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Uvea & sclera

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UVEA & SCLERA JUAN S. LOPEZ, MD Chief, Section of Uveitis Institute of Ophthalmology and Visual Sciences St. Luke’s Medical Center
UVEAL TRACT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Iris Ciliary Body Choroid
IRIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],FUNCTION: regulates pupil size
CILIARY BODY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],FUNCTIONS: 1. Acts in accommodation 2. Secretes aqueous humor
IRIS AND CILIARY BODY ,[object Object],[object Object],[object Object],[object Object]
CHOROID ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],UVEAL TRACT FUNCTION: provides nourishment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANTERIOR UVEITIS ,[object Object],[object Object],[object Object],[object Object]
ANTERIOR UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CILIARY INJECTION POSTERIOR SYNECHIAE
KERATIC PRECIPITATES Medium-size keratic precipitates Mutton fat keratic precipitates
IRIS NODULES Koeppe nodules Busacca nodule Hypopyon
INTERMEDIATE UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INTERMEDIATE UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
POSTERIOR UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
POSTERIOR UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Behcet’s Disease ,[object Object],[object Object],[object Object],[object Object]
Vogt-Koyanagi-Harada Disease ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pathological General Ophthalmology, 15 th edition, Vaughan, et al Sometimes Common Recurrence Chronic Acute Course Anterior, posterior, diffuse Anterior Site Sometimes None Iris nodules Sometimes Sometimes Posterior synechia Small, irregular Small, irregular Pupil Large gray (“mutton fat”) Fine, white Keratic precipitates Slight Marked Circumcorneal flush Marked Moderate Blurring of vision Slight Marked Photophobia None or minimal Marked Pain Insidious Acute Onset GRANULOMATOUS NONGRANULOMATOUS
Pathological ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Differential Diagnosis ,[object Object],[object Object],[object Object],Very important to know the differences!
Important to know! Posterior synechia (rare) Posterior synechia (hallmark) Hypopyon COMMON Hypopyon RARE Chemosis No swelling Diffuse hyperemia Ciliary injection Purulent Non-purulent ENDOPHTHALMITIS UVEITIS
UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Goals of Treatment: * Control inflammation * Prevent complications
SCLERA ,[object Object],[object Object],[object Object],[object Object]
SCLERA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
EPISCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SIMPLE EPISCLERITIS ,[object Object],[object Object],[object Object],Simple Sectoral Episcleritis Simple Diffuse Episcleritis
NODULAR EPISCLERITIS ,[object Object],[object Object],[object Object],Scleral translucency
EPISCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object]
SCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object]
ANTERIOR NON-NECROTIZING SCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
ANTERIOR NON-NECROTIZING SCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANTERIOR NECROTIZING SCLERITIS WITH INFLAMMATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ANTERIOR NECROTIZING SCLERITIS WITH INFLAMMATION
ANTERIOR NECROTIZING SCLERITIS WITHOUT INFLAMMATION ,[object Object],[object Object],[object Object],[object Object],[object Object]
POSTERIOR SCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Uvea & sclera

  • 1. UVEA & SCLERA JUAN S. LOPEZ, MD Chief, Section of Uveitis Institute of Ophthalmology and Visual Sciences St. Luke’s Medical Center
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  • 14. KERATIC PRECIPITATES Medium-size keratic precipitates Mutton fat keratic precipitates
  • 15. IRIS NODULES Koeppe nodules Busacca nodule Hypopyon
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  • 22. Pathological General Ophthalmology, 15 th edition, Vaughan, et al Sometimes Common Recurrence Chronic Acute Course Anterior, posterior, diffuse Anterior Site Sometimes None Iris nodules Sometimes Sometimes Posterior synechia Small, irregular Small, irregular Pupil Large gray (“mutton fat”) Fine, white Keratic precipitates Slight Marked Circumcorneal flush Marked Moderate Blurring of vision Slight Marked Photophobia None or minimal Marked Pain Insidious Acute Onset GRANULOMATOUS NONGRANULOMATOUS
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  • 25. Important to know! Posterior synechia (rare) Posterior synechia (hallmark) Hypopyon COMMON Hypopyon RARE Chemosis No swelling Diffuse hyperemia Ciliary injection Purulent Non-purulent ENDOPHTHALMITIS UVEITIS
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Hinweis der Redaktion

  1. Translucent coz of rearrangement of the superficial scleral lamellae into more parallel rows