Uveitis

Inflammation of the uveal tract

Classifications:

Anatomical Classification:

1.Anterior Uveitis

2.Intermeciate Uveitis

3.Postetior Uveitis

4.Pan-Uveitis

Clinical Classification:

a.Acute Uveitis

b.Chronic Uveitis

Causes of Uveitis:

1.Idiopathic:in most cases,no cause is found in more than 50%of the cases.

2.Non-Infectious causes:

-Behcet disease. -Sarcoidosis. -Multiple sclerosis. -Ulcerative colitis

-HLA-B27associated syndromes such as. Reiter syndrome

-Psoriatic arthritis. -Ankylosing spondylitis. -Sympathetic ophthalmia

3.Infective causes

a.bacterial; TB,syphilis,brucellosis
b.viral;HIV(AIDS),Herpes simplex,Varicella zoster,Cytomegalovirus.

c.parasitic;toxoplasmosis,toxocariasis.

d.fungal:Histoplasmosis,Cryptococcosis,Candidiasis.

Investigations:

see below.

Clinical Features:

1.Acute anterior uveitis(iritis,iridicyclitis):

--redness of the eye(red eye)

--blurring of vision

--photophobia

--irregular pupil

--eye pain

--headache

--floaters(dark spots that float in the visual field)

--dilated ciliary vessels

--cells and flares in the anterior chamber(AC){AC cells and flares}

[flares;dust-like protdins inAC]

--Keratic Precipitates(KPs);infammatory cells adhered to corneal

endothelium.
--hypopyon(pus in AC)

In chronic anterior uveitis No signs of acute infammation(white eye)

Signs:

--synechiae(adhesions) iris is adhered to the anterior lens capsule.

--iris nodules

2. Intermediate Uveitis:(cyclitis,planitis)

In some cases is discovered accidentely or presdnted with;

--floaters

--blurred vision

On examination:

--infammatory reaction in the anterior vitreous.

--normal retina

--white eye

3.Posterior Uveitis(Choroiditis, Chorio-retinitis) presented with:

--white eye

--floaters

--blurring of vision

--photopsia(seeing flashing lights)

On examination:

--retinits(yellowish spots on the retina)

--vasculitis;signs of inflamed blood vessels;

--sheathig of blood vessels

--attenuation of blood vessels

--cotton-wool spots

--edema

4.Pan-Uveitis: clinical features include all the above manifestations.

Treatme t:

The treatment is mainly by steroids

--topical steroids for anterior uveitis.

--systemic steroids for itermediate uveitis and posterior uveitis.

--intra-vitreal injections of medications is used sometimes for intermediate

uveitis and posterior uveitis.

--anti-infective cover for infective causes.

--othrt options;--cytotoxic drugs

--immune modulators