Uveitis (includes Iritis, Cyclitis, Retinitis, Choroiditis)¶
Jonathan A. Barnett
Background¶
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”Uvea” = iris + ciliary body + choroid (these 3 tissues are connected and make up the vascular layer of the eye)
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Uveitis = inflammation of either or all of these structures. However, “uveitis” is a bit of a misnomer, since it is used to denote inflammation of any ocular component
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Uveitis is usually associated with autoimmune conditions, but infections can also cause uveitis.
| Anterior Uveitis | Intermediate Uveitis | Posterior Uveitis | Panuveitis | |
|---|---|---|---|---|
| Practical synonyms | Iritis | Pars planitis, Cyclitis | Retinitis, Choroiditis, Chorioretinitis | Diffuse uveitis |
| Definition | Inflammation localized to the anterior segment | Inflammation localized to the vitreous cavity and pars plana | Inflammation localized to choroid and retina | Inflammation involving the anterior, intermediate, and posterior structures |
| Symptoms | Vision loss Usually painful Perilimbal redness |
Vision loss Pain varies |
Vision loss Pain varies |
Vision loss Pain varies |
| Common etiologies | Idiopathic HLA-B27 IBD, psoriatic arthritis, ankylosing spondylitis, reactive arthritis |
Spillover from anterior uveitis Multiple sclerosis Lymphoma Sarcoid Syphilis TB |
Immunocompromised (HIV, transplant) CMV, HSV, VZV Vasculitis Sarcoidosis Toxoplasmosis Syphilis TB |
Lymphoma Behcet’s disease Sarcoid Syphilis TB Toxoplasmosis |
Management¶
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If you suspect a patient has uveitis, consult ophthalmology for evaluation.
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Patients with any of the above associated systemic conditions (e.g., IBD) do not need an inpatient Ophthalmology consult unless the patient has visual symptoms. Referral to outpatient Ophthalmology is appropriate for routine screening.