Pneumocystis, cryptococcus
• Retinitis - CMV, varicella, toxoplasmosis
CMV retinitis - Arterial occlusion
- Haemorrhages
- Retinal necrosis
Congenital rubella - pigmentary retinopathy, cataract
microphthalmos, iritis and glaucoma

15. Treatment
• Investigations
• Steroid-antibiotic eye drops like gentadex, dexa N, Tobradex
• Subconjuctival injection of triamcinolone and
methylprednisolone for chronic uveitis
• Systemic steroids like prednisone
• Atropine eye drops once or twice a day
• Immunosuppressive agents i.e., azathioprine, methotrexate
and cyclosporin