Uveitis
Questionnaire/history:
Onset of symptoms?
Duration of symptoms?
Symptoms unilateral or bilateral?
Throbbing, dull ache or pain (posterior uveitis may be painless)?
Foreign body sensation suggestive of corneal process (eg corneal abrasion, foreign body or keratis)?
Red eye (not always)?
Diminished or blurred vision (although vision may be normal)?
Watering of the eye?
Discharge (notably absent in uveitis)?
Light sensitivity?
Flashed and/or floaters?
Unreactive or distorted pupil?
Chemical exposure, surgery?
Other causes or risk factors?
Contact lens wearer?
Past medical history?
Family history (eg autoimmune disorders)?
Drug history?
Drug allergies?
Examination:
Rashes and/or vesicles?
Eyelids (eg erythema, trichiasis, entropion or ectropion)?
Conjunctiva (including the tarsal surface)?
Pattern of redness (if present)?
Discharge?
Visual acuity using a Snellen chart?
Extraocular movements?
Pupil reaction?
- Photophobia?
- Pupil smaller?
- Direct pupillary reflex?
- Consensual pupillary reflex?
Blood pressure?
Fluorescein examination (if available)?
Management:
Referred immediately for same-day assessment by an ophthalmologist, if:
- severe eye pain and
- significant reduction in vision
Referred for assessment within 24 hours by an ophthalmologist to confirm the diagnosis with a split lamp examination with dilated pupils and measurement of intraocular pressure
Secondary care treatment depending on the underlying cause of the uveitis
Reference(s):
NICE CKS: Uveitis
Information for patient/carer(s):
NHS Health A to Z: Uveitis
Patient UK: Uveitis