Disease 27 - Uveitis

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Author:
sookylala
ID:
224942
Filename:
Disease 27 - Uveitis
Updated:
2013-06-25 00:31:03
Tags:
uveitis
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Description:
uveitis
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  1. acute?
    • sudden onset
    • limited duration
  2. recurrent
    • repeated episodes
    • separated by periods of inactivity wo tx
  3. chronic
    persistent with relapse after discontinuing tx
  4. AAU?
    • sx: sudden, uni pain, RE, photo/tear
    • signs: ciliary inj, pink epis vessels, constricted sluggish pupil, endo cell dusting, flare, synechiae, hypopyon
  5. ant chamber in AAU?
    • cells in aqueous: leukocytes, RBC, pigment cells moving upwards
    • flare: protein leaking from inflamed iris/ciliary body-> breakdown of BAB
  6. CAU?
    • granulomatous- large deposits of macrophages, plasma/giant cells
    • nongran- small precipitates and lymphocytes
    • bilateral
  7. CAU sx?
    • asymptomatic
    • aqueous cells- variable
    • flare
    • iris nodules- koeppe and busacca
    • KP- lympho, neutro, epitheloid
    • Large KP (granulomatous)- greasy, muttonfat KP glassy appearance
  8. 2ndy complications of CAU?
    cataract and glaucoma
  9. TX of AAU and CAU?
    • cyclopegic- break synechiae, relieve ciliary muscle spasm and pupillary sphincter
    • steroids- AAU- taper frmo intensive, CAU- long term weak dose
  10. HLA-B27+ uveitis?
    • uni, KP nongran
    • M>F
    • assoc disease
    • severe, acute, reccurent
  11. HLA B27- uveitis?
    • M=F
    • non assoc disease
    • chronic
    • loss of vis
  12. HLA B27 spondylarthropathies?
    • ankylosing sponylitis
    • reiter- reactive arthiritis, mild, bi, muco
    • psoriatic arthritis- NSAIDS, psoriasis
    • juvenile idiopathic arthritis- CAU, nongran, bi, asymptomatic, small KP NO HYPOPYON, post synechiae, dusting of corn end
  13. Sarcoidosis?
    • gran, inflammatory disorder
    • sx: mutton fat KP, iris nodules, trab nodules, snowball vitreous opacities, AAU and CAU, DE
    • tx: steroids
  14. Behcet?
    • HLA B51
    • east med and japan
    • bil, 30 yo M
  15. sx behcet?
    • blurr, photo, pain, floaters
    • AAU: recurrent, flare, inflam cells in AC, KPs, hypopyon
    • tx: steroids
  16. VKH?
    • idio, inflam, auto-> melanocytes
    • alopecia, vitiligo, poliosis
    • F, 20-50
    • sx: bi, chronic, diffuse gran, ant and post
  17. Viral?
    • simplex- gran, chronic, atrophy, steroids
    • zoster: atrophy, steroids, asymp/mild
    • congenital rubella: AU-> atrophy
  18. Bacterial uveitis?
    • TB-> chronic granulomatous ant uve
    • syphilis- chronic gran
    • lyme
    • cat scratch- toxoplasmosis
  19. Fuch's heterocrhomic cyclitis?
    • CAU non granulomatous
    • uni F>M, young
    • present: floaters, blurring, PSC, heterochromia
  20. SX of fuch's?
    • no synechiae
    • KP small, stellate, grey white, scattered
    • transparent nodules at pupillary border
    • low flare and cells
    • diffuse iris atrophy-> heterochromia
    • complications: cataract and glaucoma
  21. lens induced uveitis?
    • immune response to lens proteins
    • phacoanaphylactic endophthalmitis:¬†gran AU, Inc IOP
    • non gran phacoanaphylactic uveitis- less sever than other
    • tx: steroids
  22. sympathetic ophthalmia
    • RF: trauma and intraocular surgery
    • bi, granulomatous panuveitis
    • sx: blurry, pain, photophobia
    • ddx: VKH- no trauma, sarcoidosis,
    • tx: EMERGENCY
  23. intermediate uveitis
    • idio
    • sx: plars planitis (snowball formation), AU, vascular changes in retina, vitreous condensation, blur, floaters
    • tx: benign, may not require treatment

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