Uveitis differential diagnosis

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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

Differential Diagnosis

Uveitis must be differentiated from other diseases that cause conjunctival injection, 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.

Differentiating Uveitis from Other Diseases

Uveitis must be differentiated from other diseases that cause conjunctival injection, pain, irritation, or visual disturbance.

Acute Angle-Closure Glaucoma
Acute Conjunctivitis
Corneal Ulceration and Ulcerative Keratitis
Corneal Abrasion
HSV Keratitis
Intraocular Foreign Body
Scleritis
Endophthalmitis
Ultraviolet Keratitis

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:

Anterior segment

Posterior segment

Lymphoma
Malignant melanoma
Multiple sclerosis
Reticulum cell sarcoma
Retinitis pigmentosa
Retinoblastoma

Differential Diagnosis of Uveitis Subtypes by Clinical Features

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
- Unilateral
  - Infectious:
  - Non-infectious:
- Bilateral
  - Infectious:
  - Non-infectious:
Chronic:

Intermediate Uveitis

Intermediate may present with unilateral or bilateral involvement. It can be differentiated according to the following etiologies:

Infectious:
Non-infectious:

Posterior Uveitis

Posterior uveitis may present with unilateral or bilateral involvement. It can be differentiated according to the following etiologies:

Infectious:
Non-infectious:

Panuveitis

Panuveitis may present with unilateral or bilateral involvement. It can be differentiated according to the following etiologies:

Infectious:
Non-infectious:

References

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