Clinical features

Presentation is variable so that it is useful to approach the condition in terms of specific features to consider.

• reduced visual acuity - always present
• pain - present in syphilis, endogenous bacterial infection, and conditions involving the optic nerve. Usually absent in toxoplasmosis, toxocariasis and CMV retinitis.
• redness of the eye - present in diffuse uveitis; absent in toxoplasmosis or histoplasmosis
• unilateral involvement - more likely to be due to toxoplasmosis, candidiasis, toxocariasis, CMV, or endogenous bacterial infection
• hypopyon in the anterior uvea - in conditions such as Behcet's disease, toxocariasis, and endogenous bacterial infection
• mutton fat keratitic precipitates - in conditions such as sarcoidosis, tuberculosis, toxoplasmosis, and syphilis
• glaucoma - may develop in toxoplasmosis, tuberculosis, and sarcoidosis
• inflammatory changes in the vitreous humour - severe in Behcet's disease and toxoplasmosis
• retinal involvement - retinitis is often more prominent than choroiditis in toxoplasmosis, CMV, herpes, and rubella
• choroid involvement - choroiditis is the primary target of tuberculosis and Lyme disease
• mode of onset - toxoplasmosis, CMV and bacterial infections are likely to present with sudden onset; other causes are usually more insidious