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    Prof. Dr. Dr. Rukiah Syawal, SPM (K)

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    Ronald Ariyanto Wiradirnata
    The document discusses the anatomy and physiology of the uvea, which consists of the iris, ciliary body, and choroid. It describes the structures and functions of these parts of the eye. The document also discusses uveitis, which is inflammation of the uvea. It describes the causes, symptoms, signs, and classifications of uveitis. Treatment options for uveitis including medical therapies like cycloplegics, corticosteroids, and immunosuppressants as well as surgical interventions. Complications of uveitis that are discussed include secondary glaucoma, cataracts, macular edema, and retinal detachment.

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    Prof. Dr. Dr. Rukiah Syawal, SPM (K)

    Uploaded by

    Ronald Ariyanto Wiradirnata
    42 views22 pages
    The document discusses the anatomy and physiology of the uvea, which consists of the iris, ciliary body, and choroid. It describes the structures and functions of these parts of the eye. The document also discusses uveitis, which is inflammation of the uvea. It describes the causes, symptoms, signs, and classifications of uveitis. Treatment options for uveitis including medical therapies like cycloplegics, corticosteroids, and immunosuppressants as well as surgical interventions. Complications of uveitis that are discussed include secondary glaucoma, cataracts, macular edema, and retinal detachment.

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    14.10.10-uveitis

    Original Title

    14.10.10-uveitis

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    The document discusses the anatomy and physiology of the uvea, which consists of the iris, ciliary body, and choroid. It describes the structures and functions of these parts of the eye. The document also discusses uveitis, which is inflammation of the uvea. It describes the causes, symptoms, signs, and classifications of uveitis. Treatment options for uveitis including medical therapies like cycloplegics, corticosteroids, and immunosuppressants as well as surgical interventions. Complications of uveitis that are discussed include secondary glaucoma, cataracts, macular edema, and retinal detachment.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    42 views22 pages

    Prof. Dr. Dr. Rukiah Syawal, SPM (K)

    Uploaded by

    Ronald Ariyanto Wiradirnata
    The document discusses the anatomy and physiology of the uvea, which consists of the iris, ciliary body, and choroid. It describes the structures and functions of these parts of the eye. The document also discusses uveitis, which is inflammation of the uvea. It describes the causes, symptoms, signs, and classifications of uveitis. Treatment options for uveitis including medical therapies like cycloplegics, corticosteroids, and immunosuppressants as well as surgical interventions. Complications of uveitis that are discussed include secondary glaucoma, cataracts, macular edema, and retinal detachment.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 22

    Prof. Dr. dr.

    Rukiah Syawal,SpM (K)


    Anatomy and Physiology
    Uvea consists of : Iris, Ciliary body,
    Choroid
    Vascular rich Tunica vasculosa
    Vascular layer ; the eyes major blood
    supply
    Primary function : supply
    nourishment to the ocular
    structure


    Sagittal view of the eye
    IRIS
    Dividing aquous humour into Anterior Chamber
    and Posterior Chamber
    Central iris ( pupil ) control the amount of light
    entering the eye
    Miosis -- Mydriasis

    CILIARY BODY
    Produce Aquous Humor
    Contribute the maintenance IOP
    Ciliary muscles for Accomodation
    CHOROID
    Nutrition to the external half of the retina

    UVEITIS
    The inflammation of the uvea
    Causes : infectious, traumatic, neoplastic,
    autoimmune

    Symptoms
    1. Blurred Vision
    Refractive error associated with macular edem
    Opacities in the visual axis : inflammatory cells,
    fibrin, keratic precipitate (KP)
    Second cataract, vitreus debris

    2. Redness
    Pericorneal injection : Ciliary flush
    3. Pain
    Iris spasme
    4. Photophobia, lacrimation
    SIGNS
    Ciliary flush : pericorneal injection
    Anterior chamber reaction : KP, cells, flare,
    fibrin, hypopion, pigment dispersion
    Pupillary miosis : iris edem
    Iris nodule ( granulomatous uveitis)
    Synechia : S.Anterior, S.Posterior

    AQUOUS FLARE
    KERATIC PRECIPITATES
    PIGMENT DEPOSITS ON THE LENS
    POSTERIOR SYNECHIA
    KERATIC PRECIPITATES
    Classification
    Clinic. And pathologic grounds
    - Nongranulomatous
    - Granulomatous

    Anatomical IUSG ( International Uveitis Study
    Group)
    Anterior uveitis
    Intermediate uveitis
    Posterior uveitis
    Panuveitis : diffuse uveitis

    Anterior Uveitis
    Iritis Iridocyclitis keratouveitis sklero
    uveitis
    Sterile inflammatory reaction
    Some cases of unknown cause after
    resolve in 6 week (idiophatic iritis)
    Low grade inflammatory associated
    (idiophatic iritis) : JRA, Fuchs
    heterochromatic iridicyclitis

    Intermediate Uveitis
    Externally eye appears quite
    Floaters
    Chronic Cystoid macular edema
    Posterior uveitis
    Quite appearancy or with infiltrate
    Retinitis, choroiditis, chorioretinitis
    Infectious : viral, bacterial, protozoa,
    fungal
    Cause of uveitis
    Clinical
    Laboratory and medical examination
    Ancillary testing
    - Fluorosein angiography (FFA)
    - USG
    - Vitreous biopsy (vitrectomy)

    Treatment
    A. MEDICAL THERAPY
    1. Cycloplegic
    - relieve pain
    - break synechia
    - prevent synechia
    2. Corticosteroid
    a. Topical
    b. Perioculer
    c. Systemic
    d. Intravitreal
    3. Immunosuppressive
    B. SURGICAL

    CORTICOSTEROID
    The mainstay of uveitis therapy
    Potential side effect
    Specific indication
    1. Active inflammation in the eye
    2. Prevention or treatment cystoid macular
    edema
    3. Reduction of inflammation of retina,
    choroid or optic nerve
    Route administration of steroid
    Topical : ED, EO, primary for anterior uveitis
    Periocular for intemediate uveitis
    Systemic, oral, intravenous for vision threatening
    chronic uveitis
    Intravitreal for chronic uveitis and cystoid macular
    edema
    IMMUNOSUPPRESSIVE
    INDICATION :
    Vision threatening intraocular inflammation
    Reversibility of disease process
    Inadequate response to steroid treatment
    Contraindication of steroid (intorelable side effects)

    Immunosuppressive : cyclosporine, chlorambucil,
    methotrexate

    COMPLICATION OF UVEITIS
    1. Iris involvement : synechia ( anterior &/posterior),
    disturbance of aquous humor flow secondary
    glaucoma
    The meshwork clogged by inflammatory cells or
    debris, IOP increased secondary glaucoma
    2. Cataract formation
    3. Chronic uveitis macular edema
    4. Fibrin of vitreous traction retinal detachment




    SECONDARY GLAUCOMA
    POSTERIOR SYNECHIA
    SECONDARY CATARACT
    RETINAL DETACHMENT

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