00:01
So clinical manifestations,
signs and symptoms.
00:04
For anterior uveitis.
00:06
It can be unilateral or
bilateral, okay?
The patient,
because there is some innervation,
nervous innervation of the
anterior portions of the eye,
you can have pain,
you do tend to get
dilation of the pupils,
so there will be photophobia.
00:23
You can see the redness there, so
you're getting conjunctival inflammation
with increased
vascular dilation.
00:30
There is excessive tearing.
00:31
Again, we probably have
inflammation that is extending
secondarily up into the
lacrimal gland and other areas.
00:37
So you will get excessive fluid
production there that are tearing.
00:41
And as a consequence of all the
edema, because of the inflammation,
there will be reduced
visual acuity.
00:48
The pupils can be irregular,
they can be dilated,
they can be constricted.
00:52
And because you have now
kind of an abnormal inflammatory
response involving the iris,
which is going to be responsible
for controlling pupil size.
01:04
In the intermediate
or posterior uveitis,
so things that are more involved in
the posterior segment of the eye,
such as the vitreous body,
or now the retinitis or retina,
or posterior choroid.
01:16
It's not usually associated
with pain or redness,
because again, we're not involving
things that in the front of the eye.
01:23
You will have reduced visual acuity,
however, because of the edema,
that edema in the choroid will
kind of distort the retina
so that you will have
diminished visual acuity.
01:37
We will frequently get inhomogeneities
within the vitreous humor,
so you will get floaters.
01:44
And there will be visual field
effects because we will compromise
because of edema and pressure,
we will compromise neural
outputs from the eyes
so you will have
visual field cuts.
01:55
On fundoscopic exam,
it's what you see there.
01:58
It's kind of diffuse edema.
02:01
So if the vitreous looks opaque,
you don't see really good
vasculature at the back of the eye.
02:07
You can see the optic
nerve, that area of power,
but it's hard to
visualize the macula.
02:13
And what you're seeing
is just basically edema
throughout the eyes of
result of the inflammation.
02:19
Slit lamp examination
can be helpful
for identifying whether you're
looking at inflammation, edema,
and changes in the
anterior segment of the eye
or whether things are
more posterior segment.
02:29
And then we can
do some maneuvers.
02:32
These are interesting,
where you can push the eyeball from
the side with various instruments,
and then look through the
lens and see if you can see
identify areas of either
hemorrhage or discrete inflammation
in other areas of the choroid
that we don't normally visualize
with the direct fundoscopic exam
looking at the back of the eye.
02:53
Treatment.
02:53
So number 1, the list of
things that we're going to do
is we're going to try to
diminish inflammation.
02:59
And we need to do that
pretty aggressively.
03:01
So we're going to give
Glucocorticoids to
turn the heat down on the
inflammatory response.
03:09
We're going to give muscarinic
receptor antagonists, so blockers.
03:12
So we will in fact get
dilation of the pupil to get
better flow through
the eye overall.
03:20
And to relax some of the musculature,
so cyclic logics are administered.
03:25
And if necessary, if we then identify
either a bacterial cause or a viral cause,
we may give the appropriate
therapies to treat those
antibiotics or antivirals.
03:37
And with that, we've talked about this
rather broad topic of uveal inflammation
and talked about some of the
specifics related to that.
03:46
Hope you enjoyed it.