Symptoms of Uveitis
Symptoms produced by uveitis depend on which part of the uveal tract is inflamed, the rapidity of onset (sudden or insidious), the duration of the disease (limited or persistent), the course of the disease (acute, chronic, or recurrent), and sometimes the underlying etiology.
Anterior uveitis can have a range of presentations, from a quiet asymptomatic white eye to an extremely painful red eye depending on the type of uveitis and/or severity of inflammation. Sudden-onset anterior uveitis usually causes acute pain, photophobia, redness, and blurred vision. Pain results from ciliary spasm associated with inflammation in the region of the iris and may radiate over the larger area served by cranial nerve V (the trigeminal nerve). Intraocular pressure (IOP) elevation due to angle closure or trabeculitis can be another cause of pain.
In contrast, chronic anterior uveitis in patients with juvenile idiopathic arthritis (JIA) may not be associated with any symptoms at all. However, even if initially asymptomatic, chronic or severe anterior uveitis can cause blurred vision because of structural complications such as calcific band keratopathy, cataract, or macular edema.
Isolated intermediate uveitis presents with a white, quiet eye and produces symptoms of floaters and blurred vision. Floaters result from the shadows cast by vitreous cells and debris on the retina. Blurred vision can result from macular edema or vitreous opacities in the visual axis.
Presenting symptoms in patients with posterior uveitis include painless blurred vision, floaters, photopsias, scotomata, metamorphopsia, nyctalopia, or a combination of these symptoms. The blurred vision can be caused primarily by retinitis and/or choroiditis directly affecting macular function, or secondarily by complications of inflammation. Table 5-6 summarizes symptoms of uveitis.
Table 5-6 Symptoms of Uveitis
Excerpted from BCSC 2020-2021 series: Section 9 - Uveitis and Ocular Inflammation. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.