A 26-Year-Old With Chronic Eye Pain: Osmosis USMLE Study Question

January 22, 2021

Iritis, or anterior uveitis, is the most common form of intraocular inflammation. It is a common cause of a painful red eye. Uveitis occurs most frequently in people aged 20-50 years and affects men and women equally.

Iritis/uveitis can be associated with many medical conditions, including autoimmune diseases such as rheumatoid arthritis or ankylosing spondylitis, inflammatory conditions like Crohn disease or ulcerative colitis, and infectious disorders including herpes and tuberculosis. However, at least half of cases have no associated medical conditions.

Symptoms include redness of the eye, blurred vision, photophobia, eye pain, and "floaters." The diagnosis of uveitis can be made with a slit lamp examination; however, further evaluation, including blood work, should be done to look for an underlying cause. The hallmark of the disease is what is referred to as "cells and flare." "Cell" refers to the individual inflammatory cells, while "flare" is the foggy appearance given by protein that has leaked from inflamed blood vessels.

The prognosis is generally good for those who receive prompt diagnosis and treatment, but serious complications (including cataracts, glaucoma, band keratopathy, retinal edema, and permanent vision loss) may result if left untreated. Uveitis is typically treated with glucocorticoids, either as topical eye drops (prednisolone acetate) or oral therapy.

Major Takeaway: Anterior uveitis is an inflammatory eye condition associated with many rheumatologic conditions. On slit lamp examination, one sees the characteristic "cells and flare" appearance.

Read more about uveitis.

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