Dalen fuch nodules are seen in:
Ref: Kan ski: Clinical Ophthalmology; 7th edition page no 465-467Explanation:Sympathetic ophthalmitisIt is bilateral granulomatous panuveitis after penetrating trauma with prolapse of uvea.After injury, it will take 4-8 weeks for sympathetic ophthalmitis to develop.Injured eye - exciting eye; normal fellow- sympathizing eye.Causes: Penetrating injury, intraocular surgeries, cyclophotocoagulation, cyclocryotherapy,Site of injury: involving CB. iris & lens capsule.Pathogenesis: autoimmunity against uveal pigments Dalen Fueh's Nodules - Granulomas between Bruch's & RPEExpanding gasesGASESEXPANSION AT 100%DURATION OF ACTIONCONCENTRAION USED %SULPHURHEXACHLORIDE (SF6)2 times10 - 14 days20 - 30%PER FLUOR ETHANE (C2F6)3 times30 - 35 days PER FLUOROPROPANE (C3 F8)4 times55 - 65 days12-16%Earliest Symptom: Loss of accommodationEarliest Sign: Retrolental flare & cellsKP's at the back of corneaEnucleation of the injured eye within 10 days only in eyes with a hopeless visual prognosisTreatment: topical & systemic steroids Vogt-Koyanagi-Harada syndrome (VKH syndrome)Uncommon multisystem autoimmune disorderIt is characterized by chronic, bilateral, diffuse. granulomatous uveitis with accompanying dermatologic, neurologic, and auditory involvement.There are 4 stages of VKH syndromeThe prodromal stageFlu-like symptoms.Patients present with headache, nausea, meningism,Dysacusia (discomfort caused by loud noises or distortion in quality of the sounds)Tinnitus.The acute uveitic stageBlurring of vision in both eyesBilateral granulomatous anterior uveitisVariable degree of vitritisThickening of the posterior choroidElevation of the peripapillary retinal choroidal layerHyperemia and edema of the optic nerveMultiple serous retinal detachments.The convalescent stageOccurs several weeks laterGradual depigmentation of choroid causing classic orange-red discoloration, or sunset glow fundus appearance.Skin changes like vitiligo, alopecia and poliosis appearThe chronic recurrent stage - Repeated bouts of uveitis.Treatment - Early and aggressive treatment with topical, periocular and systemic corticosteroids
TB
Sarcoidosis
Sympathetic opthalmitis
Vogt-Kovanagi-Harada syndrome
Ocular Trauma