Uveitis - Anterior and Intermediate MCQs

Ans. A. Posner schlossman syndrome Glamatocyclitic crisis (posner - Schlossman syndrome) is a unilateral recurrent non- granulomatous iritis that is associated with an elevated ocular pressure during the attacks'

Complications of uveitis Early: Secondary glaucoma - angle closure, trabeculitis Seclusio pupillae Occlusio pupillae Late: Secondary glaucoma - synechiae formation, steroid induced Cataract - complicated cataract Band shaped Keratopathy, Hypotony, Cystoid macular edema: cause of low vision in uveitis Optic neuritis, Phthisis bulbi: In chronic disorders of eye sometimes there is shrinkage of eyeball, architecture is lost, IOP becomes very low, sclera gets thickened and there is calcification. Reference: parson's 22/e, chapter 17 pg. 241 sequelae

Glaucomatocyclitic crisis (Posner-Schlossman syndrome) is a rare form of open-angle glaucoma characterized by recurrent attacks of mild anterior uveitis and marked elevation of intraocular pressure, often to 40-60 mm Hg. The condition is usually unilateral and affects middle-aged patients. The iritis is generally mild with small, discrete, round keratitic precipitates. The acute attack usually resolves within a few weeks. The intraocular pressure typically returns to normal between attacks, but a chronic glaucoma may develop over time with recurrent episodes. Fuchs heterochromic iridocyclitis, pseudoexfoliation glaucoma, and pigmentary glaucoma are generally associated with chronic pressure elevation. Reference: Parsons 22nd edition/300pg

Glaucomatocyclitic crisis (Posner-Schlossman syndrome) is a rare type of open-angle glaucoma typically affecting middle-aged adults. It usually presents with unilateral eye pain and blurred vision associated with markedly increased IOP (40-60 mm Hg). A mild iritis is present and resolves spontaneously within a few weeks. The IOP usually remains normal between episodes, but a chronic secondary glaucoma may develop with an increasing number of attacks. Angle-recession glaucoma, glaucoma associated with elevated episcleral venous pressure, and exfoliation glaucoma are all chronic forms of glaucoma that are not typically associated with ocular inflammation. Reference: PARSONS 22ND EDITION/300

Explanation: Tuberculosis is not associated with 'salt and pepper' appearance of fundus. Differential diagnoses of Salt & pepper fundus: Prenatal Rubella (Option A ruled out) Congenital Syphilis (Option B ruled out ) Varicella Mumps Retinitis pigmentosa Leber congenital amaurosis Drugs: Thioridazine (anti-psychotic) Ocular features of Tuberculosis: Anterior uveitis (granulomatous) Choroiditis: serpiginous pattern, multifocal Choroidal granulomas: known as Tubercles , focal elevated dome-shaped lesions Retinal vasculitis: retinal hemorrhages Interstitial keratitis Lupus vulgaris: Reddish-brown eyelid nodules Neuroretinitis (Optic neuropathy

Ans. B. Cataract The most common complication of intermediate uveitis (pers ptanitis) is cystoid macular edema, which may decrease the visual acuity. 2nd most common complication is complicated cataract' Other complication includes retinal detachment.

Fuchs heterochromic iridocyclitis is an uncommon form of chronic iridocyclitis characterized by iris heterochromia with loss of iris pigment in the affected eye, low-grade iritis with stellate keratic precipitates, and posterior subcapsular cataract. The condition is usually unilateral and typically affects middle-aged adults. A secondary open angle glaucoma develops in approximately 15% of patients. Gonioscopy may reveal fine vessels in the anterior chamber angle, but these vessels do not lead to peripheral anterior synechiae formation or secondary angle closure. Cataract and heterochromia are not typical of Posner-Schlossman syndrome. ICE syndrome and Peters anomaly do not share any features of the triad. Reference: PARSONS 22ND EDITION/300

The ciliary body has three basic functions: Aqueous production and removal Helps in accommodation Formation of vitreous mucopolysaccharide The inner surface of the ciliary body is divided into two regions. The anterior part ( pars plicata ) is corrugated with a number of folds running in an anteroposterior direction. The posterior part (pars plana) is smooth . The arterial supply to the ciliary body is via the long posterior ciliary and anterior ciliary arteries. Reference: Parson, 22nd Edition, Pg no. 239-244.