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Anterior Uveitis (iritis) (pathophysiology (infectious etiologies (Immune…
Anterior Uveitis (iritis)
inflammation of the anterior uvea (iris and ciliary body)
granulomatous
non-granulomatous
incidence
25-52/100,000
20-50y
aetiology
idiopathic
ocular
herpes viral infection
herpes zoster opthalmicus
herpes simplex keratitis
Fuch's heterochromic cyclitis
low grade chronic unilateral iridocyclitis
trauma
sympathetic opthalmitis
systemic
seronegative arthritides
ankylosing spondylitis
Reiter's syndrome
psoriatic arthritis
IBD
juvenile chronic arthritis
sarcoidosis
pathophysiology
infectious etiologies
Immune reaction directed against foreign molecules or antigens may injure uveal tract vessels and cells
autoimmune
hypersensitivity reaction involving immune complex deposition within the uveal tract.
trauma
combination of microbial contamination and accumulation of necrotic products at the site of injury, stimulating the body to mount an inflammatory response in the anterior segment of the eye.
Inflammation of the iris and the ciliary body causes a breakdown of the blood-ocular barrier. This condition allows both protein and WBCs to extravasate into the aqueous, resulting in the typical iritis signs of cell and flare
Clinical
symptoms
(pain)
redness
photophobia
watering
blurred vision
foreign body sensation
signs
redness
inflammatory cells and flare
ciliary flush
hypopyon
keratic precipitates
incr IOP
posterior synechiae
diagnosis
slit lamp examination w fluorescein
ancillary
OP work-up for cause
CBC
ESR
ANA
HLA-B27
HIV test
CXR and pelvic XR
syphilis serology
tonometry
fundus examination
treatment
topical steroid
check IOP
prednisolone 1% every hour
need to exclude herpes
topical mydriatic
cyclopentolate 0.5-2%
prognosis
good
complications
disease
posterior synechiae
adhesions between lens and iris
high IOP --> optic nerve loss
treatment
blindness (inadequate Rx)
glaucoma
posterior subcapsular cataract