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Chapter-09 The Uveal Tract

BOOK TITLE: Basic Ophthalmology

Author
1. Jogi Renu
ISBN
9788184484519
DOI
10.5005/jp/books/10076_9
Edition
4/e
Publishing Year
2009
Pages
44
Author Affiliations
1. MGM Medical College, Indore (MP), Pt. Jawahar Lal Nehru Memorial Medical College, Raipur, Chhattisgarh, India, India, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India, Pandit Jawahar Lal Nehru Memorial Medical College, Raipur, Chhattisgarh, India
Chapter keywords

Abstract

Iris, ciliary body and choroid form the uveal tract. Iris regulates the amount of light reaching the retina by controlling the size of the pupil. Ciliary body consists of pars plicata and pars plana, the former secretes aqueous humor. Ciliary muscle is involved in accommodation. Choroid is highly vascular layer between the sclera and retina. Inflammation of the uveal tract (uveitis) may be anterior, intermediate, posterior or panuveitis. The characteristic clinical signs of anterior uveitis are circumcorneal congestion, cells and flare in the anterior chamber and keratic precipitates on the endothelium. Atropine and corticosteroids are the mainstay of treatment. Intermediate uveitis or pars planitis affects the pars plana of the ciliary body. Posterior uveitis or choroiditis may be focal, multifocal or diffuse. Endophthalmitis is inflammation of the interior of the eye. It may be bacterial, fungal or sterile. It is treated with intravitreal injections of antibiotics or antifungals. Vitrectomy may be required in severe cases. Panophthalmitis is purulent inflammation of all the structures of the eye and is treated with antibiotics by all possible routes along with vitrectomy. Evisceration may be required subsequently. Phthisis bulbi is shrinkage of the eyeball due to hypotony. Syphilis, gonorrhea, tuberculosis, leprosy, toxoplasmosis and sarcoidosis can sometimes cause uveitis. Acquired Immunodeficiency syndrome (AIDS), can cause variety of ocular lesions and complications including iritis. CMV retinitis is the most common intraocular infection in AIDS. Rubeosis iridis is neovascularization of iris which usually develops due to retinal hypoxia. Congenital anomalies involving the iris are heterochromia, polycoria, corectopia, aniridia, persistent pupillary membrane, coloboma and albinism. Malignant melanoma is a primary malignant tumour of the uveal tract derived from sheaths of Schwann of sensory nerves. Laser iridotomy (with Nd YAG, Argon or diode laser) is performed for angle closure glaucoma. Enucleation is excision of the eyeball as a whole while in evisceration the intraocular contents are scooped out.

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