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Fuchs Heterochromic Iridocyclitis
Fuchs heterochromic iridocyclitis (FHI) is a chronic unilateral uveitis appearing with the triad of heterochromia, predisposition to cataract and glaucoma, and keratitic precipitates on the posterior corneal surface. Patients are often asymptomatic and the disease is often discovered through investigation of the cause of the heterochromia or cataract. Neovascularisation (growth of new abnormal vessels) is possible and any eye surgery, such as cataract surgery, can cause bleeding from the fragile vessels in the atrophic iris causing accumulation of blood in the anterior chamber of the eye, also known as hyphema. Presentation This condition is usually unilateral, and its symptoms vary from none to mild blurring and discomfort. Signs include diffuse iris atrophy and small white keratic precipitates (deposits on the inner surface of the cornea), cells presenting in the anterior chamber as well as the anterior vitreous. Glaucoma and cataract occur frequently. Complications * Glaucom ...
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Uveitis
Uveitis () is inflammation of the uvea, the pigmented layer of the eye between the inner retina and the outer fibrous layer composed of the sclera and cornea. The uvea consists of the middle layer of pigmented vascular structures of the eye and includes the Iris (anatomy), iris, ciliary body, and choroid. Uveitis is described anatomically, by the part of the eye affected, as anterior, intermediate uveitis, intermediate or posterior, or panuveitic if all parts are involved. Anterior uveitis (iridocyclytis) is the most common, with the incidence of uveitis overall affecting approximately 1:4500, most commonly those between the ages of 20-60. Symptoms include eye pain, eye redness, floaters and blurred vision, and ophthalmic examination may show dilated ciliary body, ciliary blood vessels and the presence of cells in the Anterior chamber of eyeball, anterior chamber. Uveitis may arise spontaneously, have a genetic component, or be associated with an autoimmune disease or infection. Wh ...
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Rubella
Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild, with half of people not realizing that they are infected. A rash may start around two weeks after exposure and last for three days. It usually starts on the face and spreads to the rest of the body. The rash is sometimes itchy and is not as bright as that of measles. Swollen lymph nodes are common and may last a few weeks. A fever, sore throat, and fatigue may also occur. Joint pain is common in adults. Complications may include bleeding problems, testicular swelling, encephalitis, and inflammation of nerves. Infection during early pregnancy may result in a miscarriage or a child born with congenital rubella syndrome (CRS). Symptoms of CRS manifest as problems with the eyes such as cataracts, deafness, as well as affecting the heart and brain. Problems are rare after the 20th week of pregnancy. Rubella is usually spread from one person to t ...
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Anterior Chamber Paracentesis
Anterior chamber paracentesis (ACP) is a surgical procedure done to reduce intraocular pressure (IOP) of the eye. The procedure is used in management of glaucoma and uveitis. It is also used for clinical diagnosis of infectious uveitis. Uses Anterior chamber paracentesis is used in the management of acute angle closure glaucoma, and uveitis. It can also prevent a raise in IOP after intravitreal injections. Aqueous humor collected using anterior chamber paracentesis may be used for clinical diagnosis of infectious uveitis. Procedure In this procedure aqueous humor from the anterior chamber of eyeball is drained out by using a tuberculin syringe, with or without a plunger attached to a hypodermic needle or a paracentesis incision. Eye is anesthetized using proparacaine or tetracaine eye drops prior to ACP. Paracentesis is performed through the clear cornea adjacent to the limbus. Complications Pain, traumatic injuries of the iris, corneal abscess, inadvertent lens touch, occurrenc ...
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Vitreous Fluid
The vitreous body (''vitreous'' meaning "glass-like"; , ) is the clear gel that fills the space between the lens and the retina of the eyeball (the vitreous chamber) in humans and other vertebrates. It is often referred to as the vitreous humor (also spelled humour, from Latin meaning liquid) or simply "the vitreous". Vitreous fluid or "liquid vitreous" is the liquid component of the vitreous gel, found after a vitreous detachment. It is not to be confused with the aqueous humor, the other fluid in the eye that is found between the cornea and lens. Structure The vitreous humor is a transparent, colorless, gelatinous mass that fills the space in the eye between the lens and the retina. It is surrounded by a layer of collagen called the vitreous membrane (or hyaloid membrane or vitreous cortex) separating it from the rest of the eye. It makes up four-fifths of the volume of the eyeball. The vitreous humour is fluid-like near the centre, and gel-like near the edges. The vitreous hu ...
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Amsler Sign
Amsler sign also known as Amsler–Verrey sign is the name of the diagnostic finding seen in people with Fuchs heterochromic iridocyclitis (FHI). It is described as presence of blood (hyphema) in the aspirated aqueous fluid, in paracentesis of the anterior chamber, and is caused due to iris atrophy usually seen in FHI and exposure of the fragile iris vasculature to the aqueous fluid. The sudden change of pressure in the anterior chamber upon suction induced by the paracentesis, or during a cataract surgery, causes bursting of the fragile superficial iris capillaries resulting in micro-bleeding. This is one clinical diagnostic sign of FHI. History This sign is named after the Swiss ophthalmologist Marc Amsler (February 15, 1891 – May 3, 1968). It is sometimes referred to as Amsler–Verrey sign to acknowledge the contribution of another Swiss ophthalmologist, Florian Verrey Florian Verrey (7 October 1911, in Lausanne – 14 September 1976) was a Swiss ophthalmologist. He s ...
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Optometrist
Optometry is a specialized health care profession that involves examining the eyes and related structures for defects or abnormalities. Optometrists are health care professionals who typically provide comprehensive primary eye care. In the United States and Canada, optometrists are those that hold a Doctor of Optometry degree. They are trained and licensed to practice medicine for eye related conditions, in addition to providing refractive (optical) eye care. In the United Kingdom, optometrists may also practice medicine (and provide refractive care) for eye related conditions. The Doctor of Optometry title can also be used in the UK for those that hold the postgraduate O.D. degree. Within their scope of practice, optometrists are considered physicians and bill medical insurance(s) (example: Medicare) accordingly. Moreover, many participate in academic research for eye related conditions and disease. Optometrists are the only health care professionals with a first professiona ...
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Ophthalmologist
Ophthalmology ( ) is a surgical subspecialty within medicine that deals with the diagnosis and treatment of eye disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a medical degree, a doctor specialising in ophthalmology must pursue additional postgraduate residency training specific to that field. This may include a one-year integrated internship that involves more general medical training in other fields such as internal medicine or general surgery. Following residency, additional specialty training (or fellowship) may be sought in a particular aspect of eye pathology. Ophthalmologists prescribe medications to treat eye diseases, implement laser therapy, and perform surgery when needed. Ophthalmologists provide both primary and specialty eye care - medical and surgical. Most ophthalmologists participate in academic research on eye diseases at some point in their training and many include research as p ...
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Autoimmune
In immunology, autoimmunity is the system of immune responses of an organism against its own healthy cells, tissues and other normal body constituents. Any disease resulting from this type of immune response is termed an "autoimmune disease". Prominent examples include celiac disease, post-infectious IBS, diabetes mellitus type 1, Henoch–Schönlein purpura (HSP) sarcoidosis, systemic lupus erythematosus (SLE), Sjögren syndrome, eosinophilic granulomatosis with polyangiitis, Hashimoto's thyroiditis, Graves' disease, idiopathic thrombocytopenic purpura, Addison's disease, rheumatoid arthritis (RA), ankylosing spondylitis, polymyositis (PM), dermatomyositis (DM), Alopecia Areata and multiple sclerosis (MS). Autoimmune diseases are very often treated with steroids. Autoimmunity means presence of antibodies or T cells that react with self-protein and is present in all individuals, even in normal health state. It causes autoimmune diseases if self-reactivity can lead to tis ...
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Herpes Simplex Virus
Herpes simplex virus 1 and 2 (HSV-1 and HSV-2), also known by their taxonomical names '' Human alphaherpesvirus 1'' and ''Human alphaherpesvirus 2'', are two members of the human ''Herpesviridae'' family, a set of viruses that produce viral infections in the majority of humans. Both HSV-1 and HSV-2 are very common and contagious. They can be spread when an infected person begins shedding the virus. As of 2016, about 67% of the world population under the age of 50 had HSV-1. In the United States, about 47.8% and 11.9% are estimated to have HSV-1 and HSV-2, respectively, though actual prevalence may be much higher. Because it can be transmitted through any intimate contact, it is one of the most common sexually transmitted infections. Symptoms Many of those who are infected ''never'' develop symptoms. Symptoms, when they occur, may include watery blisters in the skin or mucous membranes of the mouth, lips, nose, genitals, or eyes ( herpes simplex keratitis). Lesions heal w ...
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Heterochromia
Heterochromia is a variation in coloration. The term is most often used to describe color differences of the iris, but can also be applied to color variation of hair or skin. Heterochromia is determined by the production, delivery, and concentration of melanin (a pigment). It may be inherited, or caused by genetic mosaicism, chimerism, disease, or injury. It occurs in humans and certain breeds of domesticated animals. Heterochromia of the eye is called heterochromia iridum or heterochromia iridis. It can be complete or sectoral. In complete heterochromia, one iris is a different color from the other. In sectoral heterochromia, part of one iris is a different color from its remainder. In central heterochromia, there is a ring around the pupil or possibly spikes of different colors radiating from the pupil. Though multiple causes have been posited, the scientific consensus is that a lack of genetic diversity is the primary reason behind heterochromia, at least in domestic ...
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Toxoplasma Gondii
''Toxoplasma gondii'' () is an obligate intracellular parasitic protozoan (specifically an apicomplexan) that causes toxoplasmosis. Found worldwide, ''T. gondii'' is capable of infecting virtually all warm-blooded animals, but felids, such as domestic cats, are the only known definitive hosts in which the parasite may undergo sexual reproduction. ''T. gondii'' has been shown to alter the behavior of infected rodents in ways that increase the rodents' chances of being preyed upon by felids. Support for this "manipulation hypothesis" stems from studies showing that ''T. gondii''-infected rats have a decreased aversion to cat urine. Because cats are the only hosts within which ''T. gondii'' can sexually reproduce to complete and begin its lifecycle, such behavioral manipulations are thought to be evolutionary adaptations that increase the parasite's reproductive success. Rats that do not avoid cat habitations will more likely become cat prey. ''Toxoplasma gondii'' infection ...
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Visual Acuity
Visual acuity (VA) commonly refers to the clarity of vision, but technically rates an examinee's ability to recognize small details with precision. Visual acuity is dependent on optical and neural factors, i.e. (1) the sharpness of the retinal image within the eye, (2) the health and functioning of the retina, and (3) the sensitivity of the interpretative faculty of the brain. The most commonly referred visual acuity is the far acuity (e.g. 6/6 or 20/20 acuity), which describes the examinee's ability to recognize small details at a far distance, and is relevant to people with myopia; however, for people with hyperopia, the near acuity is used instead to describe the examinee's ability to recognize small details at a near distance. A common cause of low visual acuity is refractive error (ametropia), errors in how the light is refracted in the eyeball, and errors in how the retinal image is interpreted by the brain. The latter is the primary cause for low vision in people with ...
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