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Anterior Uveitis

The Uvea is the highly vascular layer of the eye, involving the Iris, Ciliary body and Choroid. Anterior uveitis (AU) is the inflammation of the iris and/or ciliary body. It's usually autoimmune, but can also be due to infection, trauma, ischaemia, or malignancy. It's classified into Acute or Chronic, with Chronic AU being more granulomatous and having a less severe and longer duration of symptoms (3+ months).

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“Diagram of the human eye in English. It shows the lower part of the right eye after a central and horizontal section.” © Jmarchn CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/)

It's associations include:

  • Acute AU – IBD, Reactive Arthritis, Ankyolysing Spondylitis

  • Chronic AU – Sarcoidosis, Juvenile Idiopathic Arthritis, Syphilis


Presentation

  • Unilateral, painful red eye

  • Blurred vision

  • Ciliary flush (ring of red spreading from cornea outwards)

  • Floaters – Due to inflammatory cells in anterior chamber

  • Pupil constriction

  • Photophobia

  • O/E - Hypopyon (collection of wbc’s in anterior chamber), Posterior Synechiae (abnormal shaped pupil due to adhesions between the lens and iris)

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“Anterior uveitis” © Jonathan Trobe, M.D. CC BY 3.0 (https://creativecommons.org/licenses/by/3.0/)

Management

  • Corticosteroids – Reduces inflammation and prevent adhesions in the eye

  • Cycloplegic-Mydriatics (e.g. Cyclopentolate or Atropine) eye drops – Paralyses ciliary body and dilates pupil for pain relief




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