Anterior Uveitis (Iritis / Iridocyclitis)
Ophthalmology High-Yield Essentials
1. Clinical Presentation
- Symptoms: Pain (often dull, aching), photophobia, redness, and decreased vision.
- Signs: Ciliary flush (circumcorneal injection), cells and flare in the anterior chamber (slit-lamp exam), and sometimes a hypopyon.
- Pupil: Often small/constricted (miotic) due to iris sphincter spasm.
2. Etiological Associations
| Category | Common Associations |
|---|---|
| HLA-B27 Related | Ankylosing Spondylitis, Reactive Arthritis, Psoriatic Arthritis, and IBD. |
| Infectious | Herpes simplex/zoster, Tuberculosis, Syphilis, Toxoplasmosis. |
| Autoimmune/Other | Sarcoidosis, Behçet’s disease, Juvenile Idiopathic Arthritis (JIA). |
3. Management
- Corticosteroids: Topical (e.g., Prednisolone acetate) is the mainstay to reduce inflammation.
- Cycloplegics: (e.g., Atropine or Homatropine) to relieve ciliary spasm (pain) and prevent posterior synechiae.
4. NEET PG High-Yield Pearls
- JIA-Associated Uveitis: Often chronic, asymptomatic (“white and quiet eye”), frequently seen in young girls with oligoarticular JIA. Screen with regular slit-lamp exams.
- Posterior Synechiae: Adhesions between the iris and the lens; if 360°, they can cause iris bombe, leading to secondary glaucoma.
- Synechiae Management: Cycloplegics are essential to break or prevent synechiae formation.