UVEITIS

Isna K. Nintyastuti

Introduction
Uvea
Latin: uva="grape"
iris, ciliary body, and choroid

Uveitis
inflammation (ie, -itis) of the uvea

Classification
Uveitis
anterior uveitis
intermediate uveitis
posterior uveitis
panuveitis

Acute Anterior Uveitis

Presentation

Sudden onset
Unilateral pain
Photophobia
Redness
Associated with lacrimation
Occasionally mild ocular discomfort
Visual acuity: mild disturbance
External examination shows ciliary (circumcorneal)
injection
Miosis due to sphincter spasm
Endothelial dusting and true keratic precipitates (KP)
Aqueous cells

 Anterior vitreous cells indicate iridocyclitis

Aqueous flare reflects the presence of protein due to a
breakdown of the bloodaqueous barrier
Hypopyon
Posterior synechiae may develop quickly
IOP
Low
High

Fundus examination is usually normal

Causes

Management
Many patients with mild, self limiting
anterior uveitis need no referral
The goal of medical management of
uveitis is to effectively control
inflammation
to eliminate or reduce the risk of vision loss
from structural and functional complications
that result from uncontrolled inflammation,
namely cataracts, glaucoma, CME, and
hypotony

 Medical management
topical cycloplegics
topical or systemic nonsteroidal anti
-inflammatory drugs
topical or systemic corticosteroids

Prognosis
good

Intermediate Uveitis
Major site: vitreous.
Inflammation of the middle portion:
posterior ciliary body, pars plana)
Manifestatons:
primarily as floaters affecting vision
the eye frequently appears quiet externally.

Posterior Uveitis
intraocular inflammation primarily involving
the retina and/ or choroid

Presentation varies according to the location of the inflammatory

focus and the presence of vitritis.
a patient with a peripheral lesion may complain of floaters whereas a patient
with a lesion involving the macula will predominantly complain of impaired
central vision.

Retinitis may be focal (solitary), multifocal, geographic or diffuse.

Active lesions are characterized by whitish retinal opacities with indistinct
borders due to surrounding oedema

Choroiditis may also be focal, multifocal, geographic or diffuse.

Active choroiditis is characterized by a round, yellow nodule

Vasculitis may occur as a primary condition or as a secondary

phenomenon adjacent to a focus of retinitis.
Both arteries (periarteritis) and veins (periphlebitis) may be affected
although venous involvement is more common.
Active vasculitis is characterized by yellowish or grey-white, patchy,
perivascular cuffing