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Common Eye problem

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Diseases of uveal tract (Iris, ciliary body, choroid)

Inflammations (Uveitis) Tumors: nevus, hemangioma,

malignant melanoma, metastatic tumors (breast, lung, GU, GI tract)

Common Eye problem

Uveal tract

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Uveitis : classification

Anterior : Inflammation of iris 40-70 % Intermediate : Inflammation of ciliary body,

pars plana, vitreous,peripheral retina : 7-15 %

Posterior: Inflammation of choroid, retina, optic N : 15-22%

Panuveitis

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Anterior uveitis : Iritis Clinical :

Usually acute, duration <6 weeks Sudden onset of redness, pain, photophobia,

mild blurring of vision PE : Keratic Precipitates(KP), Flare and/or hypopyon

of anterior chamber, lenticuler precipitates Causes :

Idiopathic : 38-70 % Immune: AS, JRA, SNSA, Reiter, UC, Crohn’s disease,

Sarcoidosis, Psoriasis, Lens-induced, Behcet’s disease Vohk-Koyonagi-Harada (VKH) syndrome Infection: virus, Tbe, Syphilis Malignancy: Leukemia, Lymphoma, Retinoblastoma Hyperuricemia and gout Fuchs’ Heterochromic Iridocyclitis Trauma

Complication: glaucoma, cataract Treatment:Topical : cycloplegia, steroid, aqueous suppressant

Oral : steroid, aqueous suppressant

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Intermediate Uveitis: Cyclitis,Pars planitis, Vitritis

Clinical:Floating spot in the field of vision blurring of visionMore likely to have chronic inflammation (months

to years)PE: vitreous opacities, WBC cells in anterior

chamber and retrolental space and/or anterior vitreous, PVD

Causes: like anterior uveitis multiple sclerosis

Complication: posterior subcapsular cataract (PSC),cystoid macular edema (CME) and traction retinal detachment(TRD), choroidal neovascularization

(CNV), vitrenous hemorrhage, glaucoma

Treatment: Topical steroid or retrobulba injection Px of complication: medication, Laser,

surgery

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Postrior uveitis: choroiditis, chorioretinitis, retinitis

Clinical :Blurred vision, floaters, deep eye pain, scotomataPE : vitreous clouding, CME, geographic or coin-like

choroiditis, retinal neovascular membrane and hemorrhage and/or RD

: Mostly involve bilaterally, : Chronic course (months-years)

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Causes:

Infection : Viruses (CMV, HSV, HZV, HIV, EBV,etc), : Bacteria: Tbe, Syphilis, Neisseria menigitidis : Fungus: Candida, Histoplasma, cryptococcus

: Parasitic: Toxoplasma, Toxocara, cysticercusNon infection: Immune: Behect’s, VKH, Polyarteritis

Nodosa, Sympathetic ophthalmia, Retinal vasculitis,sarcoidosis, multiple sclerosis, SLE

: Malignancy: Leukemia, melanoma, reticulum cell sarcoma, metastatic lesions

Unknown : 40-60%

Complication: like intermediate uveitis, visual “loss”

Treatment: ATB, oral and/or IV steroid, other immunosuppressive drugs.

: Treat complication : medication, Laser, Surgery

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Disorders of Lens Opacification (Cataract) Dislocation : hereditary, traumatic Distortion

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Cataract

Senile cataract most are bilateral Childhood cataract

Congenital or infantile: may be unilateral or bilateral

Acquired Traumatic : penetrating or blunt trauma Complicated cataract : 2nd to intraocular

disease:uveitis, glaucoma, RD

Associated with systemic diseases : DM, Down syndrome, atopic dermatitis

Toxic cataract : drug ; steroid, statin, phenothiazine

After cataract (secondary membrane)

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Cataract surgery

Terms

ICCE = Intracapsular Cataract Extraction

ECCE = Extracapsular cataract Extraction

Phaco = Phacofragmentation and Phacoemulsification

IOL = Intraoular Lens

YAG Laser for after cataract

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Complication of cataract surgery

Infection

Uveitis

Glaucoma

Vitreous prolapse and RD