Acute Anterior Uveitis (Iritis)

Introduction

Acute Anterior Uveitis (or Iritis) is an inflammation of the iris (with or without the cilliary body). It usually occurs without any associated systemic inflammation. Iritis tends to recur.

Clinical features

  • Blurring of vision
  • Eyeball is tender
  • Phoptophobia due to cilliary spasms.
  • Flare and cells
  • Keratic precipitates
  • Exudation into anterior chamber
  • Hypopion
  • Posterior synechiae
  • Miosis due to spasm of sphincter pupillae

Differential diagnoses

  • Infective conjunctivitis
  • Acute iritis
  • Acute glaucoma

Complications

  • Secondary glaucoma
  • Cataracts

Investigations

  • Chest radiograph to exclude sarcoidosis and tuberculosis
  • Spinal radiograph (especially lumbrosacral segment) to exclude ankylosing spondilytis
  • Serology for rheumatoid factor, antinuclear antibodyetc

Treatment

Corticosteroid drops for treatment of inflammation:
Betamethasone sodium phosphate 0.1%

  • Apply eye drops every 1-2 hours until inflammation is controlled then reduce frequency

Subconjunctival: injection of steroid if severe
Atropine sulfate 0.5% or 1%

  • 1 drop up to 4 times daily

Caution & Contraindications

  • Avoid atropine drops if there is risk of acute glaucoma

Prevention

  • No real preventive measures