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Lens Iris pigments on lens surface Posterior subcapsular cataract Inflammation and corticosteroid use Complicated cataract Breadcrumb appearance Polychromatic lustre

Lens pigments and cataract

Vitreous in uveitis Exudates get organized Vitreous membranes, contraction Traction on retina Tractional retinal detachment Retinal tears and rhegmatogenous retinal detachment

Choroid and retina Destruction of retinal pigment epithelium (RPE) and Bruch’s membrane Chorioretinal atrophic patch White of sclera seen through Fibroblastic activity Chorioretinal adhesion RPE proliferation at edges – pigmented scars Choroidal neovascular membranes Permanent scotomas

Complications Cataract Glaucoma Hypotony Cystoid macular edema

Causes of glaucoma Closed angle Posterior synechiae Peripheral anterior synechiae Open angle Cells and protein blockage of trabecular meshwork Trabeculitis Corticosteroid induced

Causes of hypotony Acute inflammation of ciliary body - temporary hyposecretion Chronic ciliary body damage – permanent hypotony Ciliary body traction from a cyclitic membrane Hypotony more dangerous in chronic uveitis than glaucoma

Hypotony – phthisis bulbi (LE)

Cystoid macular edema Inflammatory mediators reach the macula Common cause of visual loss in uveitis

End stage of inflammatory eye diseases Atrophy with shrinkage Small globe Structures still recognizable ATROPHIC BULBI Eg. Chronic long standing uveitis Atrophy with shrinkage and disorganization Small globe Structures unrecognizable PHTHISIS BULBI Eg. Purulent endophthalmitis Irreversible blindness

Phthisis bulbi Clinically, any globe which is Sightless Shrunken Shapeless (‘squared-off’) Soft Associations Dystrophic calcification eg. band keratopathy Intraocular ossification Risk of intraocular malignancy