Anterior uveitis

Question 1

Which part(s) of the eye are affected in anterior uveitis?

Answer 1

• Iris (iritis)

- Ciliary body (iridocyclitis or cyclitis)

Question 2

What is the most common cause of anterior uveitis?

Answer 2

Idiopathic

Question 3

What non-infectious conditions is anterior uveitis associated with?

Answer 3

• HLA-B27 conditions: ankylosing spondylitis, IBD, other seronegative spondyloarthropathies
• Sarcoidosis
• Behcet disease
• SLE

Question 4

What are the most common infectious causes of anterior uveitis?

Answer 4

• HSV

- VZV

Question 5

What are the clinical features of anterior uveitis?

Answer 5

• Dull, progressive periocular pain
• Ocular hyperaemia (red eye)
• Photophobia
• Decreased visual acuity (blurred vision)
• Increased lacrimation (epiphora)
• Hypopyon

Question 6

What investigations should be done when anterior uveitis is suspected?

Answer 6

• Slit lamp examination
• Conjunctival smear and cytology if infective cause suspected
• Tonometry
• Further workup if underlying systemic condition is suspected

Question 7

What are the typical findings on slit lamp examination in anterior uveitis?

Answer 7

• Leukocytes in the anterior chamber
• Protein in the aqueous humour (vitreous haze)
• Signs of inflammation of the iris (red eye, hypopyon)

Question 8

What is the management of anterior uveitis?

Answer 8

• Urgent review by ophthalmology
• Cycloplegics - atropine, cyclopentolate
• Steroid eye drops

Question 9

What is the MOA of cycloplegics?

Answer 9

Dilates the pupil which helps to relieve pain and photophobia

Question 10

What are the potential complications of anterior uveitis?

Answer 10

• Cataract
• Secondary glaucoma
• Posterior synechia
• Anterior synechia (adhesions between the iris and anterior chamber structures)