This document describes the symptoms, signs, and differential diagnosis of uveitis. The key symptoms are dull aching and throbbing pain that is worse at night and referred to the forehead and scalp. Examination findings include lid edema, keratic precipitates, aqueous cells and flare, iris nodules and posterior synechiae, changes to the lens and intraocular pressure, and complications such as glaucoma. Granulomatous and non-granulomatous uveitis can be differentiated based on features such as onset, pain, photophobia, ciliary congestion, and characteristics of keratic precipitates, aqueous flare, iris involvement, and posterior synechiae. Careful slit lamp

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3. SYMPTOMS

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1
Dull aching;
Throbbing sensation;
Worse at night;
Referred mainly to forehead and scalp.
2
Due to circumcorneal congestion;
Which is a result of active hyperemia of
anterior ciliary vessels due to effect of toxins,
histamine and histamine-like substances and
axon reflex.
SYMPTOMS

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5
3
Due to reflex between sensory
fibres of 5th nerve (which are
irritated) and motor fibres of 7th
nerve, supplying the orbicularis
oculi muscle
occurs as a result of
lacrimatory reflex mediated by
5th nerve (afferent) and
secretomotor fibres of 7th
nerve (efferent).

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DEFECTIVE VISION
May vary from slight blur in early phase to
marked deterioration in late phase.
Factors responsible include:
•Induced myopia due to ciliary
spasm,
•Corneal haze due to odema and
KPs,
•Aqueous turbidity,
•Pupillary block due to exudates,
•Complicated cataract,
•Vitreous haze,
•Cyclitic membrane,
•Associated macular odema,
•Papillitis or
•secondary glaucoma

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Slit lamp biomicroscopic examination is essential to elicit
most of the signs of uveitis.
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SIGNS

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It is usually mild, may
accompany a severe attack
of acute anterior uveitis.
Lid Odema
A

9. It is marked in acute
iridocyclitis and minimal in
chronic iridocyclitis.
While it should be
differentiated from acute
conjunctivitis, where it is
superficial congestion.
9
B

10. Corneal signs
C
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11. Corneal signs
C
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Granular KPs
Slit lamp examination of
KPs

12. The composition and
morphology of KPs varies
with the severeity, duration
and type of uveitis.
Types of keratic
precipitates
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13. Corneal Signs
C
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14. Anterior Chamber Signs
D
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Aqueous cells as seen in slit lamp examination

15. Anterior Chamber Signs
D
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Aqueous flare as seen in slit lamp examination

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17. Anterior Chamber Signs
D
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18. Anterior Chamber Signs
D
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19. Iris Signs
E
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20. Iris signs
E
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Koppe’s nodules
Busacca’s nodules

21. Iris signs
E
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Iris bombe

22. Iris signs
E
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Segmental posterior
synaechiae Total posterior
synechiae

23. Pupillary signs
F
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Narrow pupil

24. Pupillary signs
F
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25. Changes in Lens
G
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26. Changes in Intraocular
Pressure
I
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Changes in vitreous and retina
H

27. Complications and Sequelae
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Hypertensive uveitis
Late glaucoma

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Cyclitic membrane
Band-shaped keratopathy

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31. “Differential Diagnosis
1. Acute red eye
2. Granulomatous Vs Non-Granulomatous uveitis
3. Etiological differential Diagnosis
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Feature Granulomatous Uveitis Non-granulomatous Uveitis
1. Onset Insidious Acute
2. Pain Minimal Marked
3. Photophobia Slight Marked
4. Ciliary congestion minimal Marked
5. Keratic precipitates (KPs) Mutton fat Small
6. Aqueous flare Mild Marked
7. Iris Nodules Usually present Absent
8. Posterior Synechiae Thick and broad based Thin and tenuous
9. Fundus Nodular lesions Diffuse involvement

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