Panuveitis

Panuveitis










Panuveitis is a type of uveitis, which refers to inflammation of the uveal tract of the eye. In panuveitis, all parts of the uvea are inflamed — this includes:

Iris (anterior uvea)

Ciliary body (intermediate uvea)

Choroid (posterior uvea)

It may also affect the retina, vitreous, and optic nerve.


✅ Definition:

Panuveitis is a serious form of uveitis in which inflammation involves the anterior, intermediate, and posterior parts of the uveal tract without any one area predominating.

🔎 Causes:

Infectious causes:

  • Tuberculosis (TB)

  • Syphilis

  • Toxoplasmosis

  • Herpes simplex/zoster

  • HIV/AIDS

Autoimmune or systemic diseases:

  • Sarcoidosis
  • Behçet's disease
  • Vogt-Koyanagi-Harada (VKH) syndrome
  • Systemic lupus erythematosus (SLE)
  • Rheumatoid arthritis
  • Idiopathic (unknown cause)

⚠️ Symptoms:
  • Blurred vision
  • Eye pain
  • Redness
  • Photophobia (light sensitivity)
  • Floaters
  • Decreased visual acuity

🔬 Signs (on examination):

Anterior chamber cells and flare (inflammation in front part)

  • Vitritis (inflammation in vitreous)
  • Retinal vasculitis
  • Choroiditis
  • Optic disc swelling
  • Posterior synechiae (iris stuck to lens)

🧪 Investigations:
  • Slit-lamp examination
  • Fundus examination
  • OCT (Optical coherence tomography)
  • Fluorescein angiography
  • Blood tests (e.g., ESR, CRP, ANA, VDRL)
  • Chest X-ray (for TB or sarcoidosis)
  • Mantoux test or Quantiferon TB Gold

💊 Treatment:

  • Steroids (topical, oral, periocular, or intraocular)
  • Immunosuppressive agents (like methotrexate, azathioprine)
  • Antibiotics/antivirals if infectious cause
  • Cycloplegic drops (to relieve pain and prevent synechiae)
  • Regular monitoring by an ophthalmologist

⚠️ Complications if untreated:
  • Glaucoma
  • Cataract
  • Retinal detachment
  • Vision loss
  • Macular edema
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