Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Idiopathic intracranial hypertension wikipedia , lookup
Keratoconus wikipedia , lookup
Diabetic retinopathy wikipedia , lookup
Macular degeneration wikipedia , lookup
Mitochondrial optic neuropathies wikipedia , lookup
Retinitis pigmentosa wikipedia , lookup
Anterior Uveitis (iritis) Anatomy • Uveitis = inflammation of the uvea • Uvea = iris, cilliary body, choroid • Anterior uveitis = inflammation of iris and anterior chamber • Intermediate uveitis = inflammation of middle part of the uveal tract, mainly the vitreous humour. It can also affect the underlying retina. • Posterior uveitis = inflammation which affects the back (posterior) part of the eye. It can affect the choroid, the head of the optic nerve, and the retina (or any combination of these structures). It includes chorioretinitis, retinitis and neuroretinitis. • Panuveitis = inflammation affecting the whole of the uveal tract WHO ? • Most common in young/middle aged adults 20-59yrs • Affects 17-52 people per 100,000 per yr • • • • Causes ? 50 % are idiopathic 50 % of those with anterior uveitis are HBLA27 +VE May be secondary to corneal graft Eye infections e.g. toxoplasmosis, herpes virus keratitis Other associations .. • Autoimmune : HLAB27, Reiters syndrome, Bechets • Infectious : leptospirosis, lyme disease, syphilis,TB • Systemic disease : IBD, MS, kawsaki’s, juvenile arthritis, polyarteritis nodosa,psoriatic/reactive arthritis, sarcoidosis, SLE • Drugs : Rifabutin ( similar to rifampicin) • Trauma • Cancer : NHL, HL, Leukaemia, Melanoma Presents .. Symptoms • Acute onset pain • Photophobia • Blurred vision • Decreased visual acuity • Headache Signs • Watering • Circumcorneal redness • Small or irregular pupil • +/- hypophyon ( anterior chamber pus causing white ‘fluid-level’ line) • +/- keratitic precipitates on posterior surface of cornea • Cells in anterior chamber on slit lamp exam • Increasing pain as the eyes converge and the pupils constrict Management • Urgent opthalmology referral (within 24hrs) normally topical/oral glucocorticoid steriods • Cycloplegic drops for comfort e.g. Atropine • Simple analgesia Complications • • • • • • • • Cystoid macular oedema Secondary cataract Posterior synechiae (irregular pupil shape) Raised IOP Glaucoma, secondary to either inflammatory process or steriods Vitreous opacities Retinal detachment Neovascularisation of the retina/optic nerve/iris Relapses are common BUT with prompt and effective treatment 91% return to normal vision