This document provides an overview of uveitis, including its definition, classification, clinical features, investigations, and treatment. Uveitis is an inflammation of the uveal tract and adjacent structures that can be classified anatomically by the area affected (anterior, intermediate, posterior, or pan uveitis) or clinically as acute or chronic. Common symptoms include photophobia, pain, redness, floaters, and decreased vision. Treatment involves mydriatics, topical or systemic steroids, and immunosuppressive drugs to reduce inflammation and prevent complications like glaucoma, cataracts, or retinal detachment.

1. Haneen Hassan Shaker
Group A2
Alkindy college of medicine

2. Uveitis
Definition: it is an inflammation of the uveal tract and
adjacent structures, most probably the retina.
Classification: - Anatomical.
- Clinical.
- Etiological.

4. Anatomical Classification
• 1- Anterior uveitis: which is subdivided into:
• a- Iritis: in which inflammation predominantly affects the iris.
b- Iridocyclitis: in which both the iris and anterior part of the ciliary
body are equally involved.

5. • 2- Intermediate uveitis:
• It is characterized by involvement predominantly of the posterior
part of the ciliary body ,periphery of the retina and the vitreous.

6. 3- Posterior uveitis: involve the fundus posterior
to the vitreous base:
•a. retinitis
•b. choroiditis
•c. vasculitis

7. 4- Pan uveitis:
•Involvement of the entire uveal tract.

8. 1- Acute uveitis: usually has
a sudden, symptomatic onset and persists for up to 3 months. If
the inflammation recurs following the initial attack it is referred as
recurrent acute uveitis.
2- Chronic uveitis: the onset is frequently insidious and may
be asymptomatic. It usually persists for longer than 3 months.
Acute or subacute exacerbations on chronic may occur.

9. • Etiological classification:
1- Idiopathic: which forms more than 50% of cases of uveitis.
2- Associated with a systemic disease:
a-ankylosing spodylitis, Reiter's syndrome, psoriatic arthritis and chronic juvenile
arthritis.
b- Inflammatory bowel disease: ulcerative colitis, Crohn's disease..
c- Nephritis.
d- Non-infectious multi-system disease: sarcoidosis, Behçet's disease.
e- Infectious systemic disease: e.g. TB, syphilis..
f- Diabetes.
3- Infections:
a- Bacterial: tuberculosis.
b- Fungal: Candidiasis.
c- Viral: Herpes Zoster.
4- a- Protozoa: Toxoplasmosis.
b-Nematodes: Toxocariasis

10. Clinical Features:
Anterior uveitis
• Symptoms:
1- Acute anterior uveitis:
• Photophobia,
• pain,
• redness,
• decreased visual acuity and lacrimation.
In acute anterior Uveitis, the pain is due to spasm of ciliary muscle,
and decrease visual acuity is due to turbidity of aqueous by
inflammatory cells
2- Chronic anterior uveitis:
• asymptomatic until development of complications
• give rise to mild redness(during severe exacerbation) .

12. Complications of anterior uveitis:
• 1- Posterior synechiae:
2- Cataract.

13. 3- Glaucoma: inflammatory or secondary angle closure
glaucoma.
4- Cyclitic membrane formation which leads to traction
and then detachment of the Ciliary body which causing
phthisis bulbi.

14. Intermediate Uveitis
Symptoms:
• Initially, floaters (inflammatory cells in anterior vitreous)
• later, decreased visual acuity due to macular edema (due to
associated vitritis).
Signs:
• Cellular infiltration of vitreous
(vitritis).

15. Posterior uveitis
Symptoms:
1- Floaters (due to cells and flare in the vitreous).
2- Impairment of visual acuity.
Signs:
1- Retinitis: ill-defined, focal, white, cloudy appearance of retina
with obscuration of retinal vessels.
2- Vacuities: fluffy white haziness.
3-chorioditis:appear as yellow round nodule.

16. Special investigations for patients with uveitis:
1- X-Ray:
- Sacroiliac joint (for ankylosing spondylitis).
- Chest x-ray (for TB).
- Skull calcification: toxoplasmosis.
2- Skin test: histoplasmosis,
3- Serum tests: ANA (Anti-Nuclear Antibodies) as in chronic
juvenile arthritis, toxoplasmosis test (IFAT) and ELISA.
4- HLA-typing: for ankylosing spondylitis

17. Treatment:
• 1- Mydriatics:
Short acting:
• Tropicamide
• Cyclopentolate
# Both of previous drugs have mydriatic and cycloplegic effects by
inhibiting the sphincter muscles of the iris and inhibition of Ciliary
body muscles
• .Phenylnephrine (sympathetic agonist)
Long acting: Atropine .

18. 2- Steroids:
-Topical steroids: only for anterior uveitis, because they do not reach
therapeutic levels behind the lens.
prednisolone acetate, Dexamethasone and betamethasone.
Side effects of topical steroids (especially after prolonged use):
• a- Glaucoma.
• b- Cataract.
• c- Corneal complications: they are rare, e.g. bacterial and fungal
keratitis and recurrence of herpes simplex keratitis.
• d- Systemic side effects.

19. -Systemic steroids:
• prednisolone tablets
3- Immunosuppressive agents:
Azathioprine and Methotrexate