The acute uveitic stage presents as a diffuse, bilateral, granulomatous anterior uveitis. 24 There may be some vitritis and choroiditis along with multiple, serous retinal detachments. 3,24 Mutton-fat KPs, iris nodules and increased IOP can also be present. 3 In the convalescent stage, depigmentation occurs, affecting the skin (vitiligo. Some signs may also be present that indicate specific etiologies such as corneal scars and iris atrophy in herpetic uveitis, vascularized iris nodules known as roseola in syphilis, and an anterior chamber granuloma in trematode uveitis.
Exacerbations of granulomatous uveitis are often associated with an appearance of fresh iris or fundus nodules. Posterior synechiae, cataract and glaucoma are common complications. Corneal band keratopathy develops in a few patientsand is usually associated with hypercalcemia. Figure 1. Conjunctival nodules in a patient with sarcoidosis Syphilitic uveitis is the most common ocular manifestation and is a potentially blinding disease. Brief History Iritis, iridocyclitis, iris nodules, multifocal choroiditis, Posterior Placoid chorioretintis (typical), round viteous floaters just in front of the retina Retina/RP Patients can develop permanent ocular damage from chronic inflammation before treatment is initiated. Slit-lamp exam may show granulomatous keratic precipitates, iris nodules, and anterior or posterior synechiae. Patients with intermediate uveitis more commonly complain of floaters and blurry vision Koeppe's nodule - Inflammatory nodules in granulomatous uveitis over inner margin of iris. (REMEMBER - KoePPE nodules occur in Pupillary margin) Dalen Fuch's nodules - Granulomas between Bruch's membrane and RPE (phagocytosed pigment) in sympathetic ophthalmiti
Iris nodules are accumulations of leukocytes on the anterior iris and they represent granulomatous uveitis. Iris nodules are called Koeppe nodules when they are seen at the pupillary magrin and Busacca nodules when they occur on the iris stroma (see Figure 2) LANGERHANS CELL HISTIOCYTOSIS (LCH) IS A DISORDER that is found primarily in children and young adults. Orbital involvement is most common, but uveal involvement with secondary open-angle glaucoma has been described.1 We present a case of recurrent LCH with anterior uveitis and hemorrhagic iris nodules Bussaca nodules (lie on the iris surface) which are pathognomonic for granulomatous uveitis. When the inflammation is treated, the nodules will resolve
Four black patients with Fuchs' heterochro mic uveitis had multiple nodules in the iris. The iris nodules were small, transparent, and scattered across the whole surface of the iris (Busacca's nodules) but increased in den sity toward the pupillary border. All four patients also had nodules at the pupillary border (Koeppe's nodules) The color photo shows the iris of a patient with Sarcoid Uveitis. There is an iris nodule and also an area where the inflammation caused the iris to stick to the lens. Sarcoidosis, also called sarcoid, is a disease involving abnormal collections of inflammatory cells (granulomas) that can form as nodules in multiple organs Iris nodules in patients with FUS generally presented as small white nodules at the pupillary margin (Koeppe nodules) or white dots scattered on the anterior surface of the iris (Busacca nodules). 2 24 Koeppe nodules and Busacca nodules observed in FUS are quite different from those observed in granulomatous uveitis (online supplemental figure 1) Uveitis, which may be unilateral or bilateral, is one of the most frequent ocular manifestations of syphilis. 2,3,9 Granulomatous features, including large keratic precipitates (See Figure 2) and iris nodules, may occur in syphilitic uveitis, but are by no means the norm. 10 Dilated iris vessels, known as iris roseolae (See Figure 3), occur rarely, but are relatively specific for syphilis. 10.
Iris: Iris nodules- including Koeppe nodules which are the site of posterior synechiae formation, Bussaca nodules which are a feature of granulomatous uveitis, and yellowish nodules seen in syphilitic uveitis. Iris pearls- seen in lepromatous uveitis An additional 25 cases of infectious uveitis with iris nodules were identified in 22 published reports. Analysis of the authors' cases and these reports showed that infectious uveitis with iris nodules was specifically characterised by some or all of the following: (1) creamy, soft appearance to the nodule(s), (2) unilateral disease, (3. METHODS: A retrospective review was conducted on a patient with iris nodules and anterior uveitis in the setting of LCH. Visual acuity and clinical findings that were noted on slit lamp biomicroscopy were extracted
Sarcoid uveitis generally is bilateral (90%), and both eyes manifest similar findings, and a similar clinical course. The typical findings are mutton-fat keratic precipitates, posterior iris synechiae, Koeppe nodules, trabecular sarcoidosis, snowball opacity and strings of pearls in the vitreous, segmental periphlebitis, and candle-wax drippings In addition, uveitis that presented with KP or iris nodules even only once retains the designation granulomatous forever, regardless of whether subsequent episodes appear granulomatous in character or not (Figs. 6.1 and 6.2) Treating anterior uveitis is an art and a science: Careful observation for recurrences or chronic disease, paired with quick intervention, are crucial to preventing irreversible vision loss.. Here, I provide a primer on the condition and its management. PRIMER. Anterior uveitis is one of the most common forms of intraocular inflammation. 1, 2 Classified as acute or chronic, it is more. Sarcoid uveitis Classically granulomatous iridocyclitis Mutton fat KP Iris nodules May also be non-granulomatous Usually bilateral Most often chronic, but may begin with acute disease Frequent posterior segment involvement May occur without apparent systemic diseas Koeppe nodules, seen at the inner margin of the iris in patients with granulomatous anterior uveitis.The condition may develop in diseases like sarcoidosis, tuberculosis, syphilis, and Vogt Koyanagi Harada Syndrome. Lyme disease, leprosy, and brucellosis, may also be considered in endemic areas
Uveitis - Iris Nodule - Koeppe Nodule 29-year-old woman has had problems with uveitis in the right eye for about the last two years. Her symptoms are usually floaters. Occasionally the eye gets red, it has not been very uncomfortable, and it has always been in the right eye. Has had Iris Nodule like one in photo in left eye and Right eye Iris nodules can either be busacca or koeppe which are granulomas attached to the iris, or true iris nodules. New iris nodules signify acute inflammatory episode of ocular Sarcoidosis. Posterior Uveitis: involved in 25% of ocular cases of Sarcoidosis. Most commonly involved are: periphlebitis: candle-wax dripping, vitritis, intermediate. Two types of iris nodules can develop in granulomatous uveitis. When situated at the pupillary margin (and on the surface of the iris) they are called Koeppe nodules, have a fluffy appearance and a size going from very small barely visible excresences to frank nodules 7. Iris nodules (Figures 5a & 5b) In granulomatous uveitis two types of iris nodules can develop. When situated at the pupillary margin (and on the surface of the iris) they are called Koeppe nodules, have a fluffy appearance and a size going from very small barely visible excresences to frank nodules. When nodules are situated in the body of th Key criteria for tubercular uveitis were a compatible uveitic syndrome, including: 1) anterior uveitis with iris nodules, 2) serpiginous-like tubercular choroiditis, 3) choroidal nodule (tuberculoma), 4) occlusive retinal vasculitis, and 5) in hosts with evidence of active systemic tuberculosis, multifocal choroiditis; and evidence of.
7. Iris nodules a and b Two types of iris nodules can develop in granulomatous uveitis. When situated at the pupillary margin (and on the surface of the iris) they are called Koeppe nodules, have a fluffy appearance and a size going from very small barely visible excresences to frank nodules While TB is a granulomatous process, mutton fat KPs or iris nodules do not occur much more than in a non-TB uveitis population. 30 Though TB is not on the primary differential for most episodes of uveitis, its presence should be considered prior to initiating any treatments that rely upon a mechanism of systemic immune suppression Pupillary constriction is an important sign in D/D of red eye Risk of pupil block glaucoma exists with extensive posterior synechiae Iris nodules are characteristic of granulomatous uveitis Iris nodules www.ophthalclass.blogspot.co Iris nodules are the accumulation of inflammatory cells on the surface of iris. They are suggestive of specific etiologies such as sarcoidosis, VKH, Fuchs heterochromic iridocyclitis, multiple sclerosis, and infectious uveitis iris nodules: Koeppe (small, near pupil), Bussaca (large, far from pupil) Anterior vitreous cells may be seen in iridocyclitis but often will indicate intermediate ± posterior uveitis Other signs include constricted or non-reactive pupil, cataract, chronic corneal oedema including bullous keratopath
Uveitis Condition/keywords granulomatous uveitis, busacca nodulaes, iris nodules, sarcoid bussaca iris nodules Imaging device Photo slit lamp biomicroscope Description Typical Busacca iris stromal nodules in sarcoid uveitis; notice the ps formation. Related file Granulomas may be prominent in the iris stroma or the choroid. Iris nodules are most commonly seen at the pupillary margin are described as Koeppe's nodules whereas those on the surface of iris are called as Busacca's nodules. Sarcoidosis, tuberculosis, VKH syndrome, sympathetic ophthalmia and syphilis can show iris nodules The uveitis may be unilateral or bilateral, granulomatous or non-granulomatous and with or without iris nodules, dilated iris vessels and iris atrophy. Patients with syphilis may present with posterior uveitis such as diffuse or focal chorioretinitis, neuroretinitis, necrotizing retinitis, retinal vasculitis, intermediate uveitis or panuveitis.
Interstitial keratitis, iris nodules, dilated iris vessels, and iris atrophy may be seen. The most common form of posterior uveitis is multifocal chorioretinitis, but other manifestations include focal chorioretinitis, pseudoretinitis pigmentosa, retinal necrosis, neuroretinitis, and optic neuritis The uveitis that occurs in association with multiple sclerosis is typically a pars planitis or a granulomatous anterior uveitis (anterior uveitis characterized by granulomatous lesions, including large fatty keratic precipitates, nodules on the iris, and posterior synechiae) (Figure 7) Granulomatous uveitis is often chronic (greater than 4 months duration). Anterior segment examination may reveal mutton-fat (large, greasy) KPs, nodules on the iris surface (Busacca nodules), and PAS. Anterior chamber cell and flare are also present ( Table 39-1 ) sions), and/or iris nodules. The anterior uveitis associ-ated with juvenile rheumatoid arthritis has an atypical Dr. Smith's work was supported by the National Health and Medical Research Council of Australia (997099). Dr. Rosenbaum's work was supported by the NIH (EY-06484) and Research to Prevent Blindness
Iris nodules can be present in many forms of anterior uveitis, including infectious, autoimmune and neoplastic etiologies. In general, iris nodules associated with infectious uveitis appear creamy. iris nodules (Fig 5-5) iris atrophy or heterochromia. pupillary miosis. synechiae, anterior and posterior (Fig 5-6) pigment dispersion. cataract* band keratopathy* *Observed in long-standing uveitis. The major finding in anterior uveitis is the presence of inflammatory cells and flare in the anterior chamber, but there may be many additional. .
Iris nodules, both Koeppe and Busacca nodules are also seen, mainly in dark irides,. Posterior synechiae are typically absent, however, neovascularization of iris and angles are consistent features of FUS. Rothova A. Anterior uveitis with sectoral iris atrophy in the absence of keratitis: a distinct clinical entity among herpetic eye. Anterior Uveitis - Diagnostic Techniques & Signs Iris Nodules 30. Anterior Uveitis - Diagnostic Techniques & Signs Severe Acute Anterior Uveitis 31. Anterior Uveitis - Diagnostic Techniques & Signs Gonioscope view of Peripheral Anterior Synechiae (PAS) 32 Anterior uveitis involves inflammation of the iris and ciliary body. Intermediate uveitis involves the posterior ciliary body and pars plana. Posterior uveitis involves the posterior vitreous, retina, choroid, retinal vasculature, and optic nerve. Panuveitis involves inflammation in the anterior,.. Clinically, anterior segment leukemic infiltrates can be distinguished FROM anterior uveitis in that leukemic involvement presents more commonly with normal or slightly decreased pupil size, segmental or total ciliary injection, segmental or diffuse iris swelling, hypopyon and hyphema, increased intraocular pressure, and rarely with posterior. Inflammatory nodules of the iris in children are unusual. An immunosuppressed child with the development of iris nodules and uveitis is suspicious for secondary malignancy, infectious agents, and posttransplantation lymphoproliferative disorder. Secondary malignancy is commonly lymphoma or leukemic infiltrate, but only rarely is the eye.
Diagnosis: Busacca Nodule in Sarcoidosis: Comment to photo: These iris nodules are typical for granulomatous uveitis such as sarcoidosis, tuberculosis, syphilis, and Vogt-Koyanagi-Harada syndrome Iris nodules may be seen at the pupillary included patients of all possible causes for uveitis other than margin (Koeppe nodules) or on anterior iris surface (Busacca TB who had negative tuberculin skin test results and who did nodules).27 Iris nodules were present in both groups (2.7% in not receive antitubercular therapy for uveitis in the past Uveitis, parotitis, fever and facial palsy Chronic Sarcoidosis 2 years duration, thoracic findings, chronic uveitis Thoracic/pulmonary disease major cause of morbidity Mortality is 5-10% (neurosarcoidosis) Uveitis associated with Sarcoidosis Eye Findings Skin involvement is common Orbital and eyelid granulomas Conjunctival nodules Other signs include mutton-fat keratic precipitates, anterior uveitis, iris nodules, posterior synechiae, vitritis, diffuse choroidal infiltration, Dalen-Fuchs nodules, and papillitis Signs. Pigmented or non-pigmented nodule, at least 3 mm in diameter and 1 mm in thickness, located in the inferior half of the iris ( Fig. 8.32 ). Vascularisation is easier to detect in a non-pigmented tumour ( Fig. 8.33 ). Pupillary distortion, ectropion uveae and secondary lens opacities
Another common cause of angle-closure is synechial closure, which may result from chronic intermittent irido-trabecular contact in an eye with a pre-existing narrow angle, synechiae in the angle secondary to inflammatory nodules (e.g. in sarcoidosis) or a neovascular membrane with iris neovascularisation Busacca nodules lie on the iris surface and are pathognomonic for granulomatous uveitis. Koeppe nodules (inflammatory cell precipitates) which lie at the pupillary margin and can be found in non-granulomatous as well as granulomatous uveitis. The diseases most commonly associated with iris nodules and uveitis include sarcoidosis, Vogt-Koyanagi. Iris color change is a frequent concomitant finding. Chronic uveitis may include focal iridal nodules that represent aggregates of lymphocytes and plasma cells as may the proliferation of small vessels upon the iris surface. Uveitis is typically accompanied by pain that is manifested most commonly by squinting and reflex tearing
Iris atrophy is a diagnostic feature of herpetic uveitis. Herpes simplex causes diffuse atrophy while herpes zoster typically causes sectoral atrophy. Iris nodules may be seen in sarcoidosis, tuberculosis, VKH syndrome, sympathetic ophthalmia and syphilis. Vitreous Inflammatory cells in the vitreous, which may be clumped, suggest posterior disease The next question is: What is the characteristic appearance of the iris nodule for TB uveitis? Well, this was a child I saw at the end of last year. And she presented with mild symptoms. But she had an absolutely massive nodule in her iris. Which We were wondering whether it might even be neoplastic Anterior uveitis — mutton fat KPs, iris nodules, posterior synechiae. Very rarely does it cause non-granulomatous inflammation. Retinitis can also occur with TB, just like sarcoid. And again, posterior uveitis manifestations can be just like sarcoid. Let me point out one specific thing that many of you from India know all about
Iris nodules Koeppe nodules at the pupillary border, Busacca nodules within the iris stroma, Berlin nodules in the angle Yellowish nodules from dilated iris vessels (Roseola) in syphilis uveitis). 10. Synechiae Iris involvement may manifest as either anterior or posterior synechiae 11. Band keratopath Iris roseola (pinkish iris nodules) is seen in syphilitic uveitis; Iris atrophy is pathognomonic finding in: Herpes zoster uveitis; Feature of heterochromia iridocyclitis: Hypopigmented iris. Management: Uveitis with raised IOP (also known as Hypertensive uveitis/ Glaucomatocyclitic crisis/ Posner Schlossmann syndrome) is best managed by Steroid
Anterior uveitis (iritis) This leaflet is intended for patients who attend Moorfields Eye Hospital, who are diagnosed with an eye condition called The iris may be stuck to the lens (at the pupil margin) and the pressure in your eye may be normal, high or low histologically-confirmed cases of intraocular TB that present as non-granulomatous uveitis, so non-granulomatous uveitis does not exclude TB. Iris nodules were rare. The majority of cases were unilateral, and both anterior and posterior segments were involved. One other important note from the older literature was that when tuberculosis was mor Uveitis is one of the vision threatening eye diseases. There are several conditions that can mimic uveitis. An approach to uveitis should include uveitis oriented history, ophthalmic examination, systemic evaluation, ancillary tests and laboratory investigations. Various signs and symptoms can occur in different types of uveitis. There is In nongranulomatous disease, fine keratic precipitates form over the corneal endothelium. In granulomatous uveitis, Koeppe nodules (clusters of cells on the iris sphincter margin) form. Busacca nodules are clusters of cells generally seen in the anterior chamber in severe cases (rare)
Uveitis is the third leading cause of blindness in developed nations and accounts for 10-20% of blindness worldwide The presence of mutton-fat KPs and iris nodules is strong evidence of a granulomatous inflammatory response Following the history and examination, a differential diagnosi The differential diagnosis of iris nodules in the setting of uveitis is presented in Table 2 2. 1- 4, 31- 48 Infectious uveitis is an uncommon cause of iris nodules. Most cases of uveitis with iris nodules can be attributed to non-infectious entities, such as sarcoidosis, which are generally responsive to immunosuppressive therapy Granulomatous anterior uveitis with mutton-fat keratic precipitates on posterior corneal surface and Koeppe and Busacca nodules of the iris. Granulomatous anterior uveitis with numerous Busacca nodules on the iris surface and a few mutton-fat keratic precipitates on the inferior aspect of the cornea. Mutton-fat keratic precipitates in sarcoidosis . Heterochromia was observed in 21% of affected eyes. Iris nodules were present in 36% of the affected eyes. These results are similar to the above-mentioned studies. FUS is an unilateral chronic recurrent non-granulomatous uveitis syndrome accounts for 2 ~ 11% of all uveitis Iris hyperpigmentation, pigment deposits on the anterior lens capsule (footprints of synechia), and chorioretinal scars, visible as well-defined hyperreflective lesions in the tapetal fundus or depigmented lesions in the nontapetal fundus, may provide evidence of past uveitis even if active signs of inflammation are absent
Uveitis, conjunctival nodules, cranial nerve palsies, enlarged lacrimal glands, optic neuropathy and choroid); anterior uveitis refers to the iris and ciliary body and is frequently known as. Busacca nodules within iris stroma What would be seen under slit lamp biomicroscopy of the anterior Crystalline lens with uveitis ? P igment and fibrin deposit Uveitis is further classified on the presence or absence of granulomatous inflammation, marked by mutton fat keratic precipitates (large, greasy-appearing collections of inflammatory cells on the corneal endothelium), iris nodules, and/or choroidal granulomas (Figure 1) GRANULOMATOUS UVEITIS. In granulomatous uveitis, there will be large yellowish-white cells visible on the back of the cornea, and possibly some small nodules on the iris. Granulomatous uveitis is usually less acute than the nongranulomatous form; the eye is only mildly inflamed and the patient's vision is somewhat blurred
Anterior uveitis is granulomatous with mutton fat keratic precipitates, iris nodules and formation of posterior synechiae. Intermediate uveitis is usually mild to moderate with snowballs, peripheral vasculitis and snowbanking. The most common presentation in posterior uveitis is multifocal, yellowish white choroidal tubercles Overview: Definition: Uveitis is characterized by inflammation of one or all parts of the uveal tract (iris, ciliary body, choroids). The most common form is anterior uveitis (iritis, iridocyclitis); posterior uveitis (choroiditis, chorioretinitis) is uncommon and found mostly in persons with AIDS who have cytomegalovirus (CMV) infection An anterior uveitis masking underlying tumor in the posterior segment can be seen. Pseudohypopyon with chalky-white flocculent material within the anterior chamber and white iris nodules have been described. An aqueous tap cytology can reveal tumor cells. Treatment modalities include intra-arterial, intravitreous and systemic chemotherapy Anterior Uveitis in Rabbits. A physical examination of the rabbit can reveal further symptoms including swelling of the iris, white or pink nodules on the iris, eye related discomfort (such as sensitivity to light), and a red eye. Other less common signs may include fluid buildup in the cornea (corneal edema), and unusually constricted. Ocampo VV Jr, Foster CS, Baltatzis S. Surgical excision of iris nodules in the management of sarcoid uveitis. Ophthalmology. 2001 Jul. 108(7):1296-9. . Pepose JS, Holland GN, Wilhelmus KR. Ocular Infection and Immunity. Mosby-Year Book; 1996. Rao NA, Cousins S, Forster D. Intraocular Inflammation and Uveitis
Uveitis- a photoessay . John G. O'Shea MD, David A. Infeld FRCSEd, Robert B. Harvey FRCSEd. Uveitis can be defined as inflammation of the uvea, the middle, vascular coat of the eye (Greek uva- grape) The uvea consists of the iris, ciliary body and the choroid. The International Uveitis Study Group classification separates uveitis anatomically by location of observed disease according to. Anterior uveitis (AU) is most common form of uveitis. It is diagnosed in patients suffering from a primary inflammation of the iris and/or the ciliary bodies. The disease may be acute, recurrent, or chronic, and may affect one or both eyes. Affected individuals typically present with red eyes and claim blurred vision and ocular pain.Anamnestic data and clinical findings are of vital importance. Definition. Uveitis is an inflammation of one or all parts of the uvea, or the vascular area between the retina and sclera of the eye. The anterior uvea is composed of the iris and ciliary body; an irritation of this segment, or anterior uveitis, leads to acute painful symptoms and photophobia
Busacca nodules, inflammatory nodules located on the surface of the iris in granulomatous forms of anterior uveitis such as Fuchs heterochromic iridocyclitis (FHI).  Synechiae- eye condition where the iris sticks to either the cornea or len April 3, 2018. Uveitis is the cause of 10 to 15 percent of the overall cases of blindness in the United States, 1 and accounts for 30,000 new cases. of legal blindness each year. 2 The incidence of uveitis has been calculated at 25 to 341 cases per 100,000 person years. 3-6 Among pediatric patients, males are affected more often than females Busacca nodules, inflammatory nodules located on the surface of the iris in granulomatous forms of anterior uveitis such as Fuchs heterochromic iridocyclitis (FHI). Fuchs heterochromic iridocyclitis (FHI) is a chronic unilateral uveitis appearing with the triad of heterochromia, predisposition to cataract and glaucoma, and keratitic. The following is a list of eponymous and non-eponymous nodules in Ophthalmology. Bussaca's nodule - Inflammatory nodules in granulomatous uveitis over anterior surface of iris (REMEMBER _ BuSSacca nodules occur in iris Stroma - SS)Koeppe's nodule - Inflammatory nodules in granulomatous uveitis over inner margin of iris Iris nodules may be seen at the pupillary margin (Koeppe nodules) or on anterior iris surface (Busacca nodules). 27 Iris nodules were present in both groups (2.7% in group A and 2% in group B) and were not specific for a tubercular cause of uveitis (P ϭ .74; Table 3).Tubercular anterior uveitis more commonly presents as chronic, recurrent.
An anterior uveitis masking underlying tumor in the posterior segment can be seen. Pseudohypopyon with chalky-white flocculent material within the anterior chamber and white iris nodules have been described. An aqueous tap cytology can reveal tumor cells. 25, 26 Treatment modalities include intra-arterial, intravitreous and systemic chemotherapy Old episodes of uveitis are identified by pigment deposits on lens, KPs, and festooned pupil on dilation of pupil. Busacca nodules, inflammatory nodules located on the surface of the iris. Intermediate Uveitis. Most common: Floaters, which are dark spots that float in the visual field; Blurred vision; Intermediate uveitis usually affects one eye Tapioca-like nodules over part or all of iris; Metastatic Carcinoma Gelatinous to white vascularized nodules on iris surface. May be associated with anterior uveitis, glaucoma, rubeosis, and hyphema. Iris Nevus: 17.01 External slit lamp photo 17.02 Spindle nevus 17.03 Borderline spindle nevus 17.04 Epithelioid nevu Uveitis is a generic term for inflammation of the uveal tract, which includes the iris, ciliary body, and choroid. By definition, uveitis is chronic when it persists longer than three months. Acute uveitis may vary in its course, resolving completely without recurrence, recurring intermittently, or evolving into chronic uveitis Inflammatory nodules in sarcoidosis, tuberculosis, lymphomas, and fungal infections must also be considered. Although rare in 18-year-old patients, iris melanoma should also be considered. This case illustrates the need to incorporate LCH in the differential diagnosis of anterior uveitis with associated iris nodules
Anterior Uveitis (Iritis/Iridocyclitis) Symptoms: Pain, redness, photophobia, consensual photophobia (pain in other eye), tearing, decreased vision. Signs: Cells and flare, ciliary flush (redness around limbus), KPs. Possible Band Keratopathy. Associated with HLA-B27, JIA injection') keratic precipitates (KP) - fine or 'mutton fat' aqueous cells aqueous flare intraocular pressure commonly normal but raised in some cases posterior synechiae possibly causing pupil block and iris bombé iris nodules: Koeppe (small, near pupil [college-optometrists.org]. Clinical Signs of Anterior Uveitis Ciliary Injection In iritis or iridocyclitis the enlargement of. Clinical characteristics of Fuchs' uveitis syndrome. In the chronic type of the disease, the granulomatous nodules of the iris and in the anterior chamber angle are sometimes seen (the so-called Koeppe and Busacca nodules). Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case Report