Anterior Uveitis

Anterior uveitis demonstrating hypopyon. 

  • Inflammatory disease of the iris and ciliary body.
  • There are several classifications of uveitis generally used in the literature, i.e. anatomical (anterior, intermediate, posterior and panuveitis), clinical (acute and chronic), etiologic (exogenous and endogenous) and pathologic classification (granulomatous and non-granulomatous).

Clinical features:

  • Symptoms: pain due to ciliary spasm, red eye, photophobia, decreased vision and tearing
  • Signs:
  • Associated systemic conditions: ankylosing spondylitis, Reiter's syndrome, Behçet's disease,sarcoidosis, Herpes zoster ophthalmicus and juvenile rheumatoid arthritis disease.
  • Laboratory work-up for all patients with signs of bilateral and recurrent granulomatous uveitis include: CBC, ESR, ANA, RPR, FTA-ABS, PPD and anergy panel, HLA B-27 test and chest X-ray.

Management:

  • Treatment is addressed to the co-existing systemic conditions in addition to the eye disease.
  • Ophthalmic cycloplegic drops are essential to relax ciliary spasm, decrease pain and prevent formation of posterior synechiae.
  • Topical steroid drops are used to treat inflammation.
  • If there is no clinical improvement, sub-Tenon's injection or oral steroids may be necessary.