Anterior uveitis

What it is

Anterior uveitis is also referred to as iritis, and the two names are used for the same condition. Uveitis as a whole is classified by the part of the eye involved into anterior uveitis, intermediate uveitis, posterior uveitis and panuveitis. Anterior uveitis is one of the important differentials of a red eye, and it stands in that group alongside conjunctivitis and nodular episcleritis; asked which of these will likely affect vision, the page ticks acute anterior uveitis.

Causes and risk

Anterior uveitis is usually idiopathic, and about a third of cases are associated with autoimmune, infectious or neoplastic conditions. The named causes fall into groups:

• Connective tissue disease. The HLA-B27 group holds reactive arthritis, ankylosing spondylitis, psoriatic arthritis and inflammatory bowel disease; juvenile idiopathic arthritis is the non-HLA-B27 entry.
• Infectious. Syphilis, Lyme disease, toxoplasmosis, TB, HSV and herpes zoster.
• Other. Sarcoidosis, trauma, large abrasion and post ocular surgery.

In ankylosing spondylitis, which is associated with HLA-B27 and has a peak age of 15 to 40 years, unilateral anterior uveitis, that is iritis or iridocyclitis, is described as the most important manifestation outside the joints. Iritis is also named among the complications of a corneal ulcer. Iritis, that is anterior uveitis, is also one of the eye findings looked for in the spondyloarthropathies, whose shared features are being seronegative and having HLA B27, with age of onset under 40, back pain, morning stiffness that improves with activity and is worst with rest, red eye, and more in males.