Uveitis (Inflammatory, Autoimmune Disease or Infectious Causes)

Anterior uveitis is the most common form of intraocular inflammation, primarily affecting the iris and/or ciliary body. Patients typically present with gradual onset of moderate ocular pain, tearing and reduced vision. Signs include the following: Circumcorneal injection is characteristic due to the congestion of perilimbal episcleral vessels. Increased protein content in the aqueous humour may lead to secondary open-angle glaucoma. Inflammatory cells circulating in the aqueous can deposit as keratic precipitates on the corneal endothelium, causing corneal haze due to stromal and epithelial oedema. These precipitates can be granulomatous or non-granulomatous, consisting of macrophage and lymphocyte aggregation or lymphocytes and neutrophils, respectively. Pupillary miosis is often observed. Management of anterior uveitis involves addressing the underlying cause, which may be infectious or autoimmune. Treatment typically includes corticosteroids to reduce inflammation and cycloplegic agents to relieve pain and prevent synechiae formation. Early diagnosis and appropriate treatment are crucial to prevent complications and preserve vision. Posterior uveitis refers to inflammation of the retina and/or choroid. It extends to the adjacent retina, causing retinochoroiditis. When the inflammation originates in the choroid, it can spread to the adjacent retina, resulting in retinochoroiditis. It may be due to bacteraemia, fungaemia or larva migrans and evolve into endophthalmitis. More commonly, there is a non-purulent chronic granulomatous reaction. The commonest causes of retinochoroiditis in Europe are Toxoplasma gondii infection and larva migrans from Toxocara canis infection.