Description

🎧MSRA Deep Dive: AcuteIritis (Anterior Uveitis)

Suddenpainful red eye? Blurred vision? Sensitivity to light? 🚨 Let’s break down one of the most tested ophthalmology topics for theMSRA: acute iritis, also known as anterior uveitis.

In this episode, wecover everything you need to know in a concise, high-yield format perfect forfast revision — or helping a patient in clinic. Get the essential facts,mnemonics, red flags, and NICE-aligned management steps all in one go.

🧠Core Learning Points

📌Definition

• Acute iritis = inflammation of the anterior uveal tract (iris + ciliary body)
• Most common type of uveitis
• Rapid onset (within hours–days)

📌Symptoms

🔺 Painful red eye

🔺 Photophobia (light sensitivity)

🔺 Blurred vision

🔺 Watery eye, no discharge

🔺 Usually unilateral

📝Mnemonic: PURR

Painful red eye

Unilateral

Reduced vision

Reaction to light

📌Differentials to RuleOut

• 🌫️ Conjunctivitis – itchy, gritty, sticky discharge
• 🌈 Acute angle closure glaucoma – severe pain, halos, vomiting, firm eye
• 🌊 Keratitis – corneal damage
• 🧠 Posterior/Intermediate/Pan-uveitis – different ocular zones

📌Causes

🔹 Idiopathic (most common)

🔹Autoimmune diseases:

• Ankylosing spondylitis
• Reactive arthritis
• Psoriatic arthritis
• IBD (Crohn’s/UC)
  🔹 Infections: HSV, TB, syphilis, HIV
  🔹 Trauma or post-op
  🔹 HLA-B27 associated (↑ risk)

📌Investigations

🧪Slit lamp exam – shows cells & protein flare in anteriorchamber

📏 Check intraocular pressure (to exclude secondaryglaucoma)

🧬 Bloods if: recurrent, bilateral, systemic symptoms

• HLA-B27
• ESR/CRP
• Autoimmune panel
  🩻 Chest X-ray – if sarcoidosis/TB suspected

📌Management

💧Topicalcorticosteroids (e.g. prednisolonedrops) – reduce inflammation

💧Cycloplegic drops (e.g. atropine) – dilate pupil, reduce pain &prevent synechiae

📉IOP-lowering drops – if raised pressure

📅 Taper steroids over 6+ weeks

🔁 Regular follow-up to prevent complications

📌Complications

🚨 Posterior synechiae (iris sticking to lens)

🚨 Secondary glaucoma

🚨 Cataracts (from inflammation/steroids)

🚨 Chronic uveitis or vision loss (if not treated)

📌Prognosis

👍 Excellent with prompt treatment

⚠️ Risk of recurrence (especially in HLA-B27+)

🩺 Long-term follow-up often needed

💡Patient Tips

• Don’t drive if vision is affected
• Stick to prescribed drop regimen
• Seek help quickly for any return of symptoms

📚Useful MSRA Resources– Acute Iritis

📄 Revision Notes:

https://www.passthemsra.com/topic/anterior-uveitis-revision-notes/

🧠 Flashcards:

https://www.passthemsra.com/topic/anterior-uveitis-iritis-flashcards/

💬 Accordion Q&A:

https://www.passthemsra.com/topic/anterior-uveitis-accordion-qa-notes/

🚀 Rapid Quiz:

https://www.passthemsra.com/topic/anterior-uveitis-rapid-quiz/

🧪 Quiz link:

https://www.passthemsra.com/quizzes/acute-iritis/

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