Symptoms and signs of anterior uveitis

Purpose To review the symptoms and signs of anterior ueveitis (AU), based on the anatomic classification of uveitis, iritis and iridocyclitis.Methods Review of symptoms and signs of AU.Results Perikeratic injection, small keratic precipitates (KPs), cells and flare in the anterior chamber are peculiar findings of alternating unilateral acute non-granulomatous anterior uveitis, which is commonly described in association with HLA-B27 antigen and spondyloarthropaties. In such cases, hypopyon or fibrinous exudate can also occur. Patients presenting acute anterior uveitis typically show red eyes, photophobia, ocular pain, and often blurred vision. In chronic anterior uveitis, the onset is usually subtle and patients may be asymptomatic until the development of complications. Chronic flare, Koeppe and Busacca nodules of the iris, medium-size KPs or large mutton-fat KPs, peripheral anterior synechiae and broad-based posterior synechiae represent hallmarks of granulomatous anterior uveitis which tends to chronicity. Viral anterior uveitis is typically unilateral, characterized by recurrent episodes of anterior uveitis. Endotheliitis, high intraocular pressure, and patchy/sectoral iris atrophy are also present. Juvenile Idipoathic Arthritis (JIA)-associated anterior uveitis is peculiarly a bilateral non-granulomatous chronic anterior uveitis, frequently worsened by several complications.Conclusion The typology of AU influences its clinical presentation: the clinical findings can vary on the basis of its acute or chronic, granulomatous or non-granulomatous nature. Specific AU subtypes are characterized by a large number of distinct ocular signs.