Anterior Uveitis
Definition:
Anterior uveitis is an inflammation of the front or anterior part of the uvea, the iris.
Characteristics of Anterior Uveitis
- Onset is generally acute that means the disease begins suddenly and patient notices symptoms within hours to days
- Respond well to the treatment and usually not lead to any significant vision loss
- It can recur
- Accounts for 75% of cases of Uveitis
Risk factors of Anterior Uveitis
Although it can occur to any individual, but individuals with following factors are at higher risk of developing the disease:
- HLA-B27 allele
- Ankylosing spondylitis
- Psoriatic arthritis
Causes of Anterior Uveitis
In most of the cases of anterior uveitis, there is no obvious underlying cause of the disease. It may be an isolated problem or may occur in association with other systemic diseases. The major causes of anterior uveitis include:
- Trauma to the eye, such as a blow or foreign body penetrating the eye
- Complication of other eye disease
- Adverse reaction to a medication
- Systemic disorders such as rheumatoid arthritis, rubella and mumps
- Disorders including syphilis, tuberculosis, sarcoid, viral (herpes simplex, herpes zoster, cytomegalovirus)
- Can be associated with medical conditions include Ankylosing spondylitis, Juvenile rheumatoid arthritis and Inflammatory bowel disease
Signs/symptoms of Anterior Uveitis
Anterior uveitis presents itself as following:
- Red, sore and inflamed eye
- Eye pain
- Blurring of vision
- Sensitivity to light (photophobia)
- Tearing
- Lid puffiness
- Some drooping of the eyelid
- Small pupil
Diagnosis of Anterior Uveitis
The symptoms of anterior uveitis resemble various other eye diseases, so its diagnosis requires carefully examination of the eye under bright light and high magnification. Some diagnostic tests may also be required to conclude the condition like:
- Slit lamp examination
- Dilated eye examination
- Visual acuity
- Workup including an HLA-B27, syphilis testing, and testing for sarcoid (CXR at least–the utility of angiotensin converting enzyme (ACE)
Treatment of Anterior Uveitis
Treatment of anterior uveitis should be prompt to prevent permanent damage and loss of vision from the development of glaucoma, cataract or retinal edema. Anterior uveitis usually responds well to treatment. Treatment mainly depends upon the severity of the condition and includes prescription eye drops in combination with anti-inflammatory drugs like:
- Topical corticosteroid drop such as prednisolone acetate
- Dilating drop such as cyclopentolate
- Topical cycloplegics
No specific surgical treatment is advantageous for uveitis
Complications of Anterior Uveitis
If left untreated or not monitored well, any eye with anterior uveitis can complicate and following may occur:
- Raised Eye Pressure and Synechiae
- Glaucoma
- Cataracts
- Macular Oedema
Prognosis of Anterior Uveitis
Anterior uveitis has a tendency to recur, so immediate treatment is required to shorten the duration of the attack and improve the prognosis. But it is very important to monitor all the cases of anterior uveitis to prevent complications and ease the patient.
