Uveitis, Episcleritis & Scleritis
Localise ocular inflammation and identify painful presentations requiring specialist assessment.
Quick revision ↓ Medical Dictionary
01Anterior uveitis
Inflammation in the anterior uvea can cause pain, photophobia and blurred vision with circumcorneal redness. Slit-lamp examination may show cells and flare in the anterior chamber. The pupil can be small or irregular from adhesions. Arrange prompt ophthalmic assessment because complications and alternative diagnoses require evaluation rather than treatment based on redness alone.
02Posterior involvement
Intermediate or posterior inflammation may present with floaters or visual loss and relatively little redness. Examine the posterior segment through the appropriate specialist pathway. Infection, immune-mediated disease and other causes have different treatments. The absence of severe pain does not exclude clinically important inflammation affecting the vitreous, retina or choroid.
03Systemic associations
Ask about recurrent episodes, back or joint symptoms, skin disease, bowel symptoms, infection exposure and relevant medicines. Testing should be guided by phenotype and clinical suspicion rather than an indiscriminate panel for every patient. Coordination with other specialties may be needed, while some cases remain idiopathic despite an appropriate assessment.
04Episcleral versus scleral disease
Episcleritis often causes a limited red patch and relatively mild discomfort with preserved vision. Scleritis tends to cause deeper severe pain and can be associated with systemic inflammatory disease or infection. Pain on movement, nocturnal pain or visual change increases concern. Clinical uncertainty should lead to assessment rather than reassurance based on the redness pattern alone.
05Treatment and monitoring
Uveitis treatment may include anti-inflammatory and pupil-relaxing medicines chosen by an ophthalmologist after excluding relevant infection. Monitor pressure, inflammation and complications such as cataract or macular oedema. Follow the prescribed taper and review schedule. Recurrence, treatment toxicity and systemic disease require continuing attention even if discomfort resolves quickly.
High-Yield Revision
- Posterior inflammation may have little external redness.
- Severe deep pain suggests more than simple episcleritis.
- Inflammation and treatment can both affect eye pressure.
Common Pitfalls
- Ordering identical broad tests for every uveitis presentation.
- Stopping follow-up when pain alone improves.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.