Uveitis

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Background

  • Uveitis = inflammation of iris, ciliary body, and/or choroid
Anterior uveitis
Anterior uveitis with hypopyon

Types

  • Anterior Uveitis
    • Inflammation of iris and/or ciliary body
    • Types:
      • Iritis
      • Iridocyclitis
  • Posterior uveitis = choroiditis

Causes

Complications

Clinical Features

Anterior

  • Sudden red/painful eye
  • Deep pain; worse with eye movement
    • Due to ciliary muscle spasm which irritates CN V
      • Causes consensual photophobia
  • Limbic redness (as opposed to perilimbal sparing seen in conjunctivitis)
  • Poorly reactive pupil

Posterior

  • Floaters
  • Visual changes
  • Generally does not cause redness or significant pain
  • Blind spots or flashing lights

Differential Diagnosis

Unilateral Red Eye

^Emergent diagnoses

^^Critical diagnoses

Acute onset flashers and floaters

Evaluation

  • Slit-lamp exam
    • Cell (WBCs from uveal vessels) & flare (proteinaceous transudate from uveal vessels)
    • Hypopyon (with severe disease)
  • CXR (uveitis often associated with sarcoidosis, TB)

Management

Infectious

  • Treat the underlying infection

Noninfectious

  • Anterior uveitis
  • Posterior Uveitis
    • Generally not responsive to topical treatment
    • Consult ophtho for observation vs intraocular steroid injection

Disposition

  • Generally may be discharged with urgent ophthalmology follow-up within 24-48 hours

See Also

References