Difference Of Anterior Uveitis from Intermediate Uveitis

Anterior uveitis and intermediate uveitis are two different types of uveitis, which refer to inflammation of the uveal tract in the eye. The uveal tract includes the iris, ciliary body, and choroid, but these types of uveitis affect different parts of the uveal tract, leading to distinct clinical features, causes, and treatment strategies. Below is a comparison of the two:

1. Location of Inflammation:

• Anterior Uveitis:
  • Involves inflammation in the anterior (front) part of the eye, primarily affecting the iris and the anterior chamber (the space between the cornea and the iris).
  • It is often referred to as iritis when the inflammation is confined to the iris.
• Intermediate Uveitis:
  • Affects the middle portion of the eye, specifically the ciliary body and the vitreous (the gel-like substance inside the eye).
  • This form of uveitis is often more challenging to detect because it involves deeper structures.

2. Symptoms:

• Anterior Uveitis:
  • Eye pain (often severe)
  • Redness (due to increased blood flow to the iris)
  • Photophobia (sensitivity to light)
  • Blurred vision (may be due to cells and protein in the anterior chamber)
  • Tearing (due to irritation)
• Intermediate Uveitis:
  • Floaters (spots or cobweb-like shapes floating in the vision)
  • Blurred vision (due to inflammation in the vitreous)
  • Mild or no pain (pain is less common than in anterior uveitis)
  • Decreased vision may occur gradually if the inflammation affects the retina or optic nerve.
  • Light sensitivity may be present but is often less severe than in anterior uveitis.

3. Causes:

• Anterior Uveitis:
  • Often associated with autoimmune conditions (e.g., ankylosing spondylitis, juvenile idiopathic arthritis, and Behçet’s disease).
  • Infections (e.g., herpes simplex virus, tuberculosis, or syphilis) can also cause anterior uveitis.
  • It may also be idiopathic (unknown cause).
• Intermediate Uveitis:
  • Frequently linked to autoimmune diseases such as multiple sclerosis (MS), sarcoidosis, or juvenile idiopathic arthritis (JIA).
  • It can also be caused by infections (e.g., toxoplasmosis, herpes, or tuberculosis).
  • Like anterior uveitis, it can also be idiopathic.

4. Diagnosis:

• Anterior Uveitis:
  • Diagnosis is often made through a clinical exam using a slit lamp, which can show characteristic signs of inflammation in the anterior chamber (e.g., cells and flare).
  • Pupillary reaction (sluggish or painful response) is also a typical finding.
• Intermediate Uveitis:
  • Diagnosed through a slit-lamp exam to look for inflammation in the vitreous (which may appear as “cells” floating in the vitreous).
  • Fluorescein angiography or optical coherence tomography (OCT) may be used to evaluate retinal involvement.
  • Blood tests may be performed to check for underlying systemic conditions.

5. Treatment:

• Anterior Uveitis:
  • Topical corticosteroids (eye drops) are commonly used to reduce inflammation in the anterior chamber.
  • Pupillary dilators (mydriatics) are used to relieve pain, prevent synechiae (adhesion of the iris to the lens), and reduce the risk of complications.
  • If the inflammation is more severe, oral steroids or immunosuppressive drugs may be needed.
• Intermediate Uveitis:
  • Oral corticosteroids (systemic steroids) are often necessary because the inflammation affects deeper structures of the eye.
  • Immunosuppressive agents (e.g., methotrexate, azathioprine) may be prescribed for long-term management if the condition is recurrent or resistant to treatment.
  • In some cases, biologic drugs (e.g., TNF inhibitors) may be used if the condition is related to autoimmune diseases.

6. Prognosis:

• Anterior Uveitis:
  • With proper treatment, the prognosis is generally good, although recurrent episodes may occur, and chronic cases can lead to complications such as cataracts or glaucoma.
• Intermediate Uveitis:
  • The prognosis can be more variable. Chronic or severe cases may lead to complications such as cataracts, retinal damage, macular edema, or glaucoma.
  • It may require long-term treatment and monitoring to prevent permanent vision loss.

Summary of Key Differences:

This is for informational purposes only. For medical advice or diagnosis, consult a professional.
It’s important to have your eyes checked regularly by a qualified eye care professional. 

Each form of uveitis requires careful evaluation and treatment by an eye care professional to prevent complications and preserve vision.