Anterior Uveitis/Iritis: Red & Painful Eye (Refer)

Question 1

What is anterior uveitis/iritis?

Answer 1

Inflammation or the anterior portion of the uvea - iris and ciliary body.

Question 2

What is anterior uveitis/iritis associated with?

Answer 2

HLA-B27 (and associated conditions)

Question 3

What are the features of anterior uveitis/iritis?

Answer 3

Acute onset
Ocular discomfort and pain
Pupil may be irregular and small
Photophobia (intense)
Blurred vision
Red eye
Lacrimation
Ciliary flush
Hypopyon: describes pus and inflammatory cells in the anterior chamber, often resulting in visuble fluid level
Visual acuity initially normal --> impaired

Question 4

What conditions are associated with anterior uveitis/iritis ?

Answer 4

HLA-B27 associated conditions

Ankylosing spondylitis
Reactive arthritis
Ulcerative colitis, Crohn's disease
Behcet's disease
Sarcoidosis: bilateral disease may be seen

Question 5

What is the management of anterior uveitis/iritis?

Answer 5

Urgent review by opthalmology
Cycloplegics (dilate pupil to relieve pain) e.g. Atropine, Cyclopentolate
Steroid eye drops

Question 6

What are the RED FLAG symptoms of anterior uveitis/iritis/

Answer 6

Acute onset
Pain
Blurred vision and photophobia
Small, fixed, irregular pupil
Ciliary flush