One Liners about Uveitis

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Introduction:

Uvea = (Iris + Ciliary body + Choroid)

Types:

  1. Anterior uveitis: Iritis & Iridocyclitis
  2. Intermediate uveitis: Pars planitis
  3. Posterior uveitis: Choroiditis
  4. Panuveitis: Inflammation of all the layers.

 

One Liners on Uveitis

Causes:

  • Most common cause of anterior uveitis is Idiopathic
  • Most common cause of anterior uveitis in adult: Idiopathic
  • Most common cause of anterior uveitis in children: Juvenile Rheumatoid arthritis (now known as juvenile idiopathic arthritis)
  • Most common cause of anterior uveitis associated with arthritis is JRA/ JIA
  • MC ocular involvement in JRA: Anterior uveitis
  • MC cause of posterior uveitis: CMV
  • MC cause of posterior uveitis in immunocompetent individuals: Toxoplasmosis
  • SLE is not a cause of uveitis.

 

  • Most common extra-articular manifestation of ankylosing spondylitis is Anterior uveitis
  • Uveitis is not an extra-articular manifestation of Rheumatoid arthritis [MC extra-articular manifestations of RA is Keratoconjunctivitis sicca (KCS)]

 

  • Rifabutin and Cidofovir lead to drug-induced uveitis
  • Most common ocular feature of sarcoidosis: Granulomatous panuveitis.

 

Signs & symptoms:

  • Earliest sign of anterior uveitis: Aqueous flare
  • The earliest sign of active anterior uveitis: Aqueous cells
  • Hallmark of anterior uveitis: Aqueous cells
  • Most diagnostic/ pathognomonic sign of anterior uveitis: Keratic precipitates.

 

Characteristic signs/ appearances:

  • MC symptom of posterior uveitis: Painless diminution of vision (due to macular edema)
  • Pupil in anterior uveitis/ iridocyclitis:
    • Acute: Irregular and constricted
    • Chronic: Festooned pupil
    • Characteristic: Festooned pupil

  • Iris roseola (pinkish iris nodules) is seen in syphilitic uveitis

  • Iris atrophy is pathognomonic finding in: Herpes zoster uveitis
  • Feature of heterochromia iridocyclitis: Hypopigmented iris.

 

Management:

  • Uveitis with raised IOP (also known as Hypertensive uveitis/ Glaucomatocyclitic crisis/ Posner Schlossmann syndrome) is best managed by Steroids
  • Most useful drug to reduce IOP in case of hypertensive uveitis: ?-blockers (Timolol)

 

  • Drug of choice of posterior uveitis caused by CMV: Ganciclovir
  • Treatment of choice of posterior uveitis caused by toxoplasma: Triple therapy (Steroid + Sulfasalazine + Pyrimethamine)
  • Drug of choice of toxoplasma uveitis in pregnancy: Spiramycin

 

  • IOL implantation is contraindicated in uveitis caused by JRA.

 

Complications:

  • MC complication of anterior uveitis/ iridocyclitis: Secondary open angle glaucoma
  • MC complication of recurrent anterior uveitis: Cataract
  • MC cause of complicated cataract: Chronic iridocyclitis
  • Retinal detachment is not a complication of acute anterior uveitis.

 

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