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54 Cards in this Set

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Often not a primary ocular disease but a single manifestation of another systemic disease process.
Anterior Uveitis
Most common form of ocular inflammation causing a painful red eye.
Iritis (both granulomatous and non-granulomatous)
Anterior Uveitis accounts for _________% of all uveitis seen and _:_ more common than posterior.
80-90%
4:1
Etiologies of Anterior Uveitis
(1) idiopathic
(2) traumatic
(3) post-operative
(4) ocular or systemic disease
Hypopyon almost always due to _________ associated anterior uveitis, Behcet's disease, endophthalmitis or neoplastic masquerade syndrome.
HLA-B27
Slit lamp exam of A/C for anterior uveitis. Need cells to be ________. If not, push back further with beam.
ascending
Acute Uveitis typically _______ IOP.
lowers
Herpetic uveitis, toxoplasmosis, sarcoidosis and Posner-Schlossman synd. typically _______IOP.
elevate
Bulbar and palpebral conj. granulomas can occur in _________ and ___________.
sarcoidosis
tuberculosis
Most keratic ppt' (KPs)of the cornea settle inferior between _______ and _________ forming _________.
4 o'clock
8 o'clock
Arlt's triangle
Granulomatous KPs of the cornea that are greasy suggest:
sarcoidosis
TB
syphilis
Nongranulomatous KPs of the cornea tend to be small and occur in _________
any type of uveitis
Fine stellate KPs of the corneal endo. occur in:
(1) herpetic uveitis
(2) Fuch's heterochromic iridocyclitis
(3) toxoplasmosis
(4) sarcoidosis
Sarcoidosis can present with non-granulomatous characterisitcs.
T or F
True
Hypopyon in a child or elderly must rule out:
pseudo-hypopyon composed of tumore cells from a primary or metastatic lesion
Neoplastic or proliferative lesions that cause intraocular infiltration of cells, stimulating immune-mediated uveitis.
Masquerade Synd.
Most frequent neoplastic masquerader.
Primary intraocular or retinal lymphoma (PIOL)
A high grade malignant non-Hodgkins lymphoma arising in the retina with involvement of the vitreous and sometimes the optic nerve.
Primary intraocular or retinal lymphoma (PIOL)
Think leukemia if see hypopyon in __________.
Child
Think primary intraocular lesion is see hypopyon in _________.
Adult
Primary intraocular (retinal) Lymphoma (PIOL) presents with:
(1) bilateral idiopathic steroid resistant chronic uveitis with vitritis
(2) blurred vision/painless/red eyes
(3) exudative retinal detachment
(4) fundus mass
(5) glaucoma
(6) neo
(7) optic neuropathy
(8) varying chorioretinal abnormalities
Iris nodules or iris ppts suggest:
sarcoidosis
infectious uveitis
Iris atrophy suspect:
(1) Fuchs' heterochromatic iridocyclitis
(2) herpetic uveitis
Sectoral iris atrophy suspect:
herpes
Iris atrophy of the pupillary margin suspect:
HSV
Iris atrophy of the base or root suspect:
HZO
Iris nodules in pupillary margin suspect:
Koeppe
Iris nodules in stroma suspect
BuSacca
______% of uveitis occurs in children < 16 y.o.
5-10%
AU in adults is more blinding than in children.
T or F
FALSE!
40% of cases are posterior uveitis
Pediatric AU sequelae:
(1) glaucoma
(2) macular edema
(3) retinal damage
(4) cataract formation
Anterior Uveitis workup. 5 tests:
(1) HLA-B27
(2) VDRL alone or w/FTA -ABS
(3) CBC
(4) chest x-ray
(5) ACEif uveitis chronic
Controlled inflammation is a patient with ________ cells and _____ flare in the A/C.
_______active retinal inflammation and ______ cystoid macular edema.
NO
up to 1+
N0
N0
______ limits the options for glaucoma treatment and makes mgt more difficult.
active inflammation
____% of uveitis patients will develop EIOP.
25%
Patients with uveitic glaucoma treatment.
surgery to ctrl EIOP
Any inflammation which is primarily in the region of the pars plicate, pars plana and peripheral retina.
Intermediate Uveitis
Diagnosed by presence of highest concentration of cells on anterior vitreous with or w/o evidence of exudates or classic collagen band "snowbanks". NO signs of intraocular foreign body or infection.
Idiopathic Intermed. Uveitis, Pars Plantis
Of Idiopathic Intermed. Uveitis, Pars Plantis patients, _______% lose vision to 20/40 never recover 20/20.
35%
Most common cause of pediatric anterior uveitis.
Juvenile Rheumatoid Arthritis
Most common cause of anterior uveitis.
Idiopathic
Onset of JRA in 30% of cases characterized by high remittent fever and at least one of following: lymph-adenopathy, maculopapular rash, hepatomegaly, spleeno-megaly, or pericarditis. UVEITIS RARE!
Systemic
Onset of JRA in 20% of cases in which the disease affects 5 or more joints and involves knees, wrist, and ankles.UVEITIS FAIRLY RARE!
Poluarticular
Onset JRA in 50% of cases in which 4 or less joints are involved. 75% are girls and 30% develop non-granulomatous uveitis.
Pauciarticular
For JRA treatment, you should adjust steroid therapy by the degree of flare found in the A/C.
T or F
FALSE!
degree of cell
Presents uniocularly with acute onset of severe pain, redness, photophobia and decreased vision. Affects more males in 30s w/history of back pain.
Specific AU, HLA-B27
Most common form of hypopyon uveitis in the US with fibrinous exudates (bumpy hypopyon).
Specific AU, HLA-B27
A spondyloarthropathy that occurs after enteric or urogenital infection
Sepcific AU, Reactive Arthritis- Reiters Syndrome
Reiters Syndrome triad:
(1) conjunctivitis
(2) arthritis
(3) urethritis
Stromal iris atrophy is much more common in HZO than in HSV.
T or F
TRUE!
90% uniocular. Low grade panuveitis with rapid onset cataract formation and high risk of secondary open angle glaucoma.
Specific AU, Fuch's Heterochromic Iridocyclitis
Diffuse atrophy of the iris stroma, fine stellate KPs and mild ant. seg. inflammation with moderate number of cells.
Specific AU, Fuch's Heterochromic Iridocyclitis
Rare; occurs in middle-age. UNILATERAL, acute episode of EIOP associated with AU. IOPs range 40-70.
Glaucomatocyclitic Crisis, Posner-Schlossman Syndrome
The "great mimicker". Ocular manifestations: bleph, madarosis, conjunctivitis, dacryocystitis, keratitis, iris nodules, iridocyclitis, episcleritis.
Specific Anterior Uveitis, Syphilis-T. pallidum