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doctorkarim · Credits: 84453 My Scrapbook

A 46-year-old man presents with a 3-week history of redness, light sensitivity, and episodic pain in the right eye. The patient has been using topical gentamicin (eg, Garamycin, Genoptic, Gentacidin) eye drops for 7 days, which has not relieved any of his symptoms. His past medical history is significant for sarcoidosis. What is the most likely diagnosis?

1. acute angle-closure glaucoma
2. anterior uveitis
3. episcleritis
4. toxic conjunctivitis secondary to gentamicin use

mikebrian · Credits: 719 My Scrapbook

2. anterior uveitis

cafe · Credits: 5230 My Scrapbook

Uveitis is a general term that refers to inflammation or swelling of the eye's structures responsible for its blood supply. These structures are collectively known as the uveal tract, and include the iris, ciliary body, and choroid. Uveitis is classified by the structures it affects, the underlying cause, and whether it is chronic (lasting more than 6 weeks), or acute in nature. There are four main categories of uveitis. Anterior uveitis (also known as iritis) involves the iris and ciliary body and is the most common type; intermediate uveitis affects the ciliary body, vitreous and retina; posterior uveitis involves the retina, choroid and optic nerve; and diffuse uveitis affects structures both in the front and back of the eye.

Common causes of uveitis include infection or underlying disease, but in some cases the cause is unknown. Uveitis usually affects people between 20-50 years of age.

Signs and Symptoms

The symptoms of uveitis depend on whether it is anterior, intermediate, posterior or diffuse.

Anterior

Light sensitivity

Blurred vision

Redness around the iris

Pain that may range from aching or soreness to intense discomfort

Small pupil

Tearing

Elevated intraocular pressure

Intermediate

Often affects both eyes

Floaters

Blurred vision

Posterior

Blurred vision

Pain (if the optic nerve is involved)

Diffuse

Combination of symptoms from anterior, intermediate, and posterior uveitis

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