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Elaine Wooler

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We have had a request to add lateralised versions of the above concept but with the preferred term: phacoanaphylactic endophthalmitis.

It is referred to this on Eyewiki https://eyewiki.org/Phacoanaphylactic_Endophthalmitis   
Given it is a rare condition it is also referred in Orphanet as phacoanaphylactic uveitis - https://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=en&Expert=209959  

Some questions for you please:

  1. What would be your suggested preferred term for this?
  2. Orphanet also have a synonym for this disease of Lens-induced iridocyclitis but we have this as a distinct concept in SNOMED - 70461003 |Lens-induced iridocyclitis (disorder)| - is this a duplicate concept?
  3. Lens-induced uveitis is currently modelled with the cause being 'crystallin' - is this accurate?
  4. In terms of the parent for this should it be 14589007 |Phacoanaphylaxis (disorder)| which has a synonym - allergic reaction to lens protein?

Many thanks
Elaine

Contributors (4)

5 Comments

  1. Eric Brown

    I personally don't like the term "phacoanaphylactic endophthalmitis" over the alternatives. ICD-10 refers to it as lens-induced uveitis. While the AAO EyeWiki page's title is "phacoanaphylactic endophthalmitis," the term lens-induced uveitis (LIU) is used more frequently in that article it goes on to explain that despite the "alaphylactic" component to the name, it's not one.

    The AAO BCSC book on lens and cataract (an older edition updated in 2009) refers to it as "phacoantigenic uveitis". But the BCSC book (updated 2011) on intraocular inflammation and uveitis refers to the same condition as "lens-associated uveitis" and describes it thusly: "This type of uveitis was once divided into several categories, including phacoanaphylactic endophthalmitis, phacotoxic uveitis, and phacolytic glaucoma. Some of these terms are misleading adn do not accurately describe the disease process. For example, the term phacoanaphylactic is not appropriate because anaphylaxic invovles immunoglobilin E (IgE), mast cells, and basophils, none of which are present in phacogenic uveitis..."

  2. Michael Boland

    The Uveitis community worked to standardize their terminology a while back so I have reached out to our uveitis docs to comment. I think Eric is on to the "correct" answer which reflects the work the uveitis docs did on terminology.

  3. Anthony Khawaja

    I agree with Eric too, and thanks Michael for reaching out to your uveitis colleagues.

  4. Elaine Wooler

    Hi Michael Boland were you able to gain any further information from your uveitis colleagues?  

    Many thanks

    Elaine

  5. Michael Boland

    Sorry I lost track of this.  As Eric indicated, "phacoanaphylactic" is no longer used as anaphylaxis involves types of immune response not present here.  The current terminology has "lens-associated (or induced) uveitis" as the parent and then "phacoantigenic uveitis" (formerly phacoanaphylaxis) and "phacolytic uveitis" as children of that concept.