Uveitis physical examination

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Uveitis Microchapters


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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]


A complete medical history and comprehensive eye examination must be performed by an optometrist or ophthalmologist to properly diagnosis uveitis. Eye examination of patients with uveitis is usually remarkable for eye redness and increased or decreased intraocular pressure. Depending on the affected anatomy of the uvea, "snowbanking" or optic disc edema may be seen on dilated fundus exam, and mutton fat keratic precipitates on slit lamp test may also be appreciated.[1][2] A complete physical examination can provide insight into the cause, and associated underlying conditions.

Physical examination

A complete medical history and comprehensive eye examination must be performed by an optometrist or ophthalmologist to properly diagnosis uveitis. A thorough physical examination can provide insight into the cause, and associated underlying conditions. The following findings may be found on physical examination:[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]

Organ System Findings Suggestive of
General Appearance Ill-appearing Infectious or Inflammatory/Autoimmune etiology
Masquerade syndromes
Vital Signs Fever Infectious or Inflammatory/Autoimmune etiology
Tachycardia Infectious or Inflammatory/Autoimmune etiology
Tachypnea Infectious etiology
Skin Pallor Anemia of chronic disease from any inflammatory condition
Anemia of blood loss from inflammatory bowel disease
Skin lesions
(e.g., Erythema nodosum, Rash, etc.)
TINU syndrome
Behcet's disease
Systemic Lupus Erythematosus
Juvenile Idiopathic Arthritis
Eyes Eye redness Anterior uveitis, Panuveitis
Increased intraocular pressure Chronic anterior uveitis, Posterior, Intermediate or Panuveitis
Decreased intraocular pressure Acute anterior uveitis
"Snowbanking" on dilated fundus exam Intermediate uveitis, pars planitis
Mutton Fat keratic precipitates Granulomatous etiology (e.g., Sarcoid uveitis, Tuberculous uveitis)
Optic disc edema Posterior uveitis, panuveitis
Ears Tinnitus Multiple sclerosis, sarcoidosis
Neck Neck stiffness Ankylosing spondylitis, multiple sclerosis, seronegative spondyloarthropathies
Lungs Cough Tuberculosis, Sarcoidosis
Hemoptysis Tuberculosis, Sarcoidosis
Heart Arrhythmia Behcet's disease, Sarcoidosis, Tuberculosis
Murmur Behcet's disease, Sarcoidosis, Anemia
Abdomen Abdominal Tenderness Inflammatory bowel disease, Behcet's disease
Palpable abdominal mass Inflammatory bowel disease, Behcet's disease
Hematochezia on rectal exam Inflammatory bowel disease
Back Tenderness over lumbosacaral spine Ankylosing spondylitis
Decreased range of motion of spine Ankylosing spondylitis
Genitourinary Genital ulceration Behcet's disease
Genital warts Syphilitis uveitis
Genital vesicular lesions Herpitic uveitis
Extremities Joint stiffness and swelling Seronegative spondyloarthropathies, HLA-B27 related uveitis, Reiter's syndrome
Neurological Parasthesia Syphilis, multiple sclerosis
Gait abnormalities/Ataxia Syphilis, multiple sclerosis
Cranial nerve abnormalities Sarcoidosis, multiple sclerosis


  1. Patient Trusted Medical Information and Support (2016)http://patient.info/health/uveitis-leaflet
  2. Wyngaarden, James B.; Smith Jr., Lloyd H. (1988), Cecil Textbook Of Medicine, Philadelphia, PA: W.B. Saunders Company, pp. 2293–2294, ISBN 0-7216-1850-2
  3. Sieper J, van der Heijde D, Landewé R, Brandt J, Burgos-Vagas R, Collantes-Estevez E; et al. (2009). "New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS)". Ann Rheum Dis. 68 (6): 784–8. doi:10.1136/ard.2008.101501. PMID 19147614.
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  5. National Heart, Lung, and Blood Institute - National Institiute of Health (2013)www.nhlbi.nih.gov/health/health-topics/sarc/signs
  6. Wallace CA (2006). "Current management of juvenile idiopathic arthritis". Best Pract Res Clin Rheumatol. 20 (2): 279–300. doi:10.1016/j.berh.2005.11.008. PMID 16546057.
  7. Sullivan KE (2007). "Inflammation in juvenile idiopathic arthritis". Rheum Dis Clin North Am. 33 (3): 365–88. doi:10.1016/j.rdc.2007.07.004. PMID 17936170.
  8. Baldwin DS, Levine BB, McCluskey RT, Gallo GR (1968). "Renal failure and interstitial nephritis due to penicillin and methicillin". N Engl J Med. 279 (23): 1245–52. doi:10.1056/NEJM196812052792302. PMID 4176988.
  9. Koike K, Lida S, Usui M, Matsumoto Y, Fukami K, Ueda S; et al. (2007). "Adult-onset acute tubulointerstitial nephritis and uveitis with Fanconi syndrome. Case report and review of the literature". Clin Nephrol. 67 (4): 255–9. PMID 17474563.
  10. Igarashi T, Kawato H, Kamoshita S, Nosaka K, Seiya K, Hayakawa H (1992). "Acute tubulointerstitial nephritis with uveitis syndrome presenting as multiple tubular dysfunction including Fanconi's syndrome". Pediatr Nephrol. 6 (6): 547–9. PMID 1482643.
  11. Mekhjian HS, Switz DM, Melnyk CS, Rankin GB, Brooks RK (1979). "Clinical features and natural history of Crohn's disease". Gastroenterology. 77 (4 Pt 2): 898–906. PMID 381094.
  12. Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR; et al. (2005). "Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology". Can J Gastroenterol. 19 Suppl A: 5A–36A. PMID 16151544.
  13. Farmer RG, Hawk WA, Turnbull RB (1975). "Clinical patterns in Crohn's disease: a statistical study of 615 cases". Gastroenterology. 68 (4 Pt 1): 627–35. PMID 1123132.
  14. Zouboulis CC, Vaiopoulos G, Marcomichelakis N, Palimeris G, Markidou I, Thouas B; et al. (2003). "Onset signs, clinical course, prognosis, treatment and outcome of adult patients with Adamantiades-Behçet's disease in Greece". Clin Exp Rheumatol. 21 (4 Suppl 30): S19–26. PMID 14727454.
  15. Riethmüller G, Rieber EP, Kiefersauer S, Prinz J, van der Lubbe P, Meiser B; et al. (1992). "From antilymphocyte serum to therapeutic monoclonal antibodies: first experiences with a chimeric CD4 antibody in the treatment of autoimmune disease". Immunol Rev. 129: 81–104. PMID 1464423.
  16. Treudler R, Orfanos CE, Zouboulis CC (1999). "Twenty-eight cases of juvenile-onset Adamantiades-Behçet disease in Germany". Dermatology. 199 (1): 15–9. doi:18197 Check |doi= value (help). PMID 10449951.
  17. Karincaoglu Y, Borlu M, Toker SC, Akman A, Onder M, Gunasti S; et al. (2008). "Demographic and clinical properties of juvenile-onset Behçet's disease: A controlled multicenter study". J Am Acad Dermatol. 58 (4): 579–84. doi:10.1016/j.jaad.2007.10.452. PMID 18045733.
  18. American Academy of Ophthalmology EyeWiki TB Uveitis (2015)http://eyewiki.aao.org/Tuberculosis_Uveitis
  19. American Academy of Ophthalmology EyeWiki Syphilitic Uveitis (2015)http://eyewiki.aao.org/Syphilitic_Uveitis
  20. Jacobson MA, Zegans M, Pavan PR, O'Donnell JJ, Sattler F, Rao N; et al. (1997). "Cytomegalovirus retinitis after initiation of highly active antiretroviral therapy". Lancet. 349 (9063): 1443–5. doi:10.1016/S0140-6736(96)11431-8. PMID 9164318.
  21. Hodge WG, Boivin JF, Shapiro SH, Lalonde RG, Shah KC, Murphy BD; et al. (2004). "Clinical risk factors for cytomegalovirus retinitis in patients with AIDS". Ophthalmology. 111 (7): 1326–33. doi:10.1016/j.ophtha.2004.03.001. PMID 15234132.

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