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Abstract
Uveitis is an inflammation of the uveal tract. However the term is now used to describe many forms of intraocular inflammation involving not only the uvea but also adjacent structures.
Uveitis is usually categorized anatomically into anterior, intermediate, posterior and panuveitis forms, Classified according to the mode of onset and duration, uveitis can be acute or chronic, and classified pathologically into granulomatous or non-granulomatous.
Pain, redness, tearing and photophobia comprise the classic presentation of acute anterior uveitis. Patients with IC usually present with minimal symptoms, which may include floaters or blurred vision, but usually no pain or photophobia. With posterior uveitis, many patients report a painless loss of vision, which may be mild or marked. In addition, some patients may report floaters or scotoma in patients with peripheral retinal involvement.
The conjunctiva classically shows perilimbal ciliary injection. The cornea may have keratic precipitates (KPs), The anterior chamber shows variable amounts of white cells floating in the aqueous. Often, protein also is visible in the anterior chamber as flare. The intraocular pressure (IOP) is often low in acute cases of anterior uveitis but may be elevated in chronic cases. Longstanding inflammation can cause posterior synechiae .Inflammatory nodules on the iris (Koeppe and Busacca) suggest granulomatous uveitis . Examination of the eye reveals retinitis, vasculitis and vascular sheathing involving the arteries, the veins, or both, choroiditis, cotton-wool spots, exudates, cystoid macular edema and neovascularization. Active vasculitis will be characterized by vascular sheathing around the vessels, such as “candle-wax drippings”
The main causes of visual loss from uveitis are; cystoid macular edema (CME), damage to the vitreous, glaucoma, cataract and retinal detachment .
New diagnostic advancements over the past few decades have improved the timely diagnosis of these often devastating illnesses that range from infectious to auto-immune. Proper diagnosis both through non-invasive methods such as indocyanine green angiography to more invasive methods including vitreous biopsy allows the clinician to not only determine the etiology of posterior segment inflammation, but also serves to guide the specific treatment for the underlying disease process.