The symptoms of anterior uveitis are as below.

• Photophobia
• Ocular pain
• Tenderness of the globe
• Decreased visual acuity
• Lacrimation

Photophobia is due to the reactive spasm of the inflamed muscles of the iris; whereas spasm of the ciliary muscles leads to brow pain. Visual acuity is only decreased in severe cases associated with hypopyon.
The signs of anterior uveitis include the following.

• Miosis
• Ciliary flush
• Anterior chamber cells and flare
• Hypopyon
• Keratic precipitates
• Reduced intraocular pressure (IOP)

Ciliary flush results from perilimbal conjunctival injection. Spasm of the ocular sphincter muscle causes miosis. Anterior chamber cells are infact white blood cells that are seen in the anterior chamber; whereas anterior chamber flare refers to the presence of protein precipitates in the anterior chamber. Both of these manifestations are secondary to inflammation. Hypopyon results from the collection of neutrophilic exudates inferiorly in the anterior chamber. Keratic precipitates are only occasionally present and are seen as clumps of cells on the corneal epithelium. Iritis typically reduces the intraocular pressure because the inflammation of the ciliary body causes decreased production of the aqueous humor. However, there is an exception to this rule in which severe iritis, or iritis resulting from herpes simplex and herpes zoster may cause an inflammatory glaucoma.

Intermediate uveitis usually has an insidious onset. Blurred vision accompanied by vitreous floaters are usually present. Initially, the symptoms are usually unilateral but inflammatory changes are often bilateral and asymmetric. Vitreous cells, condensations and “snowballs” are often seen on examination, the latter being vitreous aggregates of inflammatory cells. Posterior segment snowbanking is also seen.

Posterior uveitis is usually painless. This is because the choroid has no sensory innervation. Conjunctival or scleral injection is often not present. Visual acuity may be decreased. Floaters (due to debris and inflammatory cells) are present. Vitreous cells and opacities may also be seen. In certain cases, hypopyon may also form.

• Pain

  Granulomatous uveitis is characterized by blurred vision, mild pain, eye tearing, and mild sensitivity to light. [britannica.com]

  Some forms, such as iritis, cause pain and light sensitivity. Other forms, such as chorioretinitis, cause visual loss and floaters. [vision-and-eye-health.com]

  Signs of the condition include: blurred vision, floaters, eye pain, redness, and extreme sensitivity to light. If left untreated, intermediate uveitis can cause permanent damage to the eye and vision loss. [rebuildyourvision.com]

  Patients have little pain or photophobia except when having an acute episode. [emedicine.medscape.com]

  Uveitis symptoms Symptoms of anterior uveitis include: light sensitivity decreased visual acuity eye pain red eyes Intermediate and posterior uveitis usually are painless. [allaboutvision.com]

• Swelling

  Other signs may include yellow-white lesions in the retina (retinitis) or underlying choroid (choroiditis), retinal detachment, inflammation of retinal blood vessels (vasculitis), and swelling of the optic disk. [britannica.com]

  There are 4 main classifications of uveitis depending on where the swelling occurs in the eye: Anterior Uveitis (iritis) – swelling of the front part of the eye. [retinaspecialistsofmichigan.com]

  Anterior uveitis: If the swelling of the uvea is towards the front end of the eye, it is classified as anterior uveitis. [bettervisionguide.com]

  Ross got steroid eye drops to reduce swelling; that's the standard first line treatment for uveitis. But because her case was severe and the medications limited, she developed cataracts and needed eye surgery. [cnn.com]

  Uveitis is a term used to describe a variety of conditions of the eye that cause inflammation and swelling of the uvea, or the middle layer of your eye. [northwell.edu]

• Whipple Disease

  […] present with diarrhea and uveitis Crohn's dz Ulcerative colitis whipple disease what diseases present with jaundice and uveitis chronic, progressive inflammation of spine back pain (50% are asymptomatic) uveitis = acute, unilateral, recurrent and alternating [studyblue.com]

  Kawasaki's disease multiple sclerosis polyarteritis nodosa psoriatic arthritis reactive arthritis sarcoidosis systemic lupus erythematosus Vogt–Koyanagi–Harada disease Whipple's disease [edit] Rifabutin, a derivative of Rifampin, has been shown to cause [en.wikipedia.org]

• Severe Pain

  Provided that there is no serious effect on vision, severe pain or raised eye pressure, or inflammation affecting other parts of the eye, the optometrist will usually prescribe steroid drops to control the inflammation, plus other drops to relax the pupil [college-optometrists.org]

  In acute glaucoma, the patient has severe pain, the cornea of the eye is cloudy, and the pressure level of the fluid inside the eye is abnormally high; whereas in uveitis the pain is moderate, the cornea is clear, and the fluid pressure is normal or possibly [medical-dictionary.thefreedictionary.com]

  Acute angle closure glaucoma can cause redness and severe pain similar to that of uveitis, which is why it is important to check intraocular pressure at every visit. [merckmanuals.com]

  Acute angle-closure glaucoma can cause redness and severe pain similar to that of uveitis, which is why it is important to check intraocular pressure at every visit. [msdmanuals.com]

• Sepsis

  Retrospective case series of four immunosuppressed patients with uveitis complicated by sepsis. [ncbi.nlm.nih.gov]

  Panuveitis caused by Klebsiella sepsis that arose from a urinary tract infection two weeks earlier. The patient had been treated and was feeling better when the eye became painful and red. A 2-mm hypopyon is present (arrow). Figure 4. [aafp.org]

• Ulcer

  The gene has been found in people with certain autoimmune conditions, including ankylosing spondylitis and ulcerative colitis. Page last reviewed: 3 January 2020 Next review due: 3 January 2023 [nhs.uk]

  Examine the epithelium for abrasions, edema, ulcers, or foreign bodies. Inspect the stroma for deep ulcers and edema. Keratitic precipitates (white blood cells) on the endothelium are a hallmark of iritis. [emedicine.medscape.com]

  He had an associated history of recurrent mouth and genital ulcers, predating the uveitis history by about 2 years. The measurement of his intraocular CD4/CD8 ratio helped make a diagnosis of Behçet's disease uveitis. [ncbi.nlm.nih.gov]

  However, there is a need for safe and effective alternatives to corticosteroids as first line and adjunctive therapies for uveitis and other forms of ocular inflammation given the incidence of glaucoma, cataracts, ocular infections, and corneal ulcers [aldeyra.com]

• Arthritis

  When identified, the most common cause of anterior uveitis is trauma, followed by chronic joint diseases (spondyloarthropathies), juvenile idiopathic arthritis (also known as juvenile rheumatoid arthritis), and herpesvirus infection. [britannica.com]

  JIA associated uveitis is usually chronic anterior uveitis (CAU) and can occur before, or up to 7 years after the onset of arthritis. [pmmonline.org]

  Arthritis-related eye problems are highly treatable. [kidsgetarthritistoo.org]

  [PubMed] [Read by QxMD] Tags: Arthritis Conjunctivitis juvenile rheumatoid arthritis pink eye red eye uveitis Sean M. Fox I enjoy taking care of patients and I finding it endlessly rewarding to help train others to do the same. [pedemmorsels.com]

  Examples are: Ankylosing spondylitis Behcet disease Psoriasis Reactive arthritis Rheumatoid arthritis Sarcoidosis Ulcerative colitis Uveitis can also be caused by infections such as: AIDS Cytomegalovirus (CMV) retinitis Herpes zoster infection Histoplasmosis [medlineplus.gov]

• Anterior Uveitis

  Types of Uveitis When diagnosed with uveitis, your doctor may place you under one of the four types of uveitis: anterior, posterior, intermediate and panuveitis. 1. Anterior Uveitis Anterior uveitis is the most common of the four types. [rebuildyourvision.com]

  Uveitis is inflammation of the eye involving the uveal structures (iris, ciliary body and choroid). Anterior uveitis specifically refers to uveitis in the anterior segment of eye. [aldeyra.com]

  Iritis; Pars planitis; Choroiditis; Chorioretinitis; Anterior uveitis; Posterior uveitis; Iridocyclitis Durand ML. Infectious causes of uveitis. In: Bennett JE, Dolin R, Blaser MJ, eds. [medlineplus.gov]

  Anterior uveitis typically refers to inflammation of the iris and anterior chamber; intermediate uveitis refers to inflammation of the ciliary body and vitreous humour (the jellylike filling in the anterior portion of the eye); and posterior uveitis refers [britannica.com]

  Uveitis is much less common in systemic JIA and chronic anterior uveitis is not typically associated with childhood onset enthesitis related arthritis (ERA) or Rheumatoid factor positive JIA. [pmmonline.org]

• Blurred Vision

  Granulomatous uveitis is characterized by blurred vision, mild pain, eye tearing, and mild sensitivity to light. [britannica.com]

  Signs of the condition include: blurred vision, floaters, eye pain, redness, and extreme sensitivity to light. If left untreated, intermediate uveitis can cause permanent damage to the eye and vision loss. [rebuildyourvision.com]

  Acute anterior uveitis presents as follows: [2] Pain, generally developing over a few hours or days except in cases of trauma Redness Photophobia Blurred vision Increased lacrimation Chronic anterior uveitis presents primarily as blurred vision and mild [emedicine.medscape.com]

  The second case was related to a 45-year-old female patient who complained of blurred vision and a dark shadow before her right eye for 3 months. [ncbi.nlm.nih.gov]

  Light sensitivity Flashing lights Dark, floating spots (floaters) Eye pain or redness Blurred or decreased vision Narrowing of the pupils Tearing If you experience any of these symptoms, please visit your ophthalmologist. [fightingblindness.ca]

• Eye Pain

  Signs of the condition include: blurred vision, floaters, eye pain, redness, and extreme sensitivity to light. If left untreated, intermediate uveitis can cause permanent damage to the eye and vision loss. [rebuildyourvision.com]

  when the middle layer of the eye (uvea or uveal tract) becomes inflamed, causing redness, eye pain and changes to your vision. [specsavers.ie]

  Book now Uveitis is a fairly rare condition, when the middle layer of the eye (uvea or uveal tract) becomes inflamed, causing redness, eye pain and changes to your vision. [specsavers.co.uk]

  Granulomatous uveitis is characterized by blurred vision, mild pain, eye tearing, and mild sensitivity to light. [britannica.com]

  Uveitis is inflammation of the middle layer of the eye, called the uvea or uveal tract. It can cause eye pain and changes to your vision. Most cases get better with treatment – usually steroid medicine. [nhs.uk]

• Photophobia

  Pupillary examination may reveal direct photophobia when the light is directed into the affected eye, as well as consensual photophobia when light is directed into the uninvolved eye; consensual photophobia is typical of iritis, whereas photophobia due [emedicine.medscape.com]

  The common symptoms are eye pain, tenderness on touching and light sensitivity (photophobia). Photophobia occurs because light worses the spasm of the iris muscles caused by the inflammation. The area encircling the iris will look inflamed. [vision-and-eye-health.com]

  These eyeglass lenses darken automatically in sunlight to reduce photophobia-related discomfort when going outdoors. Page updated April 2019 [allaboutvision.com]

• Miosis

  Miosis Ciliary flush Anterior chamber cells and flare Hypopyon Keratic precipitates Reduced intraocular pressure (IOP) Ciliary flush results from perilimbal conjunctival injection. Spasm of the ocular sphincter muscle causes miosis. [symptoma.com]

  Pupillary miosis is common. Slit-lamp examination This is the most important aspect of the examination. Examine the cornea via direct illumination with a broad beam at a 30°-40° angle between the viewing microscope and the light source. [emedicine.medscape.com]

• Headache

  RESULTS: A 30-year-old man presented with headaches, ocular pain, photophobia, and blurred vision. He was found to have significant skin inflammation, predominantly involving areas of tattoos. [ncbi.nlm.nih.gov]

  General vision problems, including blurred or cloudy vision Floaters, spots in the eye that look like tiny rods or chains of transparent bubbles floating around in the field of vision Eye pain and redness Photophobia, an abnormal sensitivity to light Headaches [medicalnewstoday.com]

  Signs & Symptoms Uveitis may present with one or more of the following symptoms: Headaches Reddening in the eye Pain in the eye – the eye may feel sore or tender, with the pain ranging from mild to severe. [essilor.ie]

The diagnosis of uveitis is usually clinical and no specific tests are needed. Intraocular pressure measurement may be required to rule out glaucoma. Tests may be performed to determine the underlying cause of uveitis (e.g. infections, autoimmune causes and malignancies).

• Colitis

  Autoimmune side effects including colitis, dermatitis, and endocrine abnormalities are common in patients treated with ipilimumab [anti-CTLA4 (cytotoxic T-lymphocyte-associated protein 4)]. [ncbi.nlm.nih.gov]

  Examples are: Ankylosing spondylitis Behcet disease Psoriasis Reactive arthritis Rheumatoid arthritis Sarcoidosis Ulcerative colitis Uveitis can also be caused by infections such as: AIDS Cytomegalovirus (CMV) retinitis Herpes zoster infection Histoplasmosis [medlineplus.gov]

  The gene has been found in people with certain autoimmune conditions, including ankylosing spondylitis and ulcerative colitis. Page last reviewed: 3 January 2020 Next review due: 3 January 2023 [nhs.uk]

The treatment of anterior uveitis consists of the following components.

• Mydriatics: Mydriatics are given to counter the severe miosis. Dilation of the pupil prevents the formation of the posterior synechiae and also decreases the pain resulting from ciliary spasm.
• Steroids: Steroids are given to reduce inflammation. Depending upon the severity, steroids may be administered topically, subconjunctivally or systemically.
• Systemic analgesia: This is necessary to reduce pain.
• Treatment of the cause: The cause of anterior uveitis should also be promptly treated.

The treatment strategies for intermediate uveitis include the following.

• Systemic steroids are given to reduce inflammation.
• Immunosuppressive agents are also given in severe cases [9].
• Surgical options included in the treatment of intermediate uveitis include vitrectomy, cryotherapy and laser photocoagulation [10].

Posterior uveitis is treated with steroids which may be given through retrobulbar or systemic route.

With proper treatment, the prognosis of uveitis is usually good.

Untreated anterior uveitis may lead to inflammatory glaucoma and the formation of posterior synechiae and peripheral anterior synechiae. The former refers to adhesions of posterior iris to anterior lens capsule whereas the latter refers to adhesions of the iris to the cornea. Cataracts and band keratopathy may also occur.

Untreated intermediate uveitis can lead to cystoid and macular edema in up to 30% of the cases. Cataract and glaucoma may also develop in some cases.

Temporary or permanent visual impairment or even blindness may occur from uveitis in severe cases [8].

The etiological factors depend upon the type of uveitis.

Anterior uveitis is usually idiopathic. It may be the result of several connective tissue diseases. Several causes of anterior uveitis are related to HLA-B27 and include reactive arthritis, ankylosing spondylitis, psoriatic arthritis and inflammatory bowel disease [2]. Causes unrelated to HLA-B27 include juvenile idiopathic arthritis, sarcoidosis, ocular trauma, ocular surgery and infections (such as toxoplasmosis, syphilis, Lyme’s disease, herpes simplex virus, herpes zoster virus and tuberculosis) [3].

Intermediate uveitis is mostly idiopathic. Secondary causes such as sarcoidosis, Lyme’s disease and multiple sclerosis may also cause intermediate uveitis [4] [5]. Intermediate uveitis is often associated with anterior uveitis.

Posterior uveitis results from infections, autoimmune mechanisms and malignancies. The infection may be bacterial, viral, fungal or parasitic. The most common cause of posterior uveitis is parasitic infection (toxoplasmosis). Bacterial causes include syphilis and tuberculosis whereas viral causes are herpes simplex virus, cytomegalovirus (in acquired immunodeficiency syndrome). Fungal infections leading to posterior uveitis include histoplasmosis and candidiasis. Behcet’s disease is an autoimmune cause of posterior uveitis. It includes a triad of oral ulcers, genital ulcers and posterior uveitis [6]. Malignant melanoma and metastatic lesions can also cause posterior uveitis.

Uveitis is affects around 1 in 4500 people worldwide. Adults of age 20 to 60 years are usually affected whereas children are relatively spared. Anterior uveitis is the most common type of uveitis and accounts for 50 to 90% of the cases in the United States and around 30 to 50% in Asia [7].

The clinical features and manifestations of the disease result from the infection of the various parts of the uveal tract.

Uveitis results from multifactorial causes and there are no specific preventive measures against it.

If any causal infection has developed, prompt treatment is mandatory to prevent the progression of the disease and involvement of the eye(s).

Uvetis refers to the inflammation of the uveal tract of the eye. Depending upon the regions involved, may be classified into 3 types; namely anterior uveitis, intermediate uveitis and posterior uveitis [1].

Anterior uveitis is usually unilateral and can be defined as the inflammation of the iris (iritis). Iritis is usually accompanied by cyclitis (inflammation of the ciliary body). When both the iris and the ciliary body are involved, the condition is called iridocyclitis.

Intermediate uveitis refers to the inflammation of the vitreous; while inflammation of the choroid is known as posterior uveitis.

Uveitis refers to pain and swelling in the component of the eyes known as uveal tract. It may have different features depending upon the type.

Prompt treatment is necessary to avoid the development of complications.

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4. Jamilloux Y, Kodjikian L, Broussolle C, Seve P. Sarcoidosis and uveitis. Autoimmunity reviews. Aug 2014;13(8):840-849.
5. Sun SM. [Clinical analysis of sarcoidosis uveitis]. [Zhonghua yan ke za zhi] Chinese journal of ophthalmology. Mar 1988;24(2):83-85.
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10. Franklin RM. Laser photocoagulation of retinal neovascularization in intermediate uveitis. Developments in ophthalmology. 1992;23:251-260.