Uvea & sclera

UVEA & SCLERA JUAN S. LOPEZ, MD Chief, Section of Uveitis Institute of Ophthalmology and Visual Sciences St. Luke’s Medical Center

UVEAL TRACT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Iris Ciliary Body Choroid

IRIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],FUNCTION: regulates pupil size

CILIARY BODY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],FUNCTIONS: 1. Acts in accommodation 2. Secretes aqueous humor

IRIS AND CILIARY BODY ,[object Object],[object Object],[object Object],[object Object]

CHOROID ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],UVEAL TRACT FUNCTION: provides nourishment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ANTERIOR UVEITIS ,[object Object],[object Object],[object Object],[object Object]

ANTERIOR UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CILIARY INJECTION POSTERIOR SYNECHIAE

KERATIC PRECIPITATES Medium-size keratic precipitates Mutton fat keratic precipitates

IRIS NODULES Koeppe nodules Busacca nodule Hypopyon

INTERMEDIATE UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

POSTERIOR UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

POSTERIOR UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Behcet’s Disease ,[object Object],[object Object],[object Object],[object Object]

Vogt-Koyanagi-Harada Disease ,[object Object],[object Object],[object Object],[object Object],[object Object]

Pathological General Ophthalmology, 15 th edition, Vaughan, et al Sometimes Common Recurrence Chronic Acute Course Anterior, posterior, diffuse Anterior Site Sometimes None Iris nodules Sometimes Sometimes Posterior synechia Small, irregular Small, irregular Pupil Large gray (“mutton fat”) Fine, white Keratic precipitates Slight Marked Circumcorneal flush Marked Moderate Blurring of vision Slight Marked Photophobia None or minimal Marked Pain Insidious Acute Onset GRANULOMATOUS NONGRANULOMATOUS

Pathological ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Differential Diagnosis ,[object Object],[object Object],[object Object],Very important to know the differences!

Important to know! Posterior synechia (rare) Posterior synechia (hallmark) Hypopyon COMMON Hypopyon RARE Chemosis No swelling Diffuse hyperemia Ciliary injection Purulent Non-purulent ENDOPHTHALMITIS UVEITIS

UVEITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Goals of Treatment: * Control inflammation * Prevent complications

SCLERA ,[object Object],[object Object],[object Object],[object Object]

SCLERA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EPISCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

SIMPLE EPISCLERITIS ,[object Object],[object Object],[object Object],Simple Sectoral Episcleritis Simple Diffuse Episcleritis

NODULAR EPISCLERITIS ,[object Object],[object Object],[object Object],Scleral translucency

EPISCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object]

SCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

SCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object]

ANTERIOR NON-NECROTIZING SCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object]

ANTERIOR NON-NECROTIZING SCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ANTERIOR NECROTIZING SCLERITIS WITH INFLAMMATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ANTERIOR NECROTIZING SCLERITIS WITH INFLAMMATION

ANTERIOR NECROTIZING SCLERITIS WITHOUT INFLAMMATION ,[object Object],[object Object],[object Object],[object Object],[object Object]

POSTERIOR SCLERITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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