Uveitis

Objectives

 Define and classify uveitis anatomically, clinically

and etiologically
 Describe the signs and symptoms of different types
of uveitis and identify the differentiating points
 List the complications of different types of uveitis
 List the investigations needed in selected cases of
uveitis
 Describe the treatment of different types of uveitis
 Uveitis
 Anatomy of Uveal
tract: (Uvea= Grape)
 1- Iris

 2- Ciliary body

 3- Choroid
Uveitis

 Definition:

 Classification:
 - Anatomical.
 - Clinical.
 - Aetiological.
Uveitis

 Anatomical Classification:

 1- Anterior uveitis
 2- Intermediate uveitis
 3- Posterior uveitis
 4- Panuveitis
Uveitis

 Clinical classification:

 1- Acute uveitis: <3 months

 2- Chronic uveitis: >3 months
Uveitis
 Aetiological classification:
 1- Associated with a systemic
disease, e.g.:
 a- Spondyloarthopathies
 b- Inflammatory bowel disease
 c- Nephritis
 d- Non-infectious multi-system
disease
 e- infectious systemic disease
 f- Diabetes
Oral ulcers
VKH
Uveitis

 Aetiological classification:
 2- Infections:
 a- Bacterial: tuberculosis.
 b- Fungal: Candidiasis.
 c- Viral: Herpes Zoster.
Uveitis

 Aetiological classification:
 3- Infestations:
 a- Protozoa: Toxoplasmosis.
 b- Nematodes: Toxocariasis.
Uveitis

 Aetiological classification:

 4- Idiopathic: 50%
 (most common cause).
Anterior uveitis

 Symptoms:

 1- Acute anterior uveitis:

 2- Chronic anterior uveitis:
 Anterior uveitis
 Signs:
1-Circumcorneal
injection:
 Anterior uveitis
 Signs:
 2- Keratic
 Precipitates
 KPS
 Anterior uveitis
Signs:
3-inflammatory
cells
 Anterior uveitis
 Signs:
4- flare and
hypopion
Anterior uveitis

 Hypopyon
 Anterior uveitis
 Signs:
Pupillary
miosis
Anterior
Uveitis
 Miosis
 Anterior uveitis
 Signs:
IOP
 Anterior uveitis
 Signs:
Iris nodules
 Complications of anterior
uveitis:
 1- Posterior synechiae:
 2- Cataract.

 3- Glaucoma:

 4- Cyclitic membrane

formation and phthisis bulbi.

Intermediate uveitis

 Symptoms:
 Initially, floaters
 later, decreased visual acuity due
to macular oedema.
 Signs:
 Cellular infiltration of vitreous
(vitritis).
Posterior uveitis

 Symptoms:
 1- Floaters

 2- Impairment of visual acuity

 Posterior uveitis

 Signs:
 1- Cells, flare, opacities and

posterior vitreous detachment.

 2- Retinitis:

 3- Vasculitis:
Posterior uveitis
Chorioditis
Retinitis
Retinal vasculitis
Investigations

 X ray
 Skin tests
 Serological
 HLA typing
Treatment:

 1- Cycloplegic and Mydriatics:

 2- Steroids:
 Topical or periocular injection
 Intravitreal injection of steroids
 Systemic steroids
 3- Immunosuppressive agents
 4- underline cause