Ocular Manifestations of Systemic Disorders — MCQs

Question 1: What is one of the most common complications of iridocyclitis?

• A. Scleritis
• B. Secondary glaucoma (Correct Answer)
• C. Band-shaped keratopathy
• D. Corneal ulcer

Explanation: **Explanation:** **Iridocyclitis** (anterior uveitis) is characterized by inflammation of the iris and ciliary body. **Secondary glaucoma** is one of the most common and vision-threatening complications of this condition. It occurs via two primary mechanisms: 1. **Open-angle mechanism:** Inflammatory debris (cells, fibrin, and pigment) clogs the trabecular meshwork, or "trabeculitis" reduces outflow facility. 2. **Closed-angle mechanism:** Formation of **posterior synechiae** (adhesions between the iris and lens) leads to *seclusio pupillae*. This obstructs aqueous flow from the posterior to the anterior chamber, causing **iris bombé** and subsequent angle closure. **Analysis of Incorrect Options:** * **Scleritis (A):** This is an inflammation of the outer coat of the eye. While systemic diseases (like Rheumatoid Arthritis) can cause both uveitis and scleritis, one does not typically occur as a *complication* of the other. * **Band-shaped Keratopathy (C):** This is a classic complication of **chronic** uveitis (especially in Juvenile Idiopathic Arthritis) due to calcium deposition in Bowman’s layer. While common in chronic cases, secondary glaucoma occurs more frequently across both acute and chronic presentations. * **Corneal Ulcer (D):** This is typically caused by infection or trauma. Iridocyclitis may cause corneal edema or keratic precipitates (KPs), but it does not directly cause ulceration. **High-Yield Clinical Pearls for NEET-PG:** * **Most common cause of death in Uveitis:** Not applicable, but the most common cause of **blindness** in uveitis is **Cystoid Macular Edema (CME)**. * **Festooned Pupil:** Irregular pupil shape caused by patchy posterior synechiae; a hallmark of previous iridocyclitis. * **Treatment Note:** Atropine is used in iridocyclitis to provide ciliary rest and prevent the formation of posterior synechiae.