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Herpetic Anterior Uveitis — SCE Infectious Diseases MCQ

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HardInfection Prevention & ControlHerpetic Anterior UveitisSCE Infectious Diseases

A patient has unilateral hypertensive anterior uveitis with keratic precipitates and iris atrophy during a genital-HSV recurrence. Aqueous HSV PCR is negative after antiviral treatment began. Which interpretation is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Herpetic anterior uveitis remains a clinical possibility despite one negative aqueous PCR

The best answer is “Herpetic anterior uveitis remains a clinical possibility despite one negative aqueous PCR”. Viral load, sampling timing and prior treatment affect aqueous PCR sensitivity; the phenotype and specialist ophthalmic assessment determine whether repeat sampling or antiviral treatment is justified. Pain, photophobia, anterior-chamber inflammation and synechiae require urgent ophthalmic assessment; viral anterior uveitis is a clinical and laboratory synthesis and a negative PCR does not always exclude it.

Reference: Moorfields Eye Hospital guidance on uveitis: https://www.moorfields.nhs.uk/eye-conditions/uveitis