Anterior uveitis

 

Anterior Uveitis (Iritis/Iridocyclitis)

Ophthalmology: Intraocular Inflammation

1. Clinical Presentation

Anterior uveitis is inflammation of the iris and/or ciliary body. It presents as an ocular emergency requiring prompt detection to prevent permanent damage.

  • Symptoms: Pain, photophobia, blurred vision, and red eye.
  • Signs: Ciliary flush (limbal injection), cells and flare in the anterior chamber (detected via slit lamp), and potentially miosis (constricted pupil).

2. Diagnostic & Etiological Considerations

Key Association Clinical Context
HLA-B27 Positive Strongly associated with Ankylosing Spondylitis, Reactive Arthritis, and IBD.
Keratic Precipitates (KPs) White inflammatory deposits on the corneal endothelium; “mutton-fat” KPs suggest granulomatous disease (e.g., Sarcoidosis, TB).
Synechiae Adhesions between the iris and lens (posterior) or the iris and cornea (anterior).

3. Management & High-Yield Pearls

  • Standard Treatment: Topical corticosteroids (to reduce inflammation) and cycloplegics (to relieve pain and prevent synechiae formation).
  • Complication: Untreated anterior uveitis can lead to secondary glaucoma (due to trabecular meshwork obstruction) and cataracts.
  • Diagnostic Pearl: Always perform a thorough systemic review; a “first-time” anterior uveitis warrants investigation for underlying systemic autoimmune or infectious diseases.
  • Educational Resource: For management algorithms, slit-lamp grading scales for AC reaction, and high-yield question banks, visit mymedschool.org.