Uveitis

Question 1

What is uveitis?

Answer 1

Inflammation of the uvea, the middle layer of the eye.
* Anterior (iris and ciliary body)
* Posterior (choroid and retina)

Question 2

Uveitis symptoms

Answer 2

• Acute onset painful red eye
• Irregular, constricted pupil
• Blurred vision and photophobia
• Reduced visual acuity
• Hypopyon - pus and inflammatory cells in the anterior chamber

Question 3

Red eye differentials

Answer 3

• Acute angle closure glaucoma - severe pain, decreased visual acuity, semi-dilated pupil, hazy cornea
• Anterior uveitis - acute onset pain, blurred vision and photophobia, small fixed oval pupil, ciliary flush
• Scleritis - severe pain, underlying autoimmune disease e.g. RA
• Conjunctivitis - purulent discharge if bacterial, clear discharge if viral
• Keratitis - contacts
• Subconjunctival haemorrhage - history of trauma or coughing bouts
• Endophthalmitis - red eye, pain and visual loss following intraocular surgery

Question 4

Uveitis links

Answer 4

• HLA B27
• Ankylosing spondylitis
• Reactive arthritis
• IBD - Ulcerative colitis, Crohn’s disease
• Behcet’s disease
• Sarcoidosis - bilateral uveitis

Question 4

Uveitis management

Answer 4

• Urgent review by ophthalmologists
• Cycloplegics (dilate pupil, help to relieve pain and photophobia) e.g. Atropine, cyclopentolate
• MDT to control underlying disease
• Follow up clinic