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67 Cards in this Set
- Front
- Back
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Acute anterior uveitis sx
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photophobia, pain, redness
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6 signs anterior uveitis
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small kp
ciliary flush flair spill over into anterior vit iris vessel dilation hypopion |
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4 causes of hypopion in anterior uveitis
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HLA B27 - most common
Bhecets Drugs - rifabutin Endophthalmitis |
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IOP in anterior uveitis
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usually low
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Cause of decreased vision in anterior uveitis?
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CME
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T/F disc edema is never present in anterior uveitis
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False
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Bilateral new onset anterior uveitis think__
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TINU - tubulointerstitial nephritis and uveitis syndrome - do UA and urinary 2A microglobulin
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What percent of anterior uveitis cases recurr?
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2/3
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What is the prevalence of HLA B27 in whites
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8%
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HLA B27 prevalence in acute anterior uveitis
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50%
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What is the most common type of HLA B27 uveitis
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anchylosing spondylitis - back pain is worse in the AM
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Rx for anchylosing spondylitis
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start with NSAIDS
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Dx test for anchylosing spondylitis
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Sacrioliac spine film
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What % of pts who are HLA B27 positive are symptomatic (any symptoms)
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90%
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What % of HLA B27 develop disease of any kind
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25%
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Reactive arthritis
3 major features 3 minor features |
urethritis
polyarthritis uveitis also skin findings cerinate balinitis achelles tendenitis (aka Rieter's syndrome) |
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Reactive arthritis associated with what infections
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Salmonella
Shigella |
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Ulcerative colitis is associated with what HLA
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HLA B27
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Can you have uveitis with psoriasis without arthritis
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yes, worse course but on the exam usually have both skin involvement and arthritis
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Is blindness common in HLA B27
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no
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Bhecets disease prognosis
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can go blind
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Bhecets pathogenesis
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occlusive vasculitis
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4 major clinical signs of Bhecets
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Mouth ulcers
Genital ulcers Uveitis Arthritis or skin findings |
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What is the global distribution of Bhecets
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Silk road
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skin findings in Bhecet's
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Erythema nodosum
Prick of skin causes blister in minutes - not sensitive |
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HLA what in Bhecets
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HLA B51
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What is a severe complication of Bhecets
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stroke
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Rx for Bhecets
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Cyclosporine and azathioprine
or alkylating Agents colchicine works for oral ulcers only |
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Retina findings in Bhecets
(4) |
Occlusive vasculitis
+/- necrosis copper wiring pale nerve |
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What is Possner Schlossman syndrome
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Iridocyclitis
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Does Posner Schlossman change laterality
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Almost never
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Rx of Possner Schlossman
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IOP lowering and steroid
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Phacoantigenic uveitis happens when
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right after cataract surgery
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Phacoantigentic uveitis finding
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kp, dense flair
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Pathology in phacoantigenic
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Zonal granulomatous reaction, lymphocytes
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Rx for phacoantigenic
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get the lens out
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Phacolytic glaucoma pathogenesis
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leaching out of capsule, macrophages and material clog TM
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Rx for phacolytic glaucoma
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cataract extraction once inflammation is controlled
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Chronic inflammation post op
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Regular uveitis
Mechanical irritation from lens - look for pigment or TID of iris Phacoantigenic/lens induced - look for lens chip in the angle Delayed onset endophthalmitis - vitritis with a/c inflammation;Lens material or location is not associated with uveitis |
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UGH syndrome
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hyphema and glaucoma after CE/IOL, esp in anterior lens
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Immediate uveitis after CE
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staph epi
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Uveitis long after CE
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P acnes - only 25% will be culture positive
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describe herpetic uveitis
location acuity course IOP |
same eye
acute episodic high pressure |
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Rx for herpetic uveitis
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oral antivirals (topicals won't work)
Valacyclovir has best aqeous penetration Also PF but only when on antivirals if > QD |
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Hypopion cause in Refabutin
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Micobacterial death in the eye, good response to steroids
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JIA RH and ANA
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RH negative, ANA positive
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JIA joint pain duration
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Must be 6 weeks long
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Stills disease age
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<5yo
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Polyarticular uveitis makes up what % of JIA
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10% of JIA uveitis
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Pauciarticular uveitis makes up what % of all JIA
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25%, usually girls, <5 joints
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Presenting signs in JIA
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white eye, cells only
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Inflammation in white eye = 2 entities
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JIA
Fuchs |
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JIA signs and complications
(7) |
band keratopathy
fine KP flair out of proportion to cell synichia glaucoma cataracts - surgery very dangerous cyclitic membrane -> blindness |
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Age of onset JIA
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6yo
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Does arthritis correlate with uveitis in JIA
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NO
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High risk of JIA
# joints age ANA RH What is the f/u |
Pauciarticular
6yo ANA + RH- see q3mo |
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Rx of JIA
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topical PF, avoid systemic steroids
short acting cycloplegics, to keep iris moving MTX - best choice, good safety and efficacy f/u q 3 months until 7yo, then every 6 mo until teens |
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How long should JIA be controlled before CE
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at least 3 months
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Fuchs heterochromic cyclitis sx
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none, usually incidental dx, heterochromia is subtle
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Cause of heterochromia of Fuchs
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atrophy of the iris, may be darker or lighter depending on starting color of eye
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KP in Fuchs
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small diffuse KP
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Gonio in Fuchs
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bridging vessels without contraction, normal vessels that cross TM
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risk of NVG in Fuchs
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none but 60% will develop glaucoma
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Hyphema in CE
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think Fuchs
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Rx of Fuchs
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none, just treat complications
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Pathogenesis of Fuchs
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Rubella infection, even in immunized pts, high rubella titers in the AC
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