Uveitis

Question 1

What is uveitis?

Answer 1

An umbrella term for conditions causing inflammation of the uveal tract

It includes the iris, ciliary body, and choroid, along with associated structures in the eye.

Question 2

Name the four types of uveitis based on the anatomical location of inflammation.

Answer 2

• Anterior uveitis
• Intermediate uveitis
• Posterior uveitis
• Panuveitis

Anterior uveitis is the most prevalent type and a significant contributor to preventable vision loss worldwide.

Question 3

List some autoimmune diseases that can cause uveitis.

Answer 3

• Ankylosing spondylitis
• Behçet’s disease (HLA-B51 positive)
• Juvenile idiopathic arthritis
• Multiple sclerosis
• Systemic lupus erythematosus (SLE)
• Inflammatory bowel disease
• Granulomatosis with polyangiitis
• Reactive arthritis

These diseases can lead to inflammation of the uveal tract.

Question 4

What are some other causes of uveitis?

Answer 4

• Infections (e.g., herpes, tuberculosis, syphilis, HIV)
• Trauma
• Iatrogenic causes (e.g., ocular surgery or medications)
• Ischaemic conditions

These factors can also contribute to the development of uveitis.

Question 5

What are the symptoms of anterior uveitis?

Answer 5

• Painful red eye worsening over several days
• Photophobia
• Blurred vision
• Headache

These symptoms are indicative of inflammation in the anterior segment of the eye.

Question 6

What are the signs of anterior uveitis?

Answer 6

• Conjunctival injection
• Hypopyon
• Keratic precipitates
• Posterior synechiae and irregular pupil
• Anterior chamber flare
• Anterior chamber cells

These signs are observed during an ocular examination.

Question 7

What are the symptoms of intermediate uveitis?

Answer 7

• Often painless
• Floaters
• Blurred vision
• No external signs of inflammation in some cases

Symptoms may vary, and some patients may not exhibit external signs.

Question 8

What are the signs of intermediate uveitis?

Answer 8

• Inflammatory cells within the vitreous

This is typically observed during a thorough ocular examination.

Question 9

What are the symptoms of posterior uveitis?

Answer 9

• Blurred vision
• Progressive vision loss
• Flashes or floaters

These symptoms indicate inflammation in the posterior segment of the eye.

Question 10

What are the signs of posterior uveitis?

Answer 10

• Yellow/white appearance of the retina
• Cystoid macular oedema

These signs can be detected during an ocular examination.

Question 11

What is the typical presentation of panuveitis?

Answer 11

Combination of symptoms and signs from anterior, intermediate, and posterior uveitis

Patients typically exhibit a mix of symptoms from all types of uveitis.

Question 12

What are the goals of management for anterior uveitis?

Answer 12

• Identifying the aetiology
• Controlling inflammation to prevent vision loss
• Inducing remission

Management should be handled by an ophthalmologist, especially for suspected cases.

Question 13

What is the acute phase management for anterior uveitis?

Answer 13

• Cycloplegic mydriatic drops (e.g., cyclopentolate)
• Corticosteroids (topical, oral, IV, or IM)
• Analgesia

Cycloplegic drops help prevent posterior synechiae, while corticosteroids control inflammation.

Question 14

What may be necessary for chronic uveitis management?

Answer 14

• Systemic steroid-sparing immunosuppressants (e.g., methotrexate, mycophenolate)
• Biologic therapies (e.g., adalimumab)

These treatments target specific elements of the inflammatory cascade.

Question 15

How is steroid given in anterior uveitis?

Answer 15

As eye drops