Gout rarely can be associated with anterior uveitis and has been mentioned by Duke-Elder as a cause of hemorrhagic iritis. Scleritis and tenonitis also have been described. In addition to the cornea, urate crystals have been described clinically in the lens and sclera and on postmortem examination in the tarsal cartilage and in the tendons of extraocular muscles. Attacks are caused by the deposition of monosodium urate monohydrate within the joint space. Precipitating factors can include emotional stress, dehydration, surgery, and thiazide diuretics.
Attacks tend to be recurrent and usually are self-limited.
Recurrent attacks of acute gouty arthritis can result in chronic arthritis with limitation of joint mobility. Uric acid levels may be elevated as a result of primary gout. It is an autosomal dominant error of metabolism. It can occur secondarily from increased production of uric acid or decreased excretion of uric acid. The latter is seen in chronic renal disease.