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Acute anterior uveitis associated with spondyloarthritis — SCE Acute Medicine MCQ

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ModerateNeurology and OphthalmologyAcute anterior uveitis associated with spondyloarthritisSCE Acute Medicine

A 27-year-old man with ankylosing spondylitis presents with acute painful red right eye and photophobia. Visual acuity is mildly reduced, pupils are irregular and there is circumlimbal injection. There is no purulent discharge. What is the most appropriate next step in management?

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Correct answer: D — Same-day ophthalmology assessment for suspected anterior uveitis

Pain, photophobia, reduced acuity, irregular pupil and ciliary injection in a patient with spondyloarthritis suggest acute anterior uveitis. Conjunctivitis usually causes discharge and less photophobia. Episcleritis is typically milder with preserved vision. Prompt slit-lamp assessment and topical steroid under ophthalmology supervision prevent complications.

Reference: NICE CKS red eye, Royal College of Ophthalmologists uveitis guidance