ANTERIOR UVEITIS (IRITIS/IRIDOCYCLITIS):
Symptoms:
Acute Pain, red eye, photophobia, mildly decreased vision, tearing. May have recurrent episodes.
Chronic May have periods of exacerbations and remissions, fewer or none of the acute symptoms.
Critical Signs:
Cells and flare in the anterior chamber.
Differentiating Signs:
Nongranulomatous Fine keratic precipitates (KP) (white cells on the corneal endothelium).
Granulomatous Large “mutton-fat” KP, Koeppe's nodules (clusters of cells on the pupillary border), Busacca's nodules (clusters of cells on the anterior iris surface).
Other Signs:
Cells in the anterior vitreous (spillover), posterior synechiae (adhesions of the iris to the lens), miosis, low intraocular pressure (IOP) but occasionally increased (especially with herpes simplex and herpes zoster), injection of the perilimbal blood vessels (“ciliary flush”), fibrinous hypopyon (layering of white cells in the anterior chamber) if severe, cystoid macular edema if chronic, occasionally a cataract.
Note Patients will often complain of increased pain in the involved eye when light is shined in the uninvolved eye because of the consensual pupillary response.
Symptoms:
Acute Pain, red eye, photophobia, mildly decreased vision, tearing. May have recurrent episodes.
Chronic May have periods of exacerbations and remissions, fewer or none of the acute symptoms.
Critical Signs:
Cells and flare in the anterior chamber.
Differentiating Signs:
Nongranulomatous Fine keratic precipitates (KP) (white cells on the corneal endothelium).
Granulomatous Large “mutton-fat” KP, Koeppe's nodules (clusters of cells on the pupillary border), Busacca's nodules (clusters of cells on the anterior iris surface).
Other Signs:
Cells in the anterior vitreous (spillover), posterior synechiae (adhesions of the iris to the lens), miosis, low intraocular pressure (IOP) but occasionally increased (especially with herpes simplex and herpes zoster), injection of the perilimbal blood vessels (“ciliary flush”), fibrinous hypopyon (layering of white cells in the anterior chamber) if severe, cystoid macular edema if chronic, occasionally a cataract.
Note Patients will often complain of increased pain in the involved eye when light is shined in the uninvolved eye because of the consensual pupillary response.