Anterior Uveitis Flashcards
What is anterior uveitis?
Inflammation of in interior part of the uvea (including iris, ciliary body, and choroid), sometimes called iritis.
What is the underlying immune process occurring in anterior uveitis and how does it affect vision?
Anterior chamber becomes infiltrated by neutrophils, lymphocytes, and macrophages. Causes floaters in the patient’s vision.
What is the most likely cause of anterior uveitis?
Autoimmune process, but can be due to infection/trauma/ischaemia/malignancy.
What is the difference in immune cells between chronic and acute anterior uveitis?
Chronic is more granulomatous (more macrophages).
What type of conditions is acute anterior uveitis associated with?
HLA B27 related conditions - ankylosing spondylitis, inflammatory bowel disease, reactive arthritis.
What conditions is chronic anterior uveitis associated with?
Sarcoidosis, syphilis, Lyme disease, TB, HSV.
What are the three main presenting issues with anterior uveitis?
- Abnormal shaped pupil (posterior synechiae)
- Hypopyon (collection of white blood cells in anterior chamber)
- Ciliary flush
What is the typical presentation of anterior uveitis (time frame, unilateral/bilateral, associations)?
Unilateral spontaneous painful red eye with a flare of an associated disease.
What are the other symptoms associated with anterior uveitis?
- Sphincter muscle contraction causing miosis.
- Photophobia
- Pain on movement of eye
- Excessive lacrimation
How is the diagnosis of anterior uveitis confirmed?
Slit-lamp assessment and intraocular pressure measurement.
How is anterior uveitis managed?
- Steroids (oral/topical/systemic)
- Cytoplegic-mydriatic medications (cyclopentolate/atropine eye drops, antimuscarinic effect)
- Immunosuppressants (DMARDs/TNF inhibitors)
- Laser therapy, cryotherapy, or surgery (vitrectomy)
