Uveitis

A red painful eye with photophobia and increased tearing often occurs with the presentation of anterior uveitis. In addition, the patient may have decreased vision. Vascular injection, a circumcorneal injection involving the deep vessels of the sclera, is one of the primary signs of anterior uve-itis. Generally, uveitis patients are moderately light sensitive. In addition, the inflammatory process may hinder aqueous production and reduce intraocular pressure.

Patients suspected of an anterior uveitis should be referred to an ophthalmologist for consultation and treatment. The most common cause of anterior uveitis is idiopathic; other common causes include ankylosing spondylitis, inflammatory bowel disease, sarcoidosis, juvenile rheumatoid arthritis, Reiter's syndrome (urethritis, polyarteritis, and ocular inflammation), herpetic keratitis, and Lyme disease.

Patients with posterior uveitis usually present with a reduction in vision and vitreous floaters. They may have clinical signs of retinal vasculitis, retinal ischemia, optic nerve edema, and exudative retinal detachment. On careful inspection, cells may be visible floating in the vitreous. Common causes of posterior uveitis are toxoplasmosis, sarcoidosis, cytomegalovirus, Epstein-Barr virus, Behçet's disease, and Bartonella infection. Toxoplasmosis accounts for up to 30% of cases and may destroy the macula or other important visual structures. Characteristically, there is an exudation in the retina caused by an inflammatory process. Toxocara canis may also present as uveitis.

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