8. TREATMENT OF ANTERIOR UVEITIS
LOCAL SYSTEMIC TREATMENT OF
COMPLICATION
⢠Hot compress
⢠Dark glassess
⢠Atropine 1%
eyedrop
⢠Corticosteroid
⢠Corticosteroid
(dexamethason
e)
⢠Analgesics
(NSAID)
⢠Immunosupress
ant
⢠Cataract â lens
extraction
⢠Secondary
glaucoma
(timolol,
acetazolamide
tab)
⢠Annular
synechiae
ď laser
iridotomy
9. 2. Intermediate uveitis
- Inflammation involving
pars plana, peripheral
retina, choroid and
vitreous base.
⢠80% bilateral
⢠Age : 2-4 decade
⢠85% idiopathic
⢠15%- tb, syphilis
⢠C/F
- Usually asymptomatic
- Later- blurry and
decrease vision.
10. ⢠Signs
- Anterior segment appears
normal or little KPs, flare.
- Posterior segment shows
snowball / cotton ball
opacities (vitreous
condensation)
⢠Prognosis
- Good
⢠Complication
- 42% cataract
- Secondary glaucoma
- Vitreous hemorrhage
- Retinal detachment
⢠Rx
- Tropical steroid
- Immunosupressive drugs.
- Cryotherapy or indirect
laser photocoagulation
for snowbanking.
11. 3. Posterior Uveitis :
- Inflammation of the
choroid and always
involves the adjoining
retina (chorioretinitis)
⢠Clinical type
- Diffuse choroiditis.
- Disseminated choroiditis.
- Focal choroiditis.
⢠C/F
- Defective vision
- Photopsia
- Black spots floating in
front of the eyes.
- Metamorphopsia.
- Micropsia / macropsia
12. ⢠Signs
- Fundus examination
shows features of a
patch of choroiditis.
- active patch of
choriditis :
pale yellow / dirty white
raised area.
⢠Complication
- complicated cataract
- Vitreus degeneration
- retinal detachment
⢠Rx
- Corticosteroid
- Immunosupressive
- Specific treatment for
tb, syphilis
13. Clinical classification
⢠Acute uveitis
- Sudden onset
- Lasting for 6w-3m
*recurrent uveitis :
- Repeated episodes with
inactive period of >3m of rx
⢠Chronic uveitis
- Insidious onset
- Asymptomatic
- Lasting >3m-years
- Diagnosed when already
develop defective vision
16. B ) Suppurative / Purulent uveitis
- Invasion of pyogenic organism.
- May start as purulent anterior (iridocyclitis ) or
purulent posterior (choroiditis),
- which soon progresses to involve retina and
vitreous,
- which ultimately leading to endopthalmitis
and panopthalmitis.
17. ⢠Endopthalmitis â
inflammation of inner
structure of eyeball
- Etiology :
ďź GP cocci, streptococci,
pseudomonas,
pneumococci.
ďź Fungal (rare)-
Aspergilus, Fusarium,
Candida.
⢠Panopthalmitis â
intense purulent
inflammation of whole
eyeball.
- Etiology :
ďź Same
18. ⢠Endopthalmitis
- Modes of infection :
ďź Exogenous following
perforating injury,
perforated corneal ulcer,
post eye surgery.
ďź Endogenous tru blood
stream from caries teeth,
septicemia.
ďź Secondary infection
following orbital cellulitis,
thrombophlebitis,
infected corneal ulcer.
⢠Panopthalmitis
- Modes of infection :
ďź Same
19. ⢠Endopthalmitis
- c/f :
ď Severe ocular pain,
redness
ď lacrimation,
ď photophobia,
ď loss of vision
⢠Panopthalmitis
- c/f :
ď Severe ocular pain,
headache,
ď complete loss of vision,
ď profuse watering,
ď purulent discharge,
ď marked swelling and
redness of eye,
ď associated fever and
malaise.
Kp - Epitheloid cell and macrophages
Flare â leakage of protein particles into aq humour from damaged BV
Synechiae â adhere of iris and lens
Hot compress- increase circulation, reduce stasis
Dark glass â reduce photophobia, lacrimation
Floating â large exudative clump in vitreous.
Metamorphopsia â distorted images of the object.
Micropsia â sepration of visual cells, macropsia â crowding together of rods and cones.
Endopthalmitis â inf of inner structure of eyeball