Important distinguishing features of uveitis, scleritis and episcleritis
| Condition | Location of inflammation | Key symptoms | Examination findings | Causes/associations |
|---|---|---|---|---|
| Anterior uveitis | Anterior chamber, iris and ciliary body | Pain; photophobia; blurred vision; watering | Conjunctival hyperaemia; AC cells; posterior synechiae; hypopyon | Idiopathic; non-infectious, eg HLA-B27 arthropathies, JIA, sarcoidosis; infectious, eg syphilis, viral, TB |
| Intermediate uveitis | Vitreous | Floaters; blurred vision | Vitreous cells; vitreous haze | Idiopathic; non-infectious, eg sarcoidosis, MS, lymphoma; infectious, eg post-operative endophthalmitis, Lyme disease |
| Posterior uveitis | Retina and choroid | Blurred vision; distortion; field defects; floaters | Retinal and choroidal inflammation; retinal vasculitis and haemorrhages; retinal detachment; optic disc swelling | Idiopathic; non-infectious, eg sarcoidosis, Behcet's disease; infectious, eg TB, viral, toxoplasma, syphilis, candidiasis; neoplastic |
| Scleritis | Sclera | Severe pain, worse on eye movement and palpation; photophobia; watering; loss of vision | Diffuse or localised redness; does not blanch with phenylephrine; blue tinge if scleral thinning | Idiopathic; rheumatoid arthritis; SLE; vasculitis eg GPA; PAN |
| Episcleritis | Episclera | Discomfort; watering | Localised injection; blanches with phenylephrine; VA usually normal | Idiopathic; rheumatoid arthritis; SLE; vasculitis eg GPA; PAN |
GPA = granulomatosis with polyangiitis; JIA = juvenile idiopathic arthritis; MS = multiple sclerosis; PAN = polyarteritis nodosa; SLE = systemic lupus erythematosus; TB = tuberculosis.