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== Overview ==
== Overview ==
Uveitis must be differentiated from other diseases that cause [[conjunctival injection]], [[eye pain]], [[photophobia]], or [[visual disturbance]]. Masquerade syndromes, which are ophthalmic disorders that clinically present as either an anterior or posterior uveitis but are not primarily inflammatory, must be differentiated from uveitis. As uveitis manifests in a variety of clinical etiologies, differentiation must also be established in accordance with the particular subtype.<ref name="pmid26187650">{{cite journal| author=Prior-Español Á, Martínez-Morillo M, Holgado-Pérez S, Juega FJ| title=Differential diagnosis of acute bilateral uveitis in the rheumatologist's office. | journal=Reumatol Clin | year= 2016 | volume= 12 | issue= 3 | pages= 174-175 | pmid=26187650 | doi=10.1016/j.reuma.2015.05.012 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26187650  }} </ref><ref name="pmid20943722">{{cite journal| author=Guly CM, Forrester JV| title=Investigation and management of uveitis. | journal=BMJ | year= 2010 | volume= 341 | issue=  | pages= c4976 | pmid=20943722 | doi=10.1136/bmj.c4976 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20943722  }} </ref><ref name=eyewikiuveitis>American Academy of Ophthalmology EyeWiki (2015)http://eyewiki.aao.org/Category:Uveitis</ref><ref name="pmid11158819">{{cite journal| author=Rothova A, Ooijman F, Kerkhoff F, Van Der Lelij A, Lokhorst HM| title=Uveitis masquerade syndromes. | journal=Ophthalmology | year= 2001 | volume= 108 | issue= 2 | pages= 386-99 | pmid=11158819 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11158819  }} </ref>


== Differential Diagnosis ==
== Differential Diagnosis ==
Uveitis must be differentiated from other diseases that cause [[conjunctival injection]], [[eye pain]], [[photophobia]], or [[visual disturbance]]. [[Masquerade syndromes]], which are ophthalmic disorders that clinically present as either an anterior or posterior uveitis but are not primarily inflammatory, must be differentiated from uveitis. As uveitis manifests in a variety of clinical etiologies, differentiation must also be established in accordance with the particular subtype.
Uveitis must be differentiated from other diseases that cause [[conjunctival injection]], [[eye pain]], [[photophobia]], or [[visual disturbance]]. Masquerade syndromes, which are ophthalmic disorders that clinically present as either an anterior or posterior uveitis but are not primarily inflammatory, must be differentiated from uveitis. As uveitis manifests in a variety of clinical etiologies, differentiation must also be established in accordance with the particular subtype.<ref name="pmid26187650">{{cite journal| author=Prior-Español Á, Martínez-Morillo M, Holgado-Pérez S, Juega FJ| title=Differential diagnosis of acute bilateral uveitis in the rheumatologist's office. | journal=Reumatol Clin | year= 2016 | volume= 12 | issue= 3 | pages= 174-175 | pmid=26187650 | doi=10.1016/j.reuma.2015.05.012 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26187650  }} </ref><ref name="pmid20943722">{{cite journal| author=Guly CM, Forrester JV| title=Investigation and management of uveitis. | journal=BMJ | year= 2010 | volume= 341 | issue=  | pages= c4976 | pmid=20943722 | doi=10.1136/bmj.c4976 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20943722  }} </ref><ref name=eyewikiuveitis>American Academy of Ophthalmology EyeWiki (2015)http://eyewiki.aao.org/Category:Uveitis</ref><ref name="pmid11158819">{{cite journal| author=Rothova A, Ooijman F, Kerkhoff F, Van Der Lelij A, Lokhorst HM| title=Uveitis masquerade syndromes. | journal=Ophthalmology | year= 2001 | volume= 108 | issue= 2 | pages= 386-99 | pmid=11158819 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11158819  }} </ref>
   
   
=== Differentiating Uveitis from Other Diseases ===
=== Differentiating Uveitis from Other Diseases ===
Uveitis must be differentiated from other diseases that cause [[conjunctival injection]], [[eye pain]], [[photophobia]], or [[visual disturbance]].
Uveitis must be differentiated from other diseases that cause [[conjunctival injection]], [[eye pain]], [[photophobia]], or [[visual disturbance]], and include:<ref name="pmid3099921">{{cite journal| author=Dart JK| title=Eye disease at a community health centre. | journal=Br Med J (Clin Res Ed) | year= 1986 | volume= 293 | issue= 6560 | pages= 1477-80 | pmid=3099921 | doi= | pmc=1342247 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3099921  }} </ref><ref name="pmid10922425">{{cite journal| author=Leibowitz HM| title=The red eye. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 5 | pages= 345-51 | pmid=10922425 | doi=10.1056/NEJM200008033430507 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10922425  }} </ref><ref name=umichredeye>University of Michigan Eyes Have it (2009)http://kellogg.umich.edu/theeyeshaveit/red-eye/</ref>
* Acute [[closed angle glaucoma]]
* Corneal ulceration
* Acute [[conjunctivitis]]
* [[Conjunctivitis]]
* [[Corneal ulceration]] and [[Ulcerative keratitis]]
* [[Closed angle glaucoma]]
* [[Corneal abrasion]]
* [[Corneal abrasion]]
* [[HSV keratitis]]
* [[Ulcerative keratitis]]
* Herpes keratitis
* Intraocular [[foreign body]]
* Intraocular [[foreign body]]
* [[Scleritis]]
* [[Episcleritis]] or [[scleritis]]
* [[Endophthalmitis]]
* [[Endophthalmitis]]
* Ultraviolet [[keratitis]]
* Radiation-induced [[keratitis]]
 
=== Masquerade syndromes ===
=== Masquerade syndromes ===
[[Masquerade syndromes]] are ophthalmic disorders that clinically present as either an anterior or posterior uveitis, but are not primarily inflammatory. The following are some of the most common:
Masquerade syndromes are ophthalmic disorders that clinically present as either an anterior or posterior uveitis, but are not primarily inflammatory. The following are some of the most common:<ref name="pmid11158819">{{cite journal| author=Rothova A, Ooijman F, Kerkhoff F, Van Der Lelij A, Lokhorst HM| title=Uveitis masquerade syndromes. | journal=Ophthalmology | year= 2001 | volume= 108 | issue= 2 | pages= 386-99 | pmid=11158819 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11158819  }} </ref>
* '''Anterior segment'''
* '''Anterior segment'''
:* Intraocular [[foreign body]]
:* Intraocular [[foreign body]]
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:* [[Retinal detachment]]
:* [[Retinal detachment]]
* '''Posterior segment'''
* '''Posterior segment'''
:* Lymphoma
:* [[Lymphoma]]
:* [[Malignant]] [[melanoma]]
:* [[Malignant]] [[melanoma]]
:* [[Multiple sclerosis]]
:* [[Multiple sclerosis]]
:* [[Reticulum cell]] [[sarcoma]]
:* Reticulum cell [[sarcoma]]
:* [[Retinitis pigmentosa]]
:* [[Retinitis pigmentosa]]
:* [[Retinoblastoma]]
:* [[Retinoblastoma]]
=== Differential Diagnosis of Uveitis Subtypes by Clinical Features ===
:*[[Syphilis]]
As uveitis manifests in a variety of clinical etiologies, differentiation must also be established in accordance with the particular subtype. Etiologies of acute anterior unilateral infectious uveitis must be differentiated from  other subtypes that cause conjuctival injection, pain, and photophobia, such as acute anterior bilateral non-infectious uveitis or chronic anterior uveitis. Diversely, posterior infectious uveitis must be differentiated from other subtypes that cause visual changes, such as intermediate non-infectious uveitis and infectious panuveitis.
==== Anterior Uveitis ====
Anterior uveitis can be differentiated according to the following presentation:
* '''Acute''' (>3 months of active symptoms)
** '''''Unilateral'''''
*** ''Infectious'': [[Cytomegalovirus]], [[Herpes simplex]], [[Varicella zoster]]
*** ''Non-infectious'': [[seronegative spondyloarthropathy]], [[relapsing polychondritis]], [[systemic lupus erythematosus]] (SLE), [[Kawasaki disease]]
** '''''Bilateral'''''
*** '''''Infectious''''':
*** ''Non-infectious'': [[tubulointerstitial nephritis]] with uveitis (TINU syndrome)
* '''Chronic''' (>3 months of active symptoms)
** ''Infectious'': [[Tuberculosis]]
** ''Non-infectious'': [[juvenile idiopathic arthritis]], [[Sjorgen syndrome]], [[sarcoidosis]]
==== Intermediate Uveitis ====
Intermediate may present with [[unilateral]] or [[bilateral]] involvement. It can be differentiated according to the following [[etiology|etiologies]]:
* ''Infectious'': [[Lyme disease]], [[Whipple's disease]]
* ''Non-infectious'': [[multiple sclerosis]], [[sarcoidosis]], [[tubulointerstitial nephritis]] with uveitis (TINU syndrome), [[lymphoma]]
==== Posterior Uveitis ====
Posterior uveitis may present with [[unilateral]] or [[bilateral]] involvement. It can be differentiated according to the following [[etiology|etiologies]]:
* ''Infectious'': [[Toxoplasmosis]], [[Cytomegalovirus]], [[Tuberculosis]], [[Syphilis]], [[Toxocariasis]], [[Herpes simplex]], [[Varicella zoster]]
* ''Non-infectious'':[[Vogt-Koyanagi-Harada syndrome]], [[systemic lupus erythematosus]], [[granulomatosis with polyangitis]], [[Behcet's disease]], [[lymphoma]]
==== Panuveitis ====
Panuveitis may present with [[unilateral]] or [[bilateral]] involvement. It can be differentiated according to the following [[etiology|etiologies]]:
* ''Infectious'': [[Tuberculosis]], [[Syphilis]]
* ''Non-infectious'': [[juvenile idiopathic arthritis]], [[Behcet's disease]], [[sarcoidosis]], [[Vogt-Koyanagi-Harada syndrome]], [[Sjorgen syndrome]]


== References ==
== References ==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 00:37, 30 July 2020

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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

Uveitis must be differentiated from other diseases that cause conjunctival injection, eye pain, photophobia, or visual disturbance. Masquerade syndromes, which are ophthalmic disorders that clinically present as either an anterior or posterior uveitis but are not primarily inflammatory, must be differentiated from uveitis. As uveitis manifests in a variety of clinical etiologies, differentiation must also be established in accordance with the particular subtype.[1][2][3][4]

Differential Diagnosis

Uveitis must be differentiated from other diseases that cause conjunctival injection, eye pain, photophobia, or visual disturbance. Masquerade syndromes, which are ophthalmic disorders that clinically present as either an anterior or posterior uveitis but are not primarily inflammatory, must be differentiated from uveitis. As uveitis manifests in a variety of clinical etiologies, differentiation must also be established in accordance with the particular subtype.[1][2][3][4]

Differentiating Uveitis from Other Diseases

Uveitis must be differentiated from other diseases that cause conjunctival injection, eye pain, photophobia, or visual disturbance, and include:[5][6][7]

Masquerade syndromes

Masquerade syndromes are ophthalmic disorders that clinically present as either an anterior or posterior uveitis, but are not primarily inflammatory. The following are some of the most common:[4]

  • Anterior segment
  • Posterior segment

References

  1. ↑ 1.0 1.1 Prior-Español Á, Martínez-Morillo M, Holgado-Pérez S, Juega FJ (2016). "Differential diagnosis of acute bilateral uveitis in the rheumatologist's office". Reumatol Clin. 12 (3): 174–175. doi:10.1016/j.reuma.2015.05.012. PMID 26187650.
  2. ↑ 2.0 2.1 Guly CM, Forrester JV (2010). "Investigation and management of uveitis". BMJ. 341: c4976. doi:10.1136/bmj.c4976. PMID 20943722.
  3. ↑ 3.0 3.1 American Academy of Ophthalmology EyeWiki (2015)http://eyewiki.aao.org/Category:Uveitis
  4. ↑ 4.0 4.1 4.2 Rothova A, Ooijman F, Kerkhoff F, Van Der Lelij A, Lokhorst HM (2001). "Uveitis masquerade syndromes". Ophthalmology. 108 (2): 386–99. PMID 11158819.
  5. ↑ Dart JK (1986). "Eye disease at a community health centre". Br Med J (Clin Res Ed). 293 (6560): 1477–80. PMC 1342247. PMID 3099921.
  6. ↑ Leibowitz HM (2000). "The red eye". N Engl J Med. 343 (5): 345–51. doi:10.1056/NEJM200008033430507. PMID 10922425.
  7. ↑ University of Michigan Eyes Have it (2009)http://kellogg.umich.edu/theeyeshaveit/red-eye/

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