# Uveitis > Uveitis for MBBS Ophthalmology: anterior, intermediate and posterior types, keratic precipitates, synechiae, toxoplasmosis and sympathetic ophthalmia. - Canonical URL: https://prepelephant.com/topics/mbbs/ophthalmology/uveitis - Exam / course: MBBS · Subject: Ophthalmology - Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team - First published: 2026-10-02 - Last updated: 2026-10-02 - How to cite: "Uveitis", PrepElephant, https://prepelephant.com/topics/mbbs/ophthalmology/uveitis ## Direct answer Uveitis is inflammation of the uveal tract — iris, ciliary body and choroid — classified anatomically into anterior (iritis and iridocyclitis), intermediate, posterior and panuveitis. Acute anterior uveitis presents with a painful red eye, photophobia and blurred vision; the slit lamp shows keratic precipitates, cells and flare in the anterior chamber, and untreated inflammation leads to posterior synechiae, cataract, glaucoma and cystoid macular oedema. Treatment rests on cycloplegics and topical corticosteroids after a cause has been sought, since uveitis accompanies systemic diseases from tuberculosis and sarcoidosis to HLA-B27 spondyloarthropathy. ## What you must remember - **Symptoms and signs of anterior uveitis:** ciliary congestion, pain radiating to brow and temple, photophobia, lacrimation and blurred vision; the pupil is small and irregular once synechiae form. - **Slit lamp findings:** keratic precipitates — fine and white in non-granulomatous disease, mutton-fat and greasy in granulomatous disease — plus aqueous cells and flare, hypopyon in severe cases, and fibrin; Koeppe nodules at the pupil margin suggest granulomatous inflammation. - **Complications:** posterior synechiae and seclusio pupillae, iris bombe with angle closure, complicated cataract, secondary glaucoma, cystoid macular oedema, band-shaped keratopathy in chronic disease, and eventual phthisis bulbi. - **Intermediate uveitis:** inflammation centred on the pars plana, presenting with floaters and blurred vision in young adults; snowball opacities and snowbanking over the inferior pars plana are characteristic; macular oedema decides treatment. - **Posterior uveitis patterns:** toxoplasmic retinochoroiditis is a fluffy white focus beside an old pigmented scar; cytomegalovirus retinitis in acquired immunodeficiency gives haemorrhagic necrotic retina; Vogt-Koyanagi-Harada disease adds meningism, tinnitus and sunset-glow fundus. - **Sympathetic ophthalmia:** bilateral granulomatous panuveitis appearing after penetrating injury or surgery to the other eye, usually within weeks to months, with Dalen-Fuchs nodules; prevented by enucleation of a hopelessly blind injured eye early, and treated with systemic steroids and immunosuppressants. - **Principles of management:** search the cause (tuberculin test, chest radiograph, syphilis and sarcoid serology, HLA-B27 where relevant), treat with cycloplegics such as atropine to relieve spasm and prevent synechiae, and topical or systemic steroids tailored to severity, with specific antimicrobial cover when infection drives the inflammation. ## Common confusion The classic trap is calling acute anterior uveitis conjunctivitis because both are red eyes — but uveitis has ciliary injection, severe photophobia, a small sluggish pupil and no discharge, while vision is reduced; the pattern of redness and the pupil settle the question in seconds. Next, do not label every white dot in the anterior chamber pus: cells and flare indicate active inflammation, whereas settled hypopyon with a quiet eye may be sterile. Distinguish papillitis from uveitis involving the posterior segment by the absence of pain and the presence of disc swelling, and remember that in India tuberculosis and toxoplasmosis justify aggressive investigation before labelling any uveitis idiopathic. ## Exam-focused takeaway In theory, prepare the anatomical classification, signs of anterior uveitis, complications and a short note on sympathetic ophthalmia, which is asked with uncanny regularity. In viva, expect the differences between granulomatous and non-granulomatous keratic precipitates, the reason cycloplegics are given, and the timing and prevention of sympathetic ophthalmia. In the posting, attempt slit lamp examination of every suspected uveitis, follow the pupil before and after dilatation for synechiae, and link each case to its systemic work-up — that habit turns a red eye into internal medicine. ## Frequently asked questions ### What are keratic precipitates and what do their types indicate? Clusters of inflammatory cells on the corneal endothelium; fine white deposits typify non-granulomatous uveitis, while large mutton-fat deposits indicate granulomatous disease such as tuberculosis or sarcoidosis. ### Why are cycloplegics essential in anterior uveitis? They abolish ciliary spasm and pain, prevent formation of posterior synechiae by keeping the pupil mobile, and break fresh synechiae, so atropine or homatropine accompanies steroid therapy. ### What is the clinical picture of sympathetic ophthalmia? Bilateral granulomatous panuveitis with Dalen-Fuchs nodules following penetrating trauma or surgery to the fellow eye, typically developing between two weeks and a few months after injury. ### How does toxoplasmic retinochoroiditis appear? A fluffy yellow-white active retinitis adjacent to an old pigmented scar, the so-called headlight in the fog, often with severe vitritis in congenital recurrence. ### What is snowbanking? A white exudative plaque over the inferior pars plana in intermediate uveitis, with snowball vitreous opacities, floaters and macular oedema as presenting features. ### Which complications decide the visual outcome of uveitis? Cystoid macular oedema is the chief cause of permanent visual loss, followed by complicated cataract, secondary glaucoma and hypotony leading to phthisis bulbi.