{ "schema_version": 1, "kind": "condition", "id": "anterior-uveitis", "name": "Anterior Uveitis (Iridocyclitis)", "category": "chronic", "sources": "ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class FD03.01 - condition scope only, no dose · Iritis - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK430909/ · Granulomatous Uveitis - StatPearls (NCBI Bookshelf NBK570581) - disease-level clinical article (anterior-uveitis-full.txt) · Egyptian National Drug Formulary - Endocrine System Drugs 2024, Prednisolone monograph (printed pages 169-170), ophthalmic dosing · Mydrilate 1.0% Eye Drops (cyclopentolate hydrochloride) SmPC sections 4.1, 4.2 and 4.3 (eMC product 1724) · Corneal Foreign Body - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK536977/ - for the caution against atropine as the cycloplegic · Granulomatous Uveitis - StatPearls (NCBI Bookshelf NBK570581) - disease-level clinical article (anterior-uveitis-full.txt), which gives prednisolone acetate 1% eye drops every 1 to 6 hours as often the treatment of choice for most benign or moderate anterior uveitis. · Mydrilate 1.0% Eye Drops (cyclopentolate hydrochloride) SmPC section 4.2 (eMC product 1724), which for uveitis, iritis and iridocyclitis gives one or two drops up to 4 times daily or as required. Section 4.1 names dilating the pupil in inflammatory conditions of the iris and uveal tract as an indication.", "review_status": "reviewed", "verified_against": "Anterior Uveitis (Iridocyclitis) - disease-level clinical article (anterior-uveitis-clinical.txt) · Granulomatous Uveitis - StatPearls (NCBI Bookshelf NBK570581) - disease-level clinical article (anterior-uveitis-full.txt) · Egyptian National Drug Formulary - Endocrine System Drugs 2024, Prednisolone monograph (printed pages 169-170), ophthalmic dosing · Mydrilate 1.0% Eye Drops (cyclopentolate hydrochloride) SmPC sections 4.1, 4.2 and 4.3 (eMC product 1724) · Corneal Foreign Body - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK536977/ - for the caution against atropine as the cycloplegic · Granulomatous Uveitis - StatPearls (NCBI Bookshelf NBK570581) - disease-level clinical article (anterior-uveitis-full.txt), which gives prednisolone acetate 1% eye drops every 1 to 6 hours as often the treatment of choice for most benign or moderate anterior uveitis. · Mydrilate 1.0% Eye Drops (cyclopentolate hydrochloride) SmPC section 4.2 (eMC product 1724), which for uveitis, iritis and iridocyclitis gives one or two drops up to 4 times daily or as required. Section 4.1 names dilating the pupil in inflammatory conditions of the iris and uveal tract as an indication.", "verified_date": "2026-08", "treatments": [ { "id": 201, "generic": "Prednisolone", "line": 1, "is_adjunct": false, "form": "eye", "strength_mg": null, "adult_dose": "Prednisolone acetate 1% eye drops, 1 drop every 1 to 6 hours according to how active the inflammation is, then tapered slowly. The frequency and the taper are set at the slit lamp, not in general practice.", "adult_duration": "Weeks, tapered by the ophthalmologist against slit-lamp findings; stopping early is what makes it recur", "dose_source": "Granulomatous Uveitis - StatPearls (NCBI Bookshelf NBK570581) - disease-level clinical article (anterior-uveitis-full.txt), which gives prednisolone acetate 1% eye drops every 1 to 6 hours as often the treatment of choice for most benign or moderate anterior uveitis.", "rationale": "Topical corticosteroid is the first treatment for anterior uveitis in the cached article, with systemic corticosteroid reserved for severe, posterior or bilateral disease. The strength matches what Egypt sells: eight single-ingredient prednisolone 1% eye drops, from ACETASEE at about 8 EGP to APICORTE FORTE at about 63 EGP. The steroid-plus-antibiotic combination drops on the same shelf are a different product and are not what the article specifies.", "cautions": [ "SPECIALIST-INITIATED. A steroid drop put into an undiagnosed herpetic or other infectious keratitis can blind the eye. The Egyptian formulary licenses ophthalmic prednisolone for steroid-responsive ocular inflammation only after viral, fungal and bacterial infection have been excluded, and the article warns that syphilis and tuberculosis must be ruled out first because corticosteroids alone can worsen them. That exclusion needs a slit lamp.", "Two documents give different frequencies and both are recorded rather than one being chosen: the article says every 1 to 6 hours for anterior uveitis; the Egyptian formulary's ophthalmic prednisolone entry says 1 to 2 drops 2 to 4 times daily, rising to as much as 2 drops every hour in the first 24 to 48 hours. The ophthalmologist sets which applies.", "Do not stop it abruptly. The formulary directs that therapy be withdrawn by gradual tapering in chronic conditions.", "Intraocular pressure has to be monitored while it is running - steroid-induced ocular hypertension and cataract are the two costs of this treatment, and the article asks for review every 1 to 2 weeks during the active phase.", "Pain, redness and light sensitivity with a small or irregular pupil is a same-day ophthalmology referral. Recurrent or bilateral disease needs a search for a systemic cause - sarcoidosis and tuberculosis lead that list, and tuberculosis is the commonest infectious cause worldwide, more so where it is endemic." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No weight-based dose - it is instilled, not swallowed. A child needs paediatric ophthalmology, not a GP prescription: the article records that children are more prone than adults to steroid-induced raised intraocular pressure, that about 46% of children present with established complications such as cataract and posterior synechiae, and that juvenile idiopathic arthritis needs a formal slit-lamp examination rather than vision screening.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "ACETASEE 1% EYE DROPS (SUSP.) 5 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREDNISOLONE 1% EYE DROPS 5 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 13.2, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ORCHAPRED 1% SUSP. EYE DROPS 10 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORCHIDIA PHARMACEUTICAL INDUSTRIES > ORCHIDIA", "price_egp": 38.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ECONOPRED PLUS 1% EYE DROPS 5 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NOVARTIS > NOVARTIS SCIENTIFIC OFFICE", "price_egp": 43.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PHARMA PRED 1% EYE DROPS (SUSP.) 5 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > PHARCO", "price_egp": 43.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PRED FORTE 1% EYE DROPS 5 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALLERGAN > SOFICOPHARM", "price_egp": 43.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "APICORTE FORTE 1% EYE DROPS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMMAN PHARMACEUTICAL CO - JORDAN > ADM FOR TRADING & PROJECTS-EGYPT", "price_egp": 63.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OPTIPRED 10MG/ML EYE DROPS (SUSP.) 5 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JAMJOOM PHARMACEUTICALS", "price_egp": 54.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "anterior-uveitis" }, { "id": 202, "generic": "Cyclopentolate", "line": 1, "is_adjunct": false, "form": "eye", "strength_mg": null, "adult_dose": "1 or 2 drops into the affected eye up to 4 times daily, or as required", "adult_duration": "Until the inflammation and the ciliary spasm settle, under ophthalmology review", "dose_source": "Mydrilate 1.0% Eye Drops (cyclopentolate hydrochloride) SmPC section 4.2 (eMC product 1724), which for uveitis, iritis and iridocyclitis gives one or two drops up to 4 times daily or as required. Section 4.1 names dilating the pupil in inflammatory conditions of the iris and uveal tract as an indication.", "rationale": "The cached uveitis article says cycloplegics are often crucial for reducing pain and preventing synechiae - the adhesions between iris and lens that cause pupil block and angle-closure glaucoma. The article names the class without naming a drug or a dose, so the agent and the amount come from a product licence that carries uveitis as an indication in its own words. Seven single-ingredient cyclopentolate products are marketed in Egypt, from PENTOLATE at 8 EGP to PENTOLEGIC at 84 EGP.", "cautions": [ "SPECIALIST-INITIATED, alongside the steroid. Dilating an eye before an ophthalmologist has examined it removes the sign they need.", "Contraindicated in narrow-angle glaucoma or an anatomically narrow angle: the article makes the same point, that cycloplegics can be contraindicated in primary angle-closure glaucoma. Dilating such an eye can precipitate an attack.", "The strength differs between the document and the Egyptian shelf, and both are recorded: the SmPC's uveitis line specifies the 0.5% solution, while all seven single-ingredient cyclopentolate products registered in Egypt are 1%. Egypt also registers a cyclopentolate with phenylephrine (CYCLOPHRINE), which is a dilating combination and not what the uveitis line describes.", "Vision blurs and the eye becomes light-sensitive for hours - warn the patient not to drive, and expect the effect to outlast the day.", "Atropine 1% eye drops are on the Egyptian shelf and are the wrong cycloplegic to reach for here: the Corneal Foreign Body article says atropine should be avoided because its effect can last up to two weeks. Cyclopentolate wears off far sooner.", "Systemic antimuscarinic effects - dry mouth, flushing, confusion in an older patient, urinary retention - can follow eye drops, especially if the drops are frequent." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No weight-based dose - it is instilled. The Mydrilate label contraindicates cyclopentolate in children with brain damage, Down syndrome or spastic paralysis, and in small infants recommends pressing over the tear sac for two to three minutes after the drop to limit systemic absorption. The SmPC states no paediatric amount for uveitis at all, leaving it to clinical judgement, and uveitis in a child belongs with paediatric ophthalmology. The label also says outright that cyclopentolate must not be used in the first three months of life: the cycloplegia it produces has been associated with amblyopia, and a neonate absorbs more of it systemically.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "PENTOLATE 1% EYE DROPS 10 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SWIXOLATE 1% EYE DROPS 10 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CHEMIPHARM", "price_egp": 15.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COLIRCUSI CICLOPLEJICO 1% EYE DROPS 10 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "NOVARTIS > NOVARTIS SCIENTIFIC OFFICE", "price_egp": 18.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PLEGICA 1% EYE DROPS 10 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > HIKMA", "price_egp": 27.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CYPENTOLA 1% EYE DROPS 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > TALENT PHARMA", "price_egp": 44.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OFTAPANTINE 1% EYE DROPS 10*0.5 ML SDU", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL ADVANCED PHARMACEUTICALS (GAP) > MONOPHARMA PHARMACEUTICALS", "price_egp": 64.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PENTOLEGIC 1% EYE DROPS 30*0.5 ML SDU", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORCHIDIA PHARMACEUTICAL INDUSTRIES", "price_egp": 84.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "anterior-uveitis" }, { "id": 203, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Inflammation inside the front of the eye causing pain, redness and light sensitivity; it is sight-threatening, so a GP's role is same-day ophthalmology referral, with cycloplegic or steroid drops normally only started under specialist slit-lamp guidance.", "adult_duration": "Refer, with advice", "dose_source": "No dose - referral pathway, no medicine given in primary care", "rationale": "Inflammation inside the front of the eye causing pain, redness and light sensitivity; it is sight-threatening, so a GP's role is same-day ophthalmology referral, with cycloplegic or steroid drops normally only started under specialist slit-lamp guidance.", "cautions": [ "The drug rows above are what the treating service gives. They are here so that the referral is an informed one and so the GP can recognise the regimen the patient comes back on - not as permission to start it without the referral.", "RED FLAG - Signs favoring endophthalmitis (disproportionate pain, lid edema, chemosis, rapid vision decline, recent ocular trauma or surgery) require urgent differentiation from uveitis.", "RED FLAG - Severe eye pain, photophobia and reduced vision, or pus visible in the front of the eye (hypopyon): same-day ophthalmology referral. Untreated, it risks secondary glaucoma and cataract." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The drug rows above are instilled, not dosed by weight. The referral threshold and the safety-netting are the same at any age.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "anterior-uveitis" } ] }