Uveitis: Difference between revisions

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==References==
==References==
Tintinalli


[[Category:Ophtho]]
[[Category:Ophtho]]

Revision as of 14:08, 8 November 2015

Background

  • Uveitis = inflammation of iris, ciliary body, and/or choroid

Types

  • Anterior Uveitis
    • Inflammation of iris and/or ciliary body
    • Types:
      • Iritis
      • Iridocyclitis
  • Posterior uveitis = choroiditis

Causes

Clinical Features

Anterior

  • Sudden red/painful eye
  • Deep pain; worse with eye movement
    • Due to ciliary muscle spasm which irritates CN V
      • Causes consensual photophobia
  • Limbic redness (as opposed to perilimbal sparing seen in conjunctivitis)
  • Poorly reactive pupil

Posterior

  • Floaters
  • Visual changes
  • Generally does not cause redness or significant pain
  • Blind spots or flashing lights

Differential Diagnosis

Unilateral red eye

^Emergent diagnoses ^^Critical diagnoses

Acute onset flashers and floaters

Diagnosis

  • Slit-lamp
    • Cell (WBCs from uveal vessels) & flare (proteinaceous transudate from uveal vessels)
    • Hypopyon (with severe disease)
  • CXR (uveitis often associated with sarcoidosis, TB)

Treatment

  • Infectious
    • Treat the underlying infection
  • Noninfectious
    • Anterior uveitis
      • Topical Steroid (anterior only)
        • Prednisolone 1%
      • Mydriatics (sympathomimetics)
        • Prevents the formation of synechiae
        • Phenylephrine HCl or Hydroxyamphetamine HBr
      • Cycloplegics
        • Relieves pain
        • Scopolamine 0.25% OR cyclopentolate 1%
    • Posterior Uveitis
      • Generally not responsive to topical treatment
      • Consult ophtho for obs vs intraocular steroid injection

Disposition

  • Ophtho consult within 24-48hr

Complications

  • Cataracts
  • Glaucoma (from synechia)
  • Retinal detachment

References