Iris bombe occurs with
Correct Answer: Ring synechiae
Description: C i.e. Ring synechiae Annular posterior synechia/ Ring synechia are 360deg adhesion of pupillary margin to anterior capsuldial lens. Thus preventing circulation of aquous humor from posterior chamber to anterior chamber (seclusio pupillae)Q. So the aqueus collects behind the iris & pushes it anteriory like a sail lit Iris bombeQ formation. Due to this the anterior chamber becomes funnel shaped i.e. deeper in centre & shallower at periphery. And ant. surface of iris comes in contact with posterior surface of cornea at periphery, where eventually firm adhesions form (Peripheral anterior synechiae). Both ring & peripheral anterior synechaia lit secondary glaucoma. Yag laser iridotomy is treatment of choice to prevent secondary glaucoma. Complications of Anterior Uveitis - Seclusio occlusio pupillae Secondary glaucoma (most common)Q - Cyclitic membrane Complicated cataractQ Pseudoglioma due to vitreous exudation - Cystoid macular oedemaQ is common cause of visual impairment - Pthisis & atrophic bulbi - Tractional retinal detachment - Band shaped keratopathy: more common in children with JRA - Features of anterior uveitis (acute) include pain, redness /ciliary flush or congestion / perilimbal injection, tenderness, photophobia, blurred vision, keratic precipitates, aqueous flare and cellsQ. Smaller KPs are seen in nongranulomatous, whereas larger (mutton fat) KPs are characteristic of granulomatous uveitis. The normal convection currents of aqueous humor & gravitation result in KPs being typically concentrated over a triangular area (Arlt triangle) in the lower pa of cornea. A diffuse pattern of KPs is frequently seen in Fuch's hetrochromic iridocyclitis or herpetic Keratouveitis. New KPs are white and become shrunken (crenated) or more pigmented as they age. Cornea may show epithelial dendrites, geographic ulcers or stromal scarring in herpetic Keratouveitis. Conjunctiva demonstrate nodules in sarcoidosis. - Clinical features of intermediate uveitis include floaters, deterioration of vision (d/t opacities in anterior vitreous), minimal AF with occasional KPs (k/a spill over anterior uveitis), anterior vitritis, white snowball like exudates near ora serrata, coalescent exudates (snow bank appearance), mild peripheral periphlebitis. - Typical features of posterior uveitis include often painless floater with or without diminution of vision0, vitritis (detectable inflammatory cells & opacities in vitreous), retinitis- choroiditis (exudates, infiltration, odema or atrophy) and sheathing of vessels (perivascular exudates). - Other less frequent features of posterior segment involvement (i.e. complications) include macular edema, disc edema (papillitis), retrolental cyclitic membrane, vitreous haemorrhage; serous, tractional or rhegmatogenous RD; retinochoroidal neovascularization & atrophy.
Category:
Ophthalmology
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