Anterior uveitis is one of the important differentials of a red eye. It is also referred to as iritis. Anterior uveitis describes inflammation of the anterior portion of the uvea - iris and ciliary body. It is associated with HLA-B27 and may be seen in association with other HLA-B27 linked conditions (see below).

Features

• acute onset
• ocular discomfort & pain (may increase with use)
• pupil may be small +/- irregular due to sphincter muscle contraction
• photophobia (often intense)
• blurred vision
• red eye
• lacrimation
• ciliary flush: a ring of red spreading outwards
• hypopyon; describes pus and inflammatory cells in the anterior chamber, often resulting in a visible fluid level
• visual acuity initially normal → impaired

Associated conditions

• ankylosing spondylitis
• reactive arthritis
• ulcerative colitis, Crohn's disease
• Behcet's disease
• sarcoidosis: bilateral disease may be seen

Management

• urgent review by ophthalmology