eMedicine Specialties > Ophthalmology > Iris & Ciliary Body

Uveitis, Fuchs Heterochromic: Follow-up

Author: Mansoor Arif, MB, BS, Research Officer, Department of Ophthalmology, Aga Khan University Medical College
Coauthor(s): C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution; Ira G Wong, MD, MS, Associate Director, Clinical Affairs, Uveitis Service, The Francis I Proctor Foundation for Research in Ophthalmology, University of California at San Francisco; Clinical Professor, Department of Ophthalmology, University of California at San Francisco and Stanford University School of Medicine
Contributor Information and Disclosures

Updated: Dec 11, 2008

Follow-up

Further Outpatient Care

  • Patients should receive follow-up care as needed.

Complications

  • Cataracts
  • Secondary glaucoma
  • Vitreous debris that obscures vision
  • Dilated pupil
  • Corneal edema (rare)
  • Retinal detachment (rare)

Prognosis

  • The low-grade inflammation smolders over decades. Initially, vision is not significantly impaired.
  • All patients eventually develop cataracts that require surgical removal.
    • Generally, the outcome of cataract surgery with posterior chamber intraocular lens implantation is good. Some patients develop increased inflammation and transient increased intraocular pressure during the postoperative period.
    • Particular care should be given to placement of the intraocular lens within the capsular bag and the use of minimally adherent intraocular lens materials most compatible with uveitis. Acrylic intraocular lenses and surface modified polymethylmethacrylate (PMMA) intraocular lenses appear to be the most desirable materials, while first-generation silicone may create more cellular adhesion and, thus, more inflammation postoperatively.
  • Secondary glaucoma is not uncommon. This may require surgical therapy if antiglaucoma medications do not control the disease. The success for glaucoma surgery is less than that for primary open-angle glaucoma.
  • Severe vitreous inflammatory debris not only obscures vision but also may create a capacitance for inflammatory mediators. Thus, elective pars plana vitrectomy may not only improve vision but also reduce long-term inflammatory damage to the posterior segment. Vitrectomy may be performed concomitantly with cataract extraction and intraocular lens implantation or as a subsequent procedure.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the assistance of Ryan I Huffman, MD, with the literature review and referencing for this article.



More on Uveitis, Fuchs Heterochromic

Overview: Uveitis, Fuchs Heterochromic
Differential Diagnoses & Workup: Uveitis, Fuchs Heterochromic
Treatment & Medication: Uveitis, Fuchs Heterochromic
Follow-up: Uveitis, Fuchs Heterochromic
References
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References

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Further Reading

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Keywords

Fuchs heterochromic uveitis, Fuchs' heterochromic uveitis, Fuchs heterochromic iridocyclitis, Fuchs' heterochromic iridocyclitis, FHI, Fuchs' heterochromic cyclitis, Fuchs' uveitis syndrome

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Contributor Information and Disclosures

Author

Mansoor Arif, MB, BS, Research Officer, Department of Ophthalmology, Aga Khan University Medical College
Disclosure: Nothing to disclose.

Coauthor(s)

C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution
C Stephen Foster, MD, FACS, FACR, FAAO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, and Sigma Xi
Disclosure: Nothing to disclose.

Ira G Wong, MD, MS, Associate Director, Clinical Affairs, Uveitis Service, The Francis I Proctor Foundation for Research in Ophthalmology, University of California at San Francisco; Clinical Professor, Department of Ophthalmology, University of California at San Francisco and Stanford University School of Medicine
Ira G Wong, MD, MS is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

John D Sheppard Jr, MD, MMSc, Professor of Ophthalmology, Microbiology and Molecular Biology, Clinical Director, Thomas R Lee Center for Ocular Pharmacology, Program Director, Ophthalmology Residency Training, Eastern Virginia Medical School; President, Virginia Eye Consultants
John D Sheppard Jr, MD, MMSc is a member of the following medical societies: American Academy of Ophthalmology, American Society for Microbiology, American Society of Cataract and Refractive Surgery, American Uveitis Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

R Christopher Walton, MD, Professor, Director of Uveitis and Ocular Inflammatory Disease Service, Department of Ophthalmology, Assistant Dean for Graduate Medical Education, University of Tennessee College of Medicine; Consulting Staff, Regional Medical Center, Memphis Veterans Affairs Medical Center, St Jude Children's Research Hospital
R Christopher Walton, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Healthcare Executives, American Uveitis Society, Association for Research in Vision and Ophthalmology, and Retina Society
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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