Term
| Name the 3 parts of the uvea |
|
Definition
Iris
Ciliary Body
Choroid |
|
|
Term
| Uveitis that involves the iris ONLY |
|
Definition
|
|
Term
| Where do you expect to find cells in an iritis? |
|
Definition
| In AC but not anterior vitreous |
|
|
Term
| Uveitis of Iris & Ciliary Body |
|
Definition
|
|
Term
| Where do you expect to see cells in iridocyclitis? |
|
Definition
| In AC and Anterior Vitreous |
|
|
Term
| Uveitis that involves the ciliary body or pars plana area |
|
Definition
|
|
Term
| What part of the uvea is inflamed in peripheral uveitis |
|
Definition
| The ciliary body (cyclitis) |
|
|
Term
| Uveitis of the iris and choroid |
|
Definition
|
|
Term
| If classifying uveitis by affected location, what is inflammation of iris &/or ciliary body or both |
|
Definition
|
|
Term
| If classifying uveitis by affected location what is inflammation of posterior aspect of ciliary body &/or peripheral choroid and secondarily, the vitreous & retina |
|
Definition
| Intermediate (pars planitis) |
|
|
Term
| If classifying uveitis by affected location, what is inflammation of choroid, overlying retina and vitreous? |
|
Definition
|
|
Term
| If classifying uveitis by affected location what is inflammation of the entire uveal tract? |
|
Definition
|
|
Term
| If classifying uveitis by type of inflammation, what are the 2 types? |
|
Definition
Nongranulomatous
and
Granulomatous
Uveitis |
|
|
Term
Granulomatous vs. nongranulomatous Uveitis
Which tends to be chronic? |
|
Definition
|
|
Term
Granulomatous vs. nongranulomatous Uveitis
Which is associated wiht mutton fat KPs? |
|
Definition
|
|
Term
Granulomatous vs. nongranulomatous Uveitis
Which is associated with iris nodules? |
|
Definition
|
|
Term
Granulomatous vs. nongranulomatous Uveitis
Which is not associated with pathogenic organisms |
|
Definition
|
|
Term
| In what age group is the peak prevalence of uveitis? |
|
Definition
|
|
Term
| Name 2 syndromes in which males have a higher incidence of uveitis |
|
Definition
Reiter's syndrome
Ankylosing spondylitis |
|
|
Term
| Name 2 syndromes in which females have a higher incidence of uveitis |
|
Definition
Sarcoid
Juvenile chronic arthritis |
|
|
Term
| Uveitis is associated with which conditions in Anglo-Americans? |
|
Definition
Toxoplasmosis
Histoplasmosis
AS
Reiter's,
HLA-B27 dz's |
|
|
Term
| Uveitis is associated with which condition when seen in African Americans |
|
Definition
|
|
Term
| In Japanese/Asian populations, which conditions are associated with uveitis |
|
Definition
VKH syndrome
Behcet's disease |
|
|
Term
| Uveitis is strongly associated with which immunologic factor? |
|
Definition
|
|
Term
| Name some systemic symptoms you should ask your patient about when you suspect uveitis |
|
Definition
GI problems
Lower back pain
joint pain/deformities
prev. episodes
respiratory problems
oral or genital rashes |
|
|
Term
T/F
Chronic uveitis is often associated with little pain |
|
Definition
|
|
Term
T/F
Your chronic uveitis patient is much more likely to come in complaining of pain than blurry vision |
|
Definition
False
More likely to complain of blurred vision in chronic cases |
|
|
Term
| Name 5 significant diagnostic indicators of whether the uveitis is acute or chronic |
|
Definition
Onset/duration
Response to standard therapies
Recurrence
Bilateral presentations
Systemic Hx |
|
|
Term
| How do you expect your uveitis patient to respond to NPA testing? |
|
Definition
| Reduced results, painful for them |
|
|
Term
| Describe the expected characteristics of the cornea in uveitis |
|
Definition
Edema
KPs (fine or mutton fat) |
|
|
Term
| Whitish yellow lumps away from pupil border, pathognomonic for granulomatous uveitis |
|
Definition
|
|
Term
| Round/oval solid tissue at pupil border, in both granulomatous and nongranulomatous uveitis |
|
Definition
|
|
Term
| Fleshy, white-pink, slightly vascularized mass |
|
Definition
|
|
Term
| Name 4 possible pupil abnormalities associated with uveitis |
|
Definition
Normal to sluggish APD (constriction)
miotic
corectopia
fixed pupil |
|
|
Term
|
Definition
|
|
Term
| Expected IOP in chronic uveitis |
|
Definition
| Elevated if outflow is affected |
|
|
Term
| 2 types of topical drugs used in tx of uveitis |
|
Definition
|
|
Term
| NAme 2 types of oral drugs that may be given for uveitis |
|
Definition
|
|
Term
| Name 2 specific steroids recommended for uveitis treatment |
|
Definition
1% Pred Forte
0.05% Durezol |
|
|
Term
| Which cycloplegic is recommended for mild uveitis and dosage |
|
Definition
|
|
Term
| Which cycloplegic is recommended for moderately severe uveitis and dosage |
|
Definition
|
|
Term
| Steroid dosages for moderately severe uveitis |
|
Definition
Pred forte q2-3h
Durezol q4-6h |
|
|
Term
| Steroid doses for severe uveitis |
|
Definition
Pred Forte q1-2h
Durezol q2-4h |
|
|
Term
| Cycloplege recommended for severe uveitis |
|
Definition
1% atropine or 0.25% scopolamine
bid |
|
|
Term
| How soon should you see back your uveitis patient? |
|
Definition
| 1-7 days depending on severity and complicating factors |
|
|
Term
| Name 2 important considerations when evaluating your uveitis pt at follow-up |
|
Definition
Watch
Elevated IOP with steroids
Posterior segment evaluation if no reponse to therapy or worse inflammation |
|
|
Term
| When can you discontinue use of the cycloplege? |
|
Definition
| When the cellular reaction is subsiding and flare is absent |
|
|
Term
| When do you taper and discontinue the steroid |
|
Definition
Taper when improvement has been noted,
Continue until cells are minimal or absent over a 1-2 week period. |
|
|
Term
| What topical may be used to treat chronic uveitis |
|
Definition
Long term mild steroid
1 drop 0.125% prednisolone acetate q0d |
|
|
Term
| Name 2 common side effects of long term steroid |
|
Definition
Elevated IOP
Posterior Subcapsular Cataract |
|
|
Term
| Name 4 major complications associated with anterior uveitis |
|
Definition
Glaucoma
Cataracts
Band Keratopathy
Cystoid Macular Edema |
|
|
Term
| Name the situations when you should consider medical testing for your uveitis patient? |
|
Definition
Granulomatous diseases
HLA-related diseases
Autoimmune disease
Poor response to therapy
Recurrence
Bilateral/alternating
Children
Posterior
Immunocompromised patients |
|
|
Term
| chronic inflammatory arthritis of the spine especially affecting the sacroiliac joint and surrounding soft tissue |
|
Definition
|
|
Term
| Describe the uveitis that generally accompanies ankylosing spondylitis |
|
Definition
Acute
Unilateral
Recurrent
Alternating |
|
|
Term
| Name 3 lab tests for diagnosing ankylosing spondylitis |
|
Definition
Sacroiliac X-rays (bamboo spine)
ESR
HLA-B27 |
|
|
Term
| What tends to make the chronic back pain worse for ankylosing spondylitis patients? |
|
Definition
| Immobility makes it worse, gets better with activity |
|
|
Term
| Name 2 NSAIDs used to treat ankylosing spondylitis |
|
Definition
|
|
Term
| Name 2 DMARDS used to treat ankylosing spondylitis |
|
Definition
Sulfasalazine
Methotrexate |
|
|
Term
| Triad associated with Reactive Arthritis (Reiter's syndrome) |
|
Definition
Nongonococcal urethritis or cervisitis
Polyarthritis
Acute conjunctivitis or iridocyclitis |
|
|
Term
| Common Age and gender of onset of ankylosing spondylitis |
|
Definition
| Males under age of 35 years |
|
|
Term
| What venereal condition is associated with Reactive Arthritis |
|
Definition
|
|
Term
| Describe the uveitis associated with Reactive Arthritis |
|
Definition
Acute
Unilateral
alternating
recurrent
nongranulomatous |
|
|
Term
| What condition is associated with a fibrin-like clot in the pupil |
|
Definition
|
|
Term
| Name 5 ocular complications associated with Reactive Arthritis |
|
Definition
Secondary Glaucoma
Cataracts
Cystoid macular edema
Posterior/anterior synechiae
Vitreous opacification |
|
|
Term
| What is Still's Ocular triad and which condition is it associated with? |
|
Definition
Iridocyclitis
Band keratopathy
Cataract
in Juvenile Idiopathic Arthritis |
|
|
Term
| Describe the uveitis associated with juvenile idiopathic arthritis |
|
Definition
Gradual onset
chronic
bilateral
subclinical
may present with white eye |
|
|
Term
| What is the correlation between ANA and Uveitis in JIA patients |
|
Definition
JIA & Uveitis= 88% positive ANA
JIA but no uveitis= rarely positive ANA |
|
|
Term
| Name 4 ocular complications of sarcoidosis |
|
Definition
Dry eyes
Conjunctival and eyelid nodules
uveitis (40%)
Lacrimal gland disorders (70%) |
|
|
Term
| Ocular complications of sarcoidosis |
|
Definition
ant/post synechiae
Iris Bombe
Glaucoma
CME
Vitritis
Retinal neovascularization
Cataract |
|
|
Term
ACE
Serum lysozyme
serum calcium
ESR
Levels in Sarcoidosis |
|
Definition
|
|
Term
| Describe the uveitis associated with Tuberculosis |
|
Definition
Uni/bilateral
iridocyclitis
granulomatous
vasculitis
vitritis
unresponsive to steroids |
|
|
Term
| Ocular TB closely resembles what? |
|
Definition
|
|
Term
| 3 lab tests to diagnose TB |
|
Definition
PPD positive
Chest xray
Elevated ESR |
|
|
Term
| Which disease puts pts at an increased risk of TB |
|
Definition
|
|
Term
|
Definition
Isoniazid (1st choice)
Rifampin (2nd choice)
Pyrazinimide
Ethambutol |
|
|
Term
|
Definition
the spirochete
Treponema pallidum
|
|
|
Term
Syphilis
Primary Stage symptoms |
|
Definition
|
|
Term
| Syphilis Secondary Stage symptoms |
|
Definition
| Skin rash (palms, soles, trunk) |
|
|
Term
Syphilis
Tertiary stage symptoms |
|
Definition
Benign tertiary
Cardiovascular
Neurosyphilis |
|
|
Term
| Describe the uveitis associated with Syphilis |
|
Definition
Iridocyclitis
Posterior Uveitis
Optic neuritis
Uni/bilateral
Recurrent
Progressive
Unresponsive to steroids |
|
|
Term
| Classic fundus appearance with syphilis |
|
Definition
| Salt and pepper fundus (chorioretinitis) |
|
|
Term
|
Definition
Interstitial keratitis
Notched incisors
Deafness |
|
|
Term
|
Definition
|
|
Term
| Primary host of toxoplasmosis |
|
Definition
|
|
Term
| Most common cause of chorioretinitis |
|
Definition
|
|
Term
| 4 ways of contracting toxoplasmosis |
|
Definition
Ingestion of tissue cysts from contaminated raw meat
Ingestion of oocysts from soil/water/milk/vegatables
Inhalation of oocysts
Contaminated blood/organs |
|
|
Term
| 6 Ocular Clinical Presentations of Toxoplasmosis |
|
Definition
Chorioretinitis (fluffy white lesions)
Retinitis
Occlusive vasculitis
Optic neuritis
Macular edema
Anterior uveitis |
|
|
Term
| 4 Drugs used to treat Toxoplasmosis |
|
Definition
Pyrimethamine
Sulfadizine
Clindamycin
Prednisone
4-6 weeks of tx |
|
|
Term
| Why is depot steroid therapy contraindicatedi n toxoplasmosis treatment |
|
Definition
| Host's immune response is overwhelmed, leading to necrosis and the potential for a blind, phthisical globe |
|
|
Term
Traumatic Anterior Uveitis
Do BIO to rule out........ |
|
Definition
| Retinal tear or detachment |
|
|
Term
Traumatic Anterior Uveitis
Do gonioscopy to rule out..... |
|
Definition
|
|
Term
| Treatment of Traumatic Anterior Uveitis |
|
Definition
Cycloplegia alone in most cases
Topical Steroids in more severe cases |
|
|
Term
| Tx of Herpes Simplex Virus |
|
Definition
Topical antivirals
Cycloplegics
Topical steroids if epithelium is NOT involved |
|
|
Term
| Describe the uveitis associated with Fuch's Heterochromic Iridocyclitis |
|
Definition
Chronic
Unilateral
asymptomatic low grade panuveitis |
|
|
Term
Fuch's Uveitis Syndrome
High risk of what type of glaucoma? |
|
Definition
| Secondary Open Angle Glaucoma |
|
|
Term
Conj injection
Rapid cataract formation
Reduced VA
KPs
Iris atrophy/heterochromia
Which disease?
|
|
Definition
Fuch's Uveitis Syndrome
aka
Fuch's Heterochromic Iridocyclitis |
|
|
Term
| Describe KPs associated with Fuch's Heterochromic Iridocyclitis |
|
Definition
| small, round, over ENTIRE endo surface, out of proportion to inflammation |
|
|
Term
| Fuch's heterochromic iridocyclitis patient presents with one blue eye, one green, which is the affected eye? |
|
Definition
|
|
Term
| 3 aspects of Fuch's Heterochromic Iridocyclitis that can be used in differential diagnosis |
|
Definition
No posterior synechiae
Cells and flare moderate and asymptomatic
Vitreous cells are common |
|
|
Term
Tuberculosis
Syphillis
Leprosy
Brucellosis
Leptospirosis
What do these bacteria have in common? |
|
Definition
| They are all bacterial causes of uveitis |
|
|
Term
| 2 Main viruses known for causing uveitis |
|
Definition
Herpes Simplex
Herpes Zoster |
|
|
Term
| Which is the fungal cause of uveitis that was emphasized in class? |
|
Definition
|
|
Term
| Which is the protozoan cause of uveitis that was emphasized in class? |
|
Definition
|
|
Term
| Name 3 Arthritis syndromes associated with Uveitis |
|
Definition
Ankylosing Spondylitis
Reiter's syndrome
Juvenile Chronic Arthritis |
|
|
Term
| 2 GI diseases associated with uveitis |
|
Definition
Ulcerative collitis
Crohn's dz |
|
|
Term
Brief description of this test
(in top 12 Useful Lab Tests for Uveitis)
Human Leukocyte antigen (HLA) |
|
Definition
expensive
reveals conditions that are diagnosable upon Hx and Clinical exam |
|
|
Term
Brief description of this test
(in top 12 Useful Lab Tests for Uveitis)
Enzyme-linked Immunosorbent Assay (ELISA) |
|
Definition
| Diagnosing infectious posterior uveitis |
|
|
Term
Brief description of this test
(in top 12 Useful Lab Tests for Uveitis)
Serum lysozyme |
|
Definition
| moderately specific and sensitive test for sarcoid |
|
|
Term
Brief description of this test
(in top 12 Useful Lab Tests for Uveitis)
Serum calcium |
|
Definition
Lower cost and higher availability than lysozyme
Elevated in some sarcoid cases |
|
|
Term
Brief description of this test
(in top 12 Useful Lab Tests for Uveitis)
Rheumatoid Factor |
|
Definition
| The arthritic syndromes associated with Uveitis test negative for RF |
|
|
Term
Brief description of this test
(in top 12 Useful Lab Tests for Uveitis)
Complete Blood Count |
|
Definition
non-specific test for general health, inflammation and infection
available and inexpensive |
|
|
Term
Brief description of this test
(in top 12 Useful Lab Tests for Uveitis)
Anti-Nuclear Antibody (ANA) |
|
Definition
| highly correlated in patients with JRA and Uveitis |
|
|
Term
Brief description of this test
(in top 12 Useful Lab Tests for Uveitis)
Erythrocyte Sedimentation Rate (ESR) |
|
Definition
nonspecific test for inflammation
Inexpensive and widely available |
|
|
Term
Brief description of this test
(in top 12 Useful Lab Tests for Uveitis)
Purified Protein Derivative |
|
Definition
|
|
Term
Brief description of this test
(in top 12 Useful Lab Tests for Uveitis)
Syphilis Tests |
|
Definition
| Syphilis often causes cinfusing clinical pictures and uveitis that is unresponsive to treatment |
|
|
Term
| Angiotensin Converting Enzyme |
|
Definition
| Sensitive and Specific for Sarcoid |
|
|
Term
Brief description of this test
(in top 12 Useful Lab Tests for Uveitis)
Radiology |
|
Definition
widely available
Specific and Sensitive to a wide variety of conditions that cause uveitis |
|
|
