Uveitis

Background

  • Uveitis = inflammation of iris, ciliary body, and/or choroid

Types

  • Anterior Uveitis
    • Inflammation of iris and/or ciliary body
    • Types:
  • 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
  • Ciliary flush, marked injection at the limbus (as opposed to perilimbal sparing seen in conjunctivitis)
  • Typically small, poorly reactive pupil

Posterior

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

Slit-lamp exam

  • Cell (WBCs from uveal vessels) & flare (proteinaceous transudate from uveal vessels)
  • Hypopyon (with severe disease)

Differential Diagnosis

Unilateral red eye

^Emergent diagnoses ^^Critical diagnoses

Acute onset flashers and floaters

Evaluation

  • Clinical
  • Consider CXR (uveitis often associated with sarcoidosis, TB)

Management

Infectious

  • Treat the underlying infection

Noninfectious

Anterior uveitis

Disposition

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

See Also

References

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