|
|
| (9 intermediate revisions by 4 users not shown) |
| Line 10: |
Line 10: |
| | | |
| === 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]].<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> | | 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 === |
| Line 31: |
Line 32: |
| :* [[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]] |
| | | :*[[Syphilis]] |
| === 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]], [[eye 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:<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>
| |
| * '''Acute''' (>3 months of active symptoms)<ref name="pmid10688564">{{cite journal| author=McCluskey PJ, Towler HM, Lightman S| title=Management of chronic uveitis. | journal=BMJ | year= 2000 | volume= 320 | issue= 7234 | pages= 555-8 | pmid=10688564 | doi= | pmc=1117601 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10688564 }} </ref> | |
| ** '''''Unilateral'''''
| |
| *** ''Infectious'': [[Cytomegalovirus]], [[Herpes simplex]], [[Varicella zoster]], [[Syphilis]]
| |
| *** ''Non-infectious'': [[seronegative spondyloarthropathy]], [[relapsing polychondritis]], [[systemic lupus erythematosus]] (SLE), [[Kawasaki disease]]
| |
| ** '''''Bilateral'''''
| |
| *** ''Infectious'': [[Tuberculosis]], [[Syphilils]]
| |
| *** ''Non-infectious'': [[tubulointerstitial nephritis]] with uveitis (TINU syndrome)
| |
| * '''Chronic''' (>3 months of active symptoms)<ref name="pmid10688564">{{cite journal| author=McCluskey PJ, Towler HM, Lightman S| title=Management of chronic uveitis. | journal=BMJ | year= 2000 | volume= 320 | issue= 7234 | pages= 555-8 | pmid=10688564 | doi= | pmc=1117601 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10688564 }} </ref>
| |
| ** ''Infectious'': [[Tuberculosis]]
| |
| ** ''Non-infectious'': [[juvenile idiopathic arthritis]], [[Sjorgen's Syndrome]], [[sarcoidosis]]
| |
| ==== Intermediate Uveitis ====
| |
| Intermediate may present with unilateral or [[bilateral]] involvement. It can be differentiated according to the following [[etiology|etiologies]]:<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>
| |
| * ''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 most common [[etiology|etiologies]]:<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>
| |
| * ''Infectious'': [[Toxoplasmosis]], [[Cytomegalovirus]], [[Tuberculosis]], [[Syphilis]], [[Toxocariasis]], [[Herpes simplex]], [[Varicella zoster]], [[cat scratch disease]]
| |
| * ''Non-infectious'':[[Vogt-Koyanagi-Harada syndrome]], [[systemic lupus erythematosus]], [[http://www.wikidoc.org/index.php/Wegeners_granulomatosis|granulomatosis with polyangitis]], [[Behcet's disease]], [[birdshot chorioretinopathy]], [[lymphoma]]
| |
| | |
| ==== Panuveitis ====
| |
| Panuveitis may present with unilateral or [[bilateral]] involvement. It can be differentiated according to the following most common [[etiology|etiologies]]:<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>
| |
| * ''Infectious'': [[Tuberculosis]], [[Syphilis]]
| |
| * ''Non-infectious'': [[juvenile idiopathic arthritis]], [[Behcet's disease]], [[sarcoidosis]], [[Vogt-Koyanagi-Harada syndrome]], [[Sjorgen's Syndrome]]
| |
|
| |
|
| == References == | | == References == |
|
| |
| {{Reflist|2}} | | {{Reflist|2}} |
|
| |
|
| | {{WH}} |
| | {{WS}} |
|
| |
|
| [[Category:Ophthalmology]] | | [[Category:Ophthalmology]] |
| [[Category:Primary care]] | | [[Category:FinalQCRequired]] |
| | | [[Category:Emergency mdicine]] |
| {{WH}}
| | [[Category:Disease]] |
| {{WS}}
| | [[Category:Up-To-Date]] |
| | [[Category:Infectious disease]] |
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]
References
Template:WH
Template:WS