uveitis

Uveitis is inflammation of the uveal tract, consisting of the iris, ciliary body, and choroid. The condition may be limited to one part of the uvea or involve multiple segments, and it can be infectious, autoimmune, or associated with systemic diseases. Clinically, uveitis is commonly classified by anatomical location: anterior, intermediate, posterior, or panuveitis.

Anterior uveitis typically presents with painful red eye, photophobia, blurred vision, and constricted pupil; keratic precipitates on the corneal endothelium; anterior chamber cells and flare; synechiae may form; hypopyon can occur in some cases. Intermediate, posterior, and panuveitis more often cause floaters, vision loss, vitritis, chorioretinal lesions, and less overt redness.

Etiology ranges from infectious agents (herpes simplex, varicella-zoster, toxoplasma, tuberculosis, syphilis) to noninfectious inflammatory diseases (HLA-B27–associated arthritis, sarcoidosis, juvenile idiopathic arthritis, Behçet disease) and masquerade syndromes. While some cases are idiopathic, many have a systemic association.

Diagnosis combines ophthalmic examination with targeted tests to identify infection or systemic disease. Slit-lamp examination, dilated fundus exam, optical coherence tomography, fluorescein angiography, ultrasound B-scan, and laboratory tests guided by history help determine etiology and extent.

Management depends on location and cause. Anterior uveitis is usually treated with topical corticosteroids and cycloplegic agents; posterior and panuveitis may require systemic or periocular steroids, immunomodulatory therapy, or biologics. Treatment aims to suppress inflammation, prevent complications (cataract, glaucoma, macular edema), and address underlying disease. Regular follow-up is essential due to recurrence risk.

Prognosis varies with etiology and promptness of therapy. Some patients achieve full recovery, while others endure recurrent inflammation with potential long-term vision impairment. Early recognition and multidisciplinary care improve outcomes.