Uveitis is the inflammation Inflammation Inflammation is a complex set of responses to infection and injury involving leukocytes as the principal cellular mediators in the body's defense against pathogenic organisms. Inflammation is also seen as a response to tissue injury in the process of wound healing. The 5 cardinal signs of inflammation are pain, heat, redness, swelling, and loss of function. Inflammation of the uvea Uvea The pigmented vascular coat of the eyeball, consisting of the choroid; ciliary body; and iris, which are continuous with each other. Eye: Anatomy, the pigmented middle layer of the eye, which comprises the iris Iris The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. Eye: Anatomy, ciliary body Ciliary body A ring of tissue extending from the scleral spur to the ora serrata of the retina. It consists of the uveal portion and the epithelial portion. The ciliary muscle is in the uveal portion and the ciliary processes are in the epithelial portion. Eye: Anatomy, and choroid Choroid The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. Eye: Anatomy. The condition is categorized based on the site of disease; anterior uveitis is the most common. Uveitis can be caused by an infection or systemic disease, but in some cases the cause is idiopathic Idiopathic Dermatomyositis. Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship present with blurred vision Blurred Vision Retinal Detachment, eye redness Redness Inflammation, and pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways (frequently in anterior uveitis) or reduced vision Vision Ophthalmic Exam and floaters Floaters Chorioretinitis (in intermediate and posterior uveitis). Diagnosis is by dilated funduscopy and slit-lamp examination Slit-Lamp Examination Blepharitis. Treatment for anterior uveitis is topical steroids Steroids A group of polycyclic compounds closely related biochemically to terpenes. They include cholesterol, numerous hormones, precursors of certain vitamins, bile acids, alcohols (sterols), and certain natural drugs and poisons. Steroids have a common nucleus, a fused, reduced 17-carbon atom ring system, cyclopentanoperhydrophenanthrene. Most steroids also have two methyl groups and an aliphatic side-chain attached to the nucleus. Benign Liver Tumors, while uveitis in deeper locations requires an injection. Uveitis from infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease and systemic disorders requires etiology-directed therapy.
Last updated: 8 Jan, 2021
Uveitis is an inflammation Inflammation Inflammation is a complex set of responses to infection and injury involving leukocytes as the principal cellular mediators in the body’s defense against pathogenic organisms. Inflammation is also seen as a response to tissue injury in the process of wound healing. The 5 cardinal signs of inflammation are pain, heat, redness, swelling, and loss of function. Inflammation of the uvea Uvea The pigmented vascular coat of the eyeball, consisting of the choroid; ciliary body; and iris, which are continuous with each other. Eye: Anatomy, the middle layer of the eye, which comprises the iris Iris The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers – the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. Eye: Anatomy, ciliary body Ciliary body A ring of tissue extending from the scleral spur to the ora serrata of the retina. It consists of the uveal portion and the epithelial portion. The ciliary muscle is in the uveal portion and the ciliary processes are in the epithelial portion. Eye: Anatomy, and the choroid Choroid The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. Eye: Anatomy.
This image displays the essential anatomy of the eye. In cataracts, there is clouding of the lens Lens A transparent, biconvex structure of the eye, enclosed in a capsule and situated behind the iris and in front of the vitreous humor (vitreous body). It is slightly overlapped at its margin by the ciliary processes. Adaptation by the ciliary body is crucial for ocular accommodation. Eye: Anatomy, which opacifies the light as it projects to the retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy; this leads to reduced vision Vision Ophthalmic Exam, particularly at night when light levels are low.
Image by Lecturio.Left: the components of the
uvea
Uvea
The pigmented vascular coat of the eyeball, consisting of the choroid; ciliary body; and iris, which are continuous with each other.
Eye: Anatomy, the middle vascular layer of the eye
Right: general structure of the eye
Bilateral nongranulomatous anterior uveitis associated with syphilis Syphilis Syphilis is a bacterial infection caused by the spirochete Treponema pallidum pallidum (T. p. pallidum), which is usually spread through sexual contact. Syphilis has 4 clinical stages: primary, secondary, latent, and tertiary. Syphilis. (A): Lesion consistent with syphilitic chancre Chancre The primary sore of syphilis, a painless indurated, eroded papule, occurring at the site of entry of the infection. Syphilis on base of the tongue Tongue The tongue, on the other hand, is a complex muscular structure that permits tasting and facilitates the process of mastication and communication. The blood supply of the tongue originates from the external carotid artery, and the innervation is through cranial nerves. Lips and Tongue: Anatomy; (B): Slit-lamp examination Slit-Lamp Examination Blepharitis: small keratic precipitates (right) and fibrin Fibrin A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. Rapidly Progressive Glomerulonephritis deposits overlying corneal endothelium Endothelium A layer of epithelium that lines the heart, blood vessels (vascular endothelium), lymph vessels (lymphatic endothelium), and the serous cavities of the body. Arteries: Histology (left) in retroillumination
Image: “initial presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor of syphilis Syphilis Syphilis is a bacterial infection caused by the spirochete Treponema pallidum pallidum (T. p. pallidum), which is usually spread through sexual contact. Syphilis has 4 clinical stages: primary, secondary, latent, and tertiary. Syphilis” by Hospital de Olhos Santa Luzia, Estrada do Encanamento 909, CEP 52070-000, Recife-Pernambuco, Brazil. License: CC BY 2.0Image showing eye redness Redness Inflammation and irregular pupil Pupil The pupil is the space within the eye that permits light to project onto the retina. Anatomically located in front of the lens, the pupil’s size is controlled by the surrounding iris. The pupil provides insight into the function of the central and autonomic nervous systems. Pupil: Physiology and Abnormalities from anterior uveitis
Image: “Anterior-uveitis” by Jonathan Trobe, M.D. License: CC BY 3.0Diagnosis is made by dilated fundus examination Dilated Fundus Examination Chorioretinitis and slit-lamp examination Slit-Lamp Examination Blepharitis. Scleral depression is an additional maneuver to visualize structures posterior to the lens Lens A transparent, biconvex structure of the eye, enclosed in a capsule and situated behind the iris and in front of the vitreous humor (vitreous body). It is slightly overlapped at its margin by the ciliary processes. Adaptation by the ciliary body is crucial for ocular accommodation. Eye: Anatomy.
Findings
Additional laboratory and radiographic imaging are indicated when extraocular signs and symptoms are attributable to a causative disease (e.g., sarcoidosis Sarcoidosis Sarcoidosis is a multisystem inflammatory disease that causes noncaseating granulomas. The exact etiology is unknown. Sarcoidosis usually affects the lungs and thoracic lymph nodes, but it can also affect almost every system in the body, including the skin, heart, and eyes, most commonly. Sarcoidosis, syphilis Syphilis Syphilis is a bacterial infection caused by the spirochete Treponema pallidum pallidum (T. p. pallidum), which is usually spread through sexual contact. Syphilis has 4 clinical stages: primary, secondary, latent, and tertiary. Syphilis).
Fundus Fundus The superior portion of the body of the stomach above the level of the cardiac notch. Stomach: Anatomy photographs Photographs Ultrasound (Sonography) demonstrating vitreous haze in both eyes Both Eyes Refractive Errors. Patient was treated with dabrafenib DaBRAFenib Targeted and Other Nontraditional Antineoplastic Therapy and trametinib Trametinib Targeted and Other Nontraditional Antineoplastic Therapy and developed bilateral uveitis.
Image: “Uveitis as a Result of MAP Kinase Pathway Inhibition” by Royal Surrey County Hospital NHS Foundation Trust Trust Confidence in or reliance on a person or thing. Conflict of Interest, Guildford, Surrey, London, UK. License: CC BY 3.0A 27-year-old pregnant woman with Behçet’s disease panuveitis with ciliary flush and a hypopyon (layering of white cells at the lower part of the anterior chamber Anterior chamber The space in the eye, filled with aqueous humor, bounded anteriorly by the cornea and a small portion of the sclera and posteriorly by a small portion of the ciliary body, the iris, and that part of the crystalline lens which presents through the pupil. Eye: Anatomy)
Image: “Behçet’s Uveitis” by Department of Ophthalmology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey. License: CC BY 2.0Anterior uveitis: slit-lamp photograph showing large, old keratic precipitates
Image: “anterior uveitis” by L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India. License: CC BY 2.0Diffuse illumination at the slit lamp Slit Lamp A microscope with a light source that can be projected into a linear beam. It allows cross-sectional viewing of the aqueous humor; conjuncteiva; cornea; eyelids; iris; and lens of the eye. Ophthalmic Exam shows severe band keratopathy in the left eye Left Eye Refractive Errors of a boy with anterior uveitis (associated with juvenile idiopathic Idiopathic Dermatomyositis arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis).
Image: “keratopathy” by Department of Ophthalmology, Faculty of Medicine, Istanbul University, Istanbul, Turkey. License: CC BY 2.5