Ankylosing spondylitis, a common cause of anterior uveitis, frequently produces eye pain, redness, photophobia, and decreased vision, usually in one eye. Men are affected more commonly than women. Episodes of inflammation require treatment with local corticosteroids and cycloplegics. Juvenile rheumatoid arthritis, particularly the pauciarticular variety, characteristically causes chronic bilateral iridocyclitis. However, unlike most anterior uveitides, juvenile rheumatoid arthritis typically does not produce pain, photophobia, and conjunctival injection and has, therefore, been called the white iritis.
Inflammatory exacerbations require treatment with local corticosteroids and cycloplegics.
Typical ocular findings include severe anterior uveitis with hypopyon, retinal vasculitis, and optic nerve inflammation. The clinical course is usually severe, with multiple recurrences. Oral aphthae may be biopsied to demonstrate an occlusive vasculitis. Treatment with local and systemic corticosteroids along with cycloplegics may alleviate intraocular inflammation. However, most patients eventually require additional potent immunosuppressive drugs such as cyclosporine or chlorambucil, both to control the inflammation and to avoid the serious complications of long-term corticosteroid treatment.