Terminology Uveitis: inflammation of the uveal tract. Anterior uveitis: iritis and iridocyclitis (iris and ciliary body). Intermediate uveitis: inflammation of the pars plana, the peripheral retina, and the vitreous. Posterior uveitis: inflammation posterior to the vitreous base. Retinitis: primary retinal…
Ocular hypertension Diagnosis Normal IOP: mean IOP in the general population is 16 mm Hg; two standard deviations to either side of this gives a ‘normal’ IOP range of 11–21 mm Hg ( Fig. 10.1 ). Definition: 4–7% of individuals older than…
Acquired cataract Age-related cataract Subcapsular ( Fig. 9.1 ): (a) anterior lies directly under the lens capsule, and (b) posterior lies just in front of the posterior capsule and appears black on retroillumination; the latter often has a more profound…
Episcleritis Simple episcleritis Diagnosis Presentation: acute onset of redness and mild discomfort. Signs: hyperaemia may be sectoral (typically interpalpebral; Fig. 8.1 ) or diffuse. Course: spontaneous improvement occurs within several days, but recurrences may occur. Treatment: not required if mild;…
Keratoplasty Introduction Classification: (a) partial (anterior or posterior lamellar) or (b) full-thickness (penetrating [PKP]). Indications: (a) optical, (b) tectonic, (c) therapeutic, and (d) cosmetic. Donor tissue: should be removed within 12–24 hr of death and stored under special conditions; contraindications to…
Bacterial keratitis Pathogenesis Pathogens: most common are (a) Pseudomonas aeruginosa , (b) S. aureus , and (c) streptococci. Risk factors: (a) contact lens wear, (b) trauma, and (c) ocular surface disease. Diagnosis Presentation: subacute onset of pain, photophobia, blurred vision,…
Bacterial conjunctivitis Acute bacterial conjunctivitis Pathogenesis: direct eye contact with infected secretions; most common isolates are S. pneumoniae , S. aureus , H. influenza , and Moraxella catarrhalis ; uncommon but serious are gonococci and meningococci. Diagnosis Presentation: acute onset…
Definitions Keratoconjunctivitis sicca (KCS): eye with some degree of dryness. Xerophthalmia: dry eye associated with vitamin A deficiency. Xerosis: extreme dryness with keratinization occurring secondary to severe conjunctival cicatrization. Sjögren syndrome: autoimmune inflammatory disease of which KCS is a typical…
Thyroid eye disease Pathogenesis: organ-specific autoimmune reaction in which a humoral agent (IgG antibody) produces inflammation and swelling of orbital tissue, especially extraocular muscles. It consists of an active inflammatory stage (<3 years) followed by a quiescent/fibrotic stage. Diagnosis Lid…
Acquired obstruction Primary punctal stenosis Causes: (a) idiopathic, (b) chronic marginal blepharitis, (c) herpetic (simplex, zoster) lid infection, and (d) conjunctival cicatrization. Diagnosis: narrow inferior punctum in the absence of punctal malposition. Treatment: dilatation alone ( Fig. 2.1 ) rarely…