Uveitis

Inflammation of the uveal tract — the vascular coat of the eye, comprising the iris, ciliary body and choroid. Uveitis may be anterior or posterior.

Anterior uveitis (acute iritis)

Inflammation of the iris and ciliary body — the iris becomes sticky, adhering to the lens and losing its light response.

Kumar & Clark triad: redness, pain, photophobia.

Causes:

Category	Examples
Autoimmune	Seronegative arthropathies, SLE, inflammatory bowel disease, sarcoidosis
Infectious	Toxoplasmosis, syphilis, herpes viruses (including CMV), HIV

History: red eye (especially around the iris), eye pain, photophobia, blurred vision, floaters, small pupil, tearing.

Examination: constricted, irregular pupil; hypopyon (pus in the anterior chamber) may be present.

Investigations: slit lamp examination + tonometry (to differentiate from glaucoma).

Management:

• Seen in ED for slit lamp exam + tonometry to confirm diagnosis; ophthalmology review within 24 hours
• Pupil dilation (e.g. atropine eye drops) to prevent/break synechiae
• Topical steroids to reduce inflammation ± systemic steroids

Prognosis: good if treated early and consistently, but recurrence is likely.

Posterior uveitis (choroiditis)

Inflammation of the choroid, which may involve the retina and vitreous.

History: no pain, blurred vision, floaters (floating opacities).

Management: referral to ophthalmology.