Anterior uveitis

Anterior uveitis
SYMPTOMS Pain | Blurry vision | Photophobia | Tearing
SIGNS Injection | Cells and/or flare in the anterior chamber | Ciliary flush | Keratic precipitates | Posterior synechiae | Possible hypopyon | IOP can be increased or decreased depending on cause and duration
WORK-UP Thorough history | IOP check | Slit lamp examination | Dilated fundus exam | While most cases of anterior uveitis are idiopathic, targeted work-up (i.e. laboratory testing) may be indicated in recurrent or severe cases to identify a possible etiology
Topical cycloplegics (homatropine is difficult to obtain): Cyclopentolate 1% tid | Atropine 1% qd
Topical steroids (dosage depends on severity): Pred Forte 1% q1h-q6h | Durezol up to qid
Oral immunosuppressive or steroid agents may be indicated in severe cases | Treat the underlying etiology if a cause is determined
FOLLOW-UP Every 1-2 days initially during treatment
ADDITIONAL LAB | TESTS OCT of the macular to assess for macular edema
ETIOLOGY Usually idiopathic | The possible etiology list is extensive (lens-induced, HLA-B27-related, syphilis, herpes, etc.)
DIFFERENTIAL DX Intermediate uveitis | Panuveitis | Trauma | Glaucomatocyclitic crisis | Contact lens-associated red eye (CLARE)
NOTES The uveitis spectrum of conditions is vast and the possible causes are many | Steroids should be tapered appropriately