Uveitis physical examination

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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]

Physical examination

A complete medical history and comprehensive eye examination must be performed by an optometrist or ophthalmologist to properly diagnosis uveitis.

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.)	Sarcoidosis 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, Tuberculosis
Abdomen	Abdominal Tenderness	Inflammatory bowel disease, Behcet's disease
	Palpable 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

Vital Signs

• Fever in infectious etiologies
• Fever in inflammatory causes
• Tachycardia

Skin

• Behcet's disease nodules
• Bacillary angiomatosis (Cat Scratch disease)

HEENT

Eyes

• Eye redness
• increased or decreased Itraocular pressure
• Mutton fat keratic precipitates
• Snowbanking
• optic disc edema

Lungs

• Sarcoidosis
• TB

Cardiovascular

• Behcet's disease

Abdomen

• Behcet's disease
• Crohn's disease
• Ulcerative colitis

Genitourinary

• Behcet's disease nodules
• Syphilitic condylomata lata
• Herpes simplex vesicular lesions

Musculoskeletal

• Arthritidies - JIA, HLA-B27
• Back stiffness - Ankylosing Spondylitis

Neurological

• Neurosyphilis
• Neurosarcoidosis