Classic sarcoid associated anterior uveitis may present either as acute iridocyclitis, which is mostly seen in Lofgren's syndrome, or as a chronic granulomatous uveitis with mutton-fat keratic precipitates
Ocular findings and complications in 67 eyes clinically diagnosed with herpetic anterior uveitis Findings/complications Number (%) of eyes Granulomatous keratic precipitates
55 (82.2%) Corneal involvement 42 (62.6%) Iris atrophy [+ or -] transillumination 28 (41.7%) Transient IOP elevation 27 (40.2%) Pupil distortion without synechia 24 (35.8%) Posterior synechia 9 (13.4%) Permanent IOP elevation 8 (11.9%) Posterior subcapsular cataract 7 (10.4%) IOP: Intraocular pressure Table 2.
(5) The most common ocular manifestation is uveitis, with the posterior form being more common than the anterior form, the latter of which normally appears as an iridocyclitis associated with classic, granulomatous, mutton-fat keratic precipitates
, hypopyon and posterior synechiae.
(5,9,10,11) Accordingly, cases exhibiting typically unilateral, chronic, low-grade anterior chamber reaction with varying degrees of vitreous opacity, widespread small- or medium-sized keratic precipitates
(KP) in the corneal epithelium, diffuse iris atrophy and/or heterochromia but without acute exacerbations, posterior synechiae or cystoid macular edema were clinically diagnosed with FUS.
In general, where there is unilaterally raised IOP, it is important to think of inflammation as a possible underlying cause, and so careful examination of the anterior chamber for evidence of cells/flare, old keratic precipitates
(Figure 4) and posterior synechiae is very useful.
Evaluation of corneal endothelium and keratic precipitates
by specular microscopy in anterior uveitis.
At the slit lamp, are there signs of inflammation in the anterior segment (ciliary injection, keratic precipitates
, aqueous flare and cells) that might suggest an inflammatory condition?