Introduction

UVEA
Dr. Gilbert WS Simanjuntak
Bagian IP Mata FK-UKI
SMF IP Mata RS PGI Cikini
UPF Retina RSMata Cicendo/FK-UNPAD

Uveal Tract
Anatomically composed of:
The iris
The ciliary body
The choroid

Middle vascular layer of the eye

Contributes blood supply to the outer retina

The eye is the window of the human body

through which it feels its way and enjoys
the beauty of the world
Leonardo da Vinci (1452-1519)

The Iris
Anterior extention of the ciliary body
Dividing the anterior chamber from the posterior
chamber
Stroma contain sphincter and dilator muscles
Blood supply: major circle of iris
Sensory fibersfibers the in the ciliary body
Controls the amount of light entering the eye
Constriction parasymphatetic
Dilation symphathetic

The Ciliary Body

Pars plicata: corrugated
Pars plana: flattened posterior pole

Composed mainly of capillaries and veins (drain

through the vortex vein)
Ciliary processes and ciliary epithelium are
responsible for the formation of aqueous

Ciliary muscle: longitudinal, circular and radial

fibers focus for near/distant objects in the visual
field
Blood supply derived from the major circle of the
iris

The Choroid
Posterior segment of the uveal tract, between the
retina and the sclera
Composed of choroidal blood vessels
(choriocapiilaries) 4 vortex vein
Nourish the outer portion of the underlying retina
(outer retina)

UVEITIS
Symptoms of disorders depend upon the site of the
disease process:
Pain
Blurring of vision
Photophobia
Red eye
Smaller pupil

Anatomic location:
Anterior
Intermediate
Posterior

Pathologic:
Granulomatous
Non-granulomatous

Clinical Findings in Uveitis

a. history

Pain, photophobia, blurrred of vision, redness

Acute/insidious
Previous episodes of arthritis
Possible exposure to toxoplasma, tuberculosis,
syphilis and histoplasma
Possibility of a focus of infection elsewhere in the
body

b. symptoms and signs

VA
Circumcorneal flush/ciliary injection
Fine white deposits (keratic precipitates, KPs)
or large keratic precipitates (mutton fat) on the
posterior surface of the cornea
Cells and flare

c. laboratory
Nodules (Koeppe or Busacca)
Small pupil; synechiae ant or post (irregular pupil)
Yellowish-white patches seen hazily in the
retina/choroid (fresh active lesion) or pigment
deposition in the healed stage (scar)

Extensive laboratory usually not indicated in:

Anterior uveitis, particularly non-granulomatous
Responsive to non-specific treatment

Non-responsive anterior/posterior uveitis

laboratory investigation (tailored):
Routine CBC
IgM-anti Toxo, VDRL, Chest X-ray, Mantous test,
ANA, ds-DNA, etc

Differential Diagnosis

Complications

Conjunctivitis
Keratitis or keratoconjunctivitis
Acute glaucoma
Scleritis/episcleritis
Endophthalmitis (infectious uveitis)

Peripheral anterior synechiae glaucoma

Posterior synechiae glaucoma
Cataract
Retinal detachment
Cystoid macular edema

Schematic Therapy

HIV and Kaposi Sarcoma

Fine Keratic Precipitates (KPs

(KPs)) and
Large Mutton Fat

Fuchs Heterochromic Iridocyclitis

Ankylosing Spondylitis

Juvenile Rheumatoid Arthritis

Masquarade Syndrome

Toxoplasma and Acute Retinal Necrosis

Hypopyon and Koeppe Nodules

Syphilis

HIV

Vasculitis and Oral Ulcer/Behcet

Ulcer/Behcet

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