Uveitis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tarek Nafee, M.D. [2]

Overview

History

Obtaining a complete history is an important aspect of making a diagnosis of uveitis. It provides insight into cause, precipitating factors, and associated underlying conditions. The presence of intermittent or persistent symptoms of uveitis unilaterally or bilaterally, in addition to any of the following, is suggestive of the following most common etiologies:

  • Ankylosing spondylitis
    • Back pain that improves with exercise and worsens with rest
    • Morning stiffness
    • Lumbar pain at night
    • Pain is chronic
    • Buttock pain
  • Sarcoid uveitis
    • Fever
    • Anorexia
    • Cough
    • Shortness of breath
    • Chest pain
    • Bone and joint pain
    • Skin lesions
    • Renal abnormality or history of hypercalcemia
    • History of abnormal EKG
    • History of infertility in males
  • Juvenile idiopathic arthritis
    • Joint pain and swelling in a child for at least 6 weeks
    • Morning stiffness
    • Improvement with exercise
  • TINU syndrome
    • Fever
    • Malaise
    • Flank pain
    • Rash
    • Polyuria or oliguria
    • Gross hematuria
  • Inflammatory bowel disease
    • Hematochezia
    • History of anemia
    • Weight loss
    • Abdominal pain
    • Fever
    • Arthalgia
  • Behcet's disease
    • Patient of Mediterranean or Middle Eastern descent
    • Oral aphthous ulcers
    • Painful genital ulcers
    • Skin lesions
    • History of vascular abnormalities
    • Fever and malaise
    • Headaches
  • CMV retinitis
    • History of AIDS
    • Recent anti-retroviral therapy (ART)
    • Photopsia
  • Toxoplasmosis
    • History of AIDS or immunosuppression
    • Fever
    • Cough
    • Children born in endemic regions
  • Tuberculosis
    • Fever
    • Night sweats
    • Weight loss
    • History of chronic pulmonary infection
    • Travel to endemic regions or exposure to TB
    • History of AIDS or immunosuppression
  • Syphilis
    • History of unprotected sex
    • History of recent sexually transmitted infections
    • History of HIV infection
    • History of Substance abuse
  • Isolated uveal diseases or idiopathic (e.g., birdshot chorioretinopathy, Fuch's heterochromic uveitis ,acute posterior multifocal placoid pigment epitheliopathy, multifocal choroiditis and panuveitis, Vogt-Koyanagi-Harada syndrome, etc.)
    • Isolated symptoms of uveitis with unremarkable systemic manifestations (see below)

Symptoms

Uveitis can present unilaterally or bilaterally. Symptoms may develop acutely or indolently, and may vary depending on the underlying etiology of the uveitis. Acute uveitis attacks are more commonly symptomatic and affect the anterior chamber. Chronic, indolent courses may not present with pain or eye redness.
Common symptoms of uveitis, according to anatomic location, include:

References

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