What are the recommended first-line treatments for acute anterior uveitis in adults?

Recommended first-line treatments for acute anterior uveitis in adults include:

• Immediate (same-day) ophthalmological assessment to confirm diagnosis and initiate treatment.
• Topical corticosteroids to reduce intraocular inflammation.
• Use of cycloplegic agents to relieve pain and prevent synechiae formation.
• Non-steroidal anti-inflammatory drugs (NSAIDs) may be considered adjunctively but are not first-line alone.
• Systemic treatment is generally reserved for severe or refractory cases or when associated with systemic disease.

These treatments aim to control inflammation promptly to prevent complications and preserve vision. Early specialist involvement is critical.

Note: The provided NICE guideline excerpt specifically highlights the importance of immediate ophthalmological assessment for acute anterior uveitis but does not detail pharmacological treatment protocols. However, standard UK clinical practice and NICE guidance on spondyloarthritis (which often associates with uveitis) support topical corticosteroids and cycloplegics as first-line treatments in acute anterior uveitis ².