Uveitis

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Inflammation of the uvea of the eye. It is classified as either anterior (involves iris and ciliary body) or posterior (involves choroid which is the posterior part of the uvea).

Cause

• Systemic diseases (TB, HIV, lymphoma, autoimmune disease, leprosy, toxoplasmosis)
• Cytomegalovirus (CMV)
• Post-trauma
• Idiopathic

Clinical features

• Anterior uveitis: Involves the iris and ciliary body, pain, photophobia, ciliary infection, poor vision, small and irregular pupil, cells and flare in the anterior chamber, and keratic precipitates
• Posterior uveitis: Involves choroid, poor vision, cells in the vitreous

Investigations

• Investigation of uveitis is broad and requires a high index of suspicion
• Diagnosis of uveitis requires expertise and can only be confirmed by slit lamp examinations

ManagementTreatment

If at HC2 and HC3

• Do not give any medicine
• Explain seriousness of the condition to the patient
• Refer urgently to a qualified eye health worker

Anterior uveitis

• Topical steroids eye drops
• Periocular steroids may be used in severe anterior uveitis
• Atropine eye drops to relieve pain
• Refer bilateral cases, and where there is poor vision and associated ocular complications

Posterior uveitis

• Treat the primary condition if any
• Topical, periocular and systemic steroids
• Atropine/Cyclopegics to relieve pain in anterior uveitis

Prevention

• Wear protective goggles when hammering, sawing, chopping, grinding
• Warn children playing with sticks about risk of eye injuries