Introduction
Anterior uveitis is one of the important differentials of a red eye. It is also referred to as iritis. Anterior uveitis describes inflammation of the anterior portion of the uvea - iris and ciliary body. It is associated with HLA-B27 and may be seen in association with other HLA-B27 linked conditions (see below).
Epidemiology
- Incidence: 40.00 cases per 100,000 person-years
- Peak incidence: 30-40 years
- Sex ratio: 1:1
| Condition | Relative incidence |
|---|---|
| Anterior uveitis | 1 |
| Microbial keratitis | 0.50 |
| Acute angle closure glaucoma | 0.25 |
| <1 | 1-5 | 6+ | 16+ | 30+ | 40+ | 50+ | 60+ | 70+ | 80+ |
Aetiology
Associated conditions
- ankylosing spondylitis
- reactive arthritis
- ulcerative colitis, Crohn's disease
- Behcet's disease
- sarcoidosis: bilateral disease may be seen
Clinical features
Features
- acute onset
- ocular discomfort & pain (may increase with use)
- pupil may be irregular and small
- photophobia (often intense)
- blurred vision
- red eye
- lacrimation
- ciliary flush
- hypopyon; describes pus and inflammatory cells in the anterior chamber, often resulting in a visible fluid level
- visual acuity initially normal → impaired
Management
Management
- urgent review by ophthalmology
- cycloplegics (dilates the pupil which helps to relieve pain and photophobia) e.g. Atropine, cyclopentolate
- steroid eye drops