Uveitis is inflammation of the uvea, the middle layer of the eye that includes the iris, ciliary body and choroid. Anterior uveitis is the most common type and is often linked to HLA-B27 diseases such as ankylosing spondylitis.
Key symptoms
- Eye pain and redness
- Light sensitivity (photophobia)
- Blurred vision
- Floaters in posterior uveitis
- Tearing
What you find on exam
- Redness concentrated around the cornea (ciliary flush)
- Small or irregular pupil
- Pain in the affected eye when light is shone in the other eye
- Slit lamp: cells and flare in the anterior chamber; hypopyon if severe
- Joints, back, skin and bowel symptoms
Tests
- Slit lamp exam by an ophthalmologist
- Intraocular pressure
- HLA-B27, syphilis and tuberculosis tests guided by history
- Chest X-ray if sarcoidosis is suspected
- Dilated fundus exam for posterior involvement
Treatment basics
- Same-day ophthalmology referral
- Topical steroid drops such as prednisolone acetate
- Cycloplegic drops such as cyclopentolate for pain and to prevent adhesions
- Systemic steroids or immunosuppressants for posterior or recurrent disease
- Treat any infectious cause
Red flags
- Reduced vision
- Hypopyon or very high eye pressure
- Uveitis in a patient with HIV or immune suppression
Practice it in Making Synapses
Making Synapses cases
Related guides
Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.