Complications

The visual prognosis of acute anterior uveitis as commonly seen in young people is usually good unless recurrences are frequent. Chronic uveitis is more prone to complications. Secondary glaucoma can cause serious problems and a careful check on the intraocular pressure must be maintained. The rise in intraocular pressure might be due to direct obstruction of the aqueous outflow by inflammatory cells or by the presence of adhesions between the peripheral part of the iris and the posterior surface of the cornea (peripheral anterior synechiae). Sometimes, especially when treatment has been inadequate, the posterior synechiae sticking the pupil margin to the anterior surface of the lens become extensive enough to obstruct the passage of aqueous through the pupil. The iris bulges forward, giving the appearance known as iris bombe. Secondary glaucoma can also result from the use of topical steroids in predisposed individuals. Cataract is a further serious complication, which can appear after repeated attacks of anterior uveitis. It nearly always first affects the posterior subcapsular zone of the lens and, unfortunately, interferes with the vision at an early stage. Cataracts can also result from long-term use of topical or systemic steroids.

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