| What is the purpose of imaging the eye in the context of investigations? | Ascertaining diagnosis, extent of disease & follow up, teleconsultation | Investigations to rule out other causes of clinical presentation Refer to Ophthalmologist for detailed examination Eye Care facility should have: Mandatory: Slit lamp, ophthalmoscope (direct or indirect), intraocular pressure assessment device Preferred: Fundus camera, Fundus fluorescein angiongram(FFA), Optical Coherence Tomography (OCT) Imaging of eye: Ascertaining diagnosis, extent of disease & follow up, teleconsultation Essential: CXR for healed/ active pulmonary TB TREATMENT REFERRAL TO HIGHER CENTRE Optional: CT Chest (if available) for healed/active pulmonary TB Desirable: Mantoux Test (standardised tuberculin units): l0 mm induration considered positive Retinal photographs using fundus camera Optical coherence tomography scans (if available) Fluorescein angiograms (if available) • Not confident to treat • Vision threatening • Non-response to treatment • Side effects due to treatment • Atypical reaction | 357 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725964687_10_intraocular_tuberculosis_15032022.pdf | Investigations to rule out other causes of clinical presentation Refer to Ophthalmologist for detailed examination Eye Care facility should have: Mandatory: Slit lamp, ophthalmoscope (direct or indirect), intraocular pressure assessment device Preferred: Fundus camera, Fundus fluorescein angiongram(FFA), Optical Coherence Tomography (OCT) Imaging of eye: Ascertaining diagnosis, extent of disease & follow up, teleconsultation Essential: CXR for healed/ active pulmonary TB TREATMENT REFERRAL TO HIGHER CENTRE Optional: CT Chest (if available) for healed/active pulmonary TB Desirable: Mantoux | 1 | page=1,block=12 | 0.700 | valid |
| What are some ocular symptoms of granulomatous anterior uveitis? | Blurred vision • Redness • Photophobia • Pain in the eye • Floaters • Flashes of lights | When to suspect Granulomatous anterior uveitis Examination of the eyes Ocular Symptoms • Blurred vision • Redness • Photophobia • Pain in the eye • Floaters • Flashes of lights Clinical signs • Assess visual acuity • Anterior chamber cells, Keratic precipitates, Synechiae, Irregular pupil, RAPD • Complicated cataract, high or very low intraocular pressure • Vitritis, Pars plana exudates, Retinal vasculitis, Retinitis, Choroiditis, Optic nerve head swelling | 89 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725964687_10_intraocular_tuberculosis_15032022.pdf | When to suspect Granulomatous anterior uveitis Examination of the eyes Ocular Symptoms • Blurred vision • Redness • Photophobia • Pain in the eye • Floaters • Flashes of lights Clinical signs • Assess visual acuity • Anterior chamber cells, Keratic precipitates, Synechiae, Irregular pupil, RAPD • Complicated cataract, high or very low intraocular pressure • Vitritis, Pars plana exudates, Retinal vasculitis, Retinitis, Choroiditis, Optic nerve head swelling | 1 | page=1,block=6 |
| What equipment is mandatory for an eye care facility to have for investigations? | Slit lamp, ophthalmoscope (direct or indirect), intraocular pressure assessment device | Investigations to rule out other causes of clinical presentation Refer to Ophthalmologist for detailed examination Eye Care facility should have: Mandatory: Slit lamp, ophthalmoscope (direct or indirect), intraocular pressure assessment device Preferred: Fundus camera, Fundus fluorescein angiongram(FFA), Optical Coherence Tomography (OCT) Imaging of eye: Ascertaining diagnosis, extent of disease & follow up, teleconsultation Essential: CXR for healed/ active pulmonary TB TREATMENT REFERRAL TO HIGHER CENTRE Optional: CT Chest (if available) for healed/active pulmonary TB Desirable: Mantoux Test (standardised tuberculin units): l0 mm induration considered positive Retinal photographs using fundus camera Optical coherence tomography scans (if available) Fluorescein angiograms (if available) • Not confident to treat • Vision threatening • Non-response to treatment • Side effects due to treatment • Atypical reaction | 157 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725964687_10_intraocular_tuberculosis_15032022.pdf | Investigations to rule out other causes of clinical presentation Refer to Ophthalmologist for detailed examination Eye Care facility should have: Mandatory: Slit lamp, ophthalmoscope (direct or indirect), intraocular pressure assessment device Preferred: Fundus camera, Fundus fluorescein angiongram(FFA), Optical Coherence Tomography (OCT) Imaging of eye: Ascertaining diagnosis, extent of disease & follow up, teleconsultation Essential: CXR for healed/ active pulmonary TB TREATMENT REFERRAL TO HIGHER CENTRE Optional: CT Chest (if available) for healed/active pulmonary TB Desirable: Mantoux |
| What imaging techniques are preferred for eye investigations? | Fundus camera, Fundus fluorescein angiongram(FFA), Optical Coherence Tomography (OCT) | Investigations to rule out other causes of clinical presentation Refer to Ophthalmologist for detailed examination Eye Care facility should have: Mandatory: Slit lamp, ophthalmoscope (direct or indirect), intraocular pressure assessment device Preferred: Fundus camera, Fundus fluorescein angiongram(FFA), Optical Coherence Tomography (OCT) Imaging of eye: Ascertaining diagnosis, extent of disease & follow up, teleconsultation Essential: CXR for healed/ active pulmonary TB TREATMENT REFERRAL TO HIGHER CENTRE Optional: CT Chest (if available) for healed/active pulmonary TB Desirable: Mantoux Test (standardised tuberculin units): l0 mm induration considered positive Retinal photographs using fundus camera Optical coherence tomography scans (if available) Fluorescein angiograms (if available) • Not confident to treat • Vision threatening • Non-response to treatment • Side effects due to treatment • Atypical reaction | 255 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725964687_10_intraocular_tuberculosis_15032022.pdf | Investigations to rule out other causes of clinical presentation Refer to Ophthalmologist for detailed examination Eye Care facility should have: Mandatory: Slit lamp, ophthalmoscope (direct or indirect), intraocular pressure assessment device Preferred: Fundus camera, Fundus fluorescein angiongram(FFA), Optical Coherence Tomography (OCT) Imaging of eye: Ascertaining diagnosis, extent of disease & follow up, teleconsultation Essential: CXR for healed/ active pulmonary TB TREATMENT REFERRAL TO HIGHER CENTRE Optional: CT Chest (if available) for healed/active pulmonary TB Desirable: Mantoux |
| What should be monitored when using systemic steroids for eye inflammation? | Monitor body weight, blood sugar & blood pressure | • Frequency of follow up: 1-2 weeks in 1st month followed by monthly for 3 months & then 3 monthly • Eye: Clinical grading of inflammation using fundus photographs & OCT scans (if available) • Steroids: › Topical: Monitor IOP, cataract and any signs of bacterial/ fungal infection › Systemic steroids: Monitor body weight, blood sugar & blood pressure | 302 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725964687_10_intraocular_tuberculosis_15032022.pdf | • Frequency of follow up: 1-2 weeks in 1st month followed by monthly for 3 months & then 3 monthly • Eye: Clinical grading of inflammation using fundus photographs & OCT scans (if available) • Steroids: › Topical: Monitor IOP, cataract and any signs of bacterial/ fungal infection › Systemic steroids: Monitor body weight, blood sugar & blood pressure | 1 | page=1,block=31 | 0.700 | valid |
| What should be monitored when using topical steroids for eye inflammation? | Monitor IOP, cataract and any signs of bacterial/ fungal infection | • Frequency of follow up: 1-2 weeks in 1st month followed by monthly for 3 months & then 3 monthly • Eye: Clinical grading of inflammation using fundus photographs & OCT scans (if available) • Steroids: › Topical: Monitor IOP, cataract and any signs of bacterial/ fungal infection › Systemic steroids: Monitor body weight, blood sugar & blood pressure | 214 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725964687_10_intraocular_tuberculosis_15032022.pdf | • Frequency of follow up: 1-2 weeks in 1st month followed by monthly for 3 months & then 3 monthly • Eye: Clinical grading of inflammation using fundus photographs & OCT scans (if available) • Steroids: › Topical: Monitor IOP, cataract and any signs of bacterial/ fungal infection › Systemic steroids: Monitor body weight, blood sugar & blood pressure | 1 | page=1,block=31 | 0.700 | valid |
| What is the recommended duration of ATT treatment depending on clinical response and side effects? | 2 months of RHEZ + 7 months of RH | • ATT : 2 months of RHEZ + 7 months of RH depending on clinical response & side effects to treatment • Add pyridoxine 10 mg/day • Corticosteroids : Topical steroids eye drops for severe/anterior chamber inflammation • For treatment in children refer to paediatrician • Systemic corticosteroids for severe inflammation in consultation with Uveitis expert Panuveitis/Posterior uveitis Retinal vasculitis Intermeditate uveitis Choroiditis | 8 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725964687_10_intraocular_tuberculosis_15032022.pdf | • ATT : 2 months of RHEZ + 7 months of RH depending on clinical response & side effects to treatment • Add pyridoxine 10 mg/day • Corticosteroids : Topical steroids eye drops for severe/anterior chamber inflammation • For treatment in children refer to paediatrician • Systemic corticosteroids for severe inflammation in consultation with Uveitis expert Panuveitis/Posterior uveitis Retinal vasculitis Intermeditate uveitis Choroiditis | 1 | page=1,block=33 | 0.700 |
| What type of medication is recommended for severe or anterior chamber inflammation? | Topical steroids eye drops | • ATT : 2 months of RHEZ + 7 months of RH depending on clinical response & side effects to treatment • Add pyridoxine 10 mg/day • Corticosteroids : Topical steroids eye drops for severe/anterior chamber inflammation • For treatment in children refer to paediatrician • Systemic corticosteroids for severe inflammation in consultation with Uveitis expert Panuveitis/Posterior uveitis Retinal vasculitis Intermeditate uveitis Choroiditis | 148 | factual | 0.490 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725964687_10_intraocular_tuberculosis_15032022.pdf | • ATT : 2 months of RHEZ + 7 months of RH depending on clinical response & side effects to treatment • Add pyridoxine 10 mg/day • Corticosteroids : Topical steroids eye drops for severe/anterior chamber inflammation • For treatment in children refer to paediatrician • Systemic corticosteroids for severe inflammation in consultation with Uveitis expert Panuveitis/Posterior uveitis Retinal vasculitis Intermeditate uveitis Choroiditis | 1 | page=1,block=33 | 0.700 | valid |
| Who should be consulted for the treatment of children? | paediatrician | • ATT : 2 months of RHEZ + 7 months of RH depending on clinical response & side effects to treatment • Add pyridoxine 10 mg/day • Corticosteroids : Topical steroids eye drops for severe/anterior chamber inflammation • For treatment in children refer to paediatrician • Systemic corticosteroids for severe inflammation in consultation with Uveitis expert Panuveitis/Posterior uveitis Retinal vasculitis Intermeditate uveitis Choroiditis | 253 | factual | 0.490 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725964687_10_intraocular_tuberculosis_15032022.pdf | • ATT : 2 months of RHEZ + 7 months of RH depending on clinical response & side effects to treatment • Add pyridoxine 10 mg/day • Corticosteroids : Topical steroids eye drops for severe/anterior chamber inflammation • For treatment in children refer to paediatrician • Systemic corticosteroids for severe inflammation in consultation with Uveitis expert Panuveitis/Posterior uveitis Retinal vasculitis Intermeditate uveitis Choroiditis | 1 | page=1,block=33 | 0.700 | valid |
| Who should be consulted for the use of systemic corticosteroids in severe inflammation? | Uveitis expert | • ATT : 2 months of RHEZ + 7 months of RH depending on clinical response & side effects to treatment • Add pyridoxine 10 mg/day • Corticosteroids : Topical steroids eye drops for severe/anterior chamber inflammation • For treatment in children refer to paediatrician • Systemic corticosteroids for severe inflammation in consultation with Uveitis expert Panuveitis/Posterior uveitis Retinal vasculitis Intermeditate uveitis Choroiditis | 339 | factual | 0.490 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725964687_10_intraocular_tuberculosis_15032022.pdf | • ATT : 2 months of RHEZ + 7 months of RH depending on clinical response & side effects to treatment • Add pyridoxine 10 mg/day • Corticosteroids : Topical steroids eye drops for severe/anterior chamber inflammation • For treatment in children refer to paediatrician • Systemic corticosteroids for severe inflammation in consultation with Uveitis expert Panuveitis/Posterior uveitis Retinal vasculitis Intermeditate uveitis Choroiditis | 1 | page=1,block=33 | 0.700 | valid |