Anterior Uveitis (Iritis)

Question 1

What is anterior uveitis?

Answer 1

Inflammation of the uvea, specifically affecting the anterior segment of the eye, including the iris and ciliary body.

Question 2

What are the common symptoms of anterior uveitis?

Answer 2

Eye pain, redness, photophobia, blurred vision, and tearing.

Question 3

What are the common causes of anterior uveitis?

Answer 3

Idiopathic, autoimmune conditions (e.g., ankylosing spondylitis, sarcoidosis), infections (e.g., herpes, syphilis), and trauma.

Question 4

What is the pathophysiology of anterior uveitis?

Answer 4

Immune-mediated inflammation leads to disruption of the blood-aqueous barrier, causing cellular infiltration and protein leakage.

Question 5

What are the clinical signs of anterior uveitis?

Answer 5

Conjunctival redness, perilimbal (ciliary) injection, keratic precipitates, and posterior synechiae.

Question 6

What are keratic precipitates?

Answer 6

Small white or grey deposits of inflammatory cells on the corneal endothelium.

Question 7

What are posterior synechiae?

Answer 7

Adhesions between the iris and the lens, potentially causing an irregular pupil shape.

Question 8

What is the typical onset of anterior uveitis?

Answer 8

Sudden, often with unilateral involvement, though bilateral cases can occur.

Question 9

What is the role of slit-lamp examination in anterior uveitis?

Answer 9

To identify anterior chamber inflammation, keratic precipitates, and cells or flare in the aqueous humour.

Question 10

What is “flare” in the context of anterior uveitis?

Answer 10

Protein leakage into the aqueous humour, giving it a smoky or hazy appearance.

Question 11

What systemic conditions are associated with anterior uveitis?

Answer 11

Ankylosing spondylitis, reactive arthritis, inflammatory bowel disease, and Behçet’s disease.

Question 12

What infections can cause anterior uveitis?

Answer 12

Herpes simplex, varicella-zoster, syphilis, and tuberculosis.

Question 13

What is the treatment for anterior uveitis?

Answer 13

Topical corticosteroids (e.g., prednisolone) and cycloplegics (e.g., atropine) to reduce inflammation and pain.

Question 14

What is the role of cycloplegics in anterior uveitis?

Answer 14

To relieve pain caused by ciliary spasm and prevent the formation of posterior synechiae.

Question 15

What are the complications of untreated anterior uveitis?

Answer 15

Cataracts, glaucoma, retinal detachment, and permanent vision loss.

Question 16

What are the differential diagnoses for anterior uveitis?

Answer 16

Conjunctivitis, scleritis, keratitis, and angle-closure glaucoma.

Question 17

What is the prognosis for anterior uveitis with treatment?

Answer 17

Generally good with prompt and appropriate treatment, but recurrences are common in chronic or autoimmune cases.

Question 18

What is HLA-B27, and how is it related to anterior uveitis?

Answer 18

HLA-B27 is a genetic marker associated with autoimmune diseases that frequently cause anterior uveitis.

Question 19

What is the role of systemic immunosuppressants in anterior uveitis?

Answer 19

Used for severe or recurrent cases, particularly when associated with systemic autoimmune conditions.

Question 20

What investigations are required for recurrent anterior uveitis?

Answer 20

Blood tests (e.g., HLA-B27, inflammatory markers), chest X-ray, and serology for infections like syphilis or tuberculosis.

Question 21

What is hypopyon?

Answer 21

A collection of white blood cells in the anterior chamber, visible as a yellowish-white layer.

Question 22

What is the significance of recurrent anterior uveitis?

Answer 22

Recurrent episodes may indicate an underlying systemic condition requiring investigation.

Question 23

How does trauma cause anterior uveitis?

Answer 23

Direct injury to the eye disrupts the blood-aqueous barrier, triggering inflammation.

Question 24

Why is early diagnosis of anterior uveitis important?

Answer 24

Prompt treatment prevents complications such as synechiae, glaucoma, and vision loss.

Question 25

What lifestyle modifications are recommended for anterior uveitis?

Answer 25

Avoid triggers such as stress, manage systemic diseases, and attend regular follow-ups for early detection of recurrences.