Location

• anterior
• intermediate
• posterior   (retina/choroid/vitreous)
• panuveitis
• +/- macular oedema (a secondary response)
  

Onset etc

• acute/chronic (several attacks over 3 months is usually a flare up of chronic)
• acute < 3months; chronic >3 months
• ?related to CMV
  ' Our results indicate that CMV is a major cause of AU in Thailand and show that FHUS can be caused by both CMV and Rubella virus'.

Acute uveitis

This may be due to

• HLA B27 uveitis

  • acute; hypopyon often; settles with treatment
  • accounts for 50% of acute anterior uveitis (AAU)
  • ankylosing spondylitis/reactive/reiters/enteropathic/?psoriatic
• less often, CMV Eye 2012
  • "10 CMV-positive patients, four had endotheliitis, two had Posner–Schlossman syndrome, and one Fuchs heterochromic uveitis syndrome (FHUS). Five out of 21 (24%) samples tested by GWC for Rubella virus were positive, three of which exhibited clinical features of FHUS."

Bechets

• bilateral, mouth ulcer recurrent and painful/HLA B51, genital ulcers
• Behcets disease group         
• Infliximab works Arch 2012

Chronic anterior

• HSV/sarcoid/syphilis

Drug induced

• intravenous biphosphonates
• etanercept

FHUS (Fuchs heterochromic uveitis syndrome)

• 24% rubella Eye 2012

TB

• all types

JIA

• no symptoms
• arthritis first (1 year before)
• +ANA, oligo JIA
• JIA all children must be screen within 6 weeks and every 8 weeks for 6 months

Sarcoid

• subacute/often bilateral/fine or granulomatous KP/choroidal granuloma/exudate around veins
• SOBOE, tired
• ACE, Ca++, urine,renal function, LFT, CXR

MS

intermediate with macular oedema

TINU

tubular interstitial nephritis and uveitis; 1% of AAU..sudden bilateral, young patients

Perioperative

Control uveitis for 3 months; IV methylpred followed by short course of oral steroids

Toxoplasmosis

To treat, read this paper. Eye 2012 

• traditional
  • pyrimethamine, sulpahdiazine, folinic acid, (systemic steroids if sight threatened)...details Eye 2012 
• intravitreal
  • intravitreal clindamycin and dexamethasone

Secondary prophylaxis

trimethoprim/sulpahmethoxazole once every 3 days.see Eye 2012 

CMV retininits

Eye 2012   Solid organ transplantation 8 months after transplant, HIV infection.

"Pale necrotic retina with focal haemorrhage, in sectors of retina, spreading cetnrifugally along vascular arcades"  PCR diagnosis. Treat Eye 2012

Coeliac disease    

32% increase in uveitis risk BMJ 2012