# Anterior Uveitis (Iridocyclitis) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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. - Verified date: 2026-08 ## 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. ## Treatment metadata - Prednisolone — eye - Cyclopentolate — eye - Referral & safety-netting (no drug therapy) ## Complete treatment card ```text ANTERIOR UVEITIS (IRIDOCYCLITIS) 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 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. (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (5) - Typical ocular symptoms are pain, photophobia, redness, floaters, and decreased vision [floaters · photophobia · redness] - Joint pain, fatigue, shortness of breath, dry cough, and rash can point to sarcoidosis and warrant a chest x-ray [breathlessness · cough · fatigue · joint pain · rash] - Cough, night sweats, weight loss, or a travel history can raise suspicion for tuberculosis [cough · night sweats · weight loss] - A sexual history may prompt additional testing for syphilis and other sexually transmitted infections - Uveitis can be idiopathic or tied to systemic disease, so a broad review of systems is important SIGNS - what you find (3) - Exam starts with visual acuity and intraocular pressure, then pupil exam, slit-lamp exam, and a dilated fundus exam - Slit-lamp exam of the front of the eye may show mutton-fat precipitates on the inner corneal surface, cells in the aqueous, and iris nodules - Findings in the back of the eye may include cells in the vitreous, snowball opacities, inflamed retinal vessels, and choroidal lesions that are focal or spread out TESTS (8) - Baseline labs - CBC, ESR, CRP - help gauge inflammation and are guided by clinical suspicion - Infectious work-up can include a TB skin test or interferon-gamma release assay plus nontreponemal and treponemal syphilis testing - Non-infectious work-up can include serum ACE, calcium, and HLA-B27, plus HLA-DR15/HLA-A29 in younger patients when birdshot chorioretinopathy is suspected - Chest x-ray, with CT chest if abnormal, is more sensitive for diagnosing sarcoidosis - Conjunctival biopsy can find noncaseating granulomas in a large minority of sarcoidosis patients - When infection or malignancy is possible, sampling the aqueous or vitreous - by paracentesis, tap, or vitrectomy - can pick up microbial genetic material or special antibody ratios - Fluorescein angiography is the gold-standard test for the blood-retinal barrier and for identifying retinal vasculitis - Tonometry and assessment of the iridocorneal angle separate acute angle-closure glaucoma from uveitis IF NOT THIS - what else fits (7) - Nongranulomatous uveitis, often idiopathic or HLA-B27-linked, has smaller keratic precipitates, a more acute onset, more pain, and usually no iris nodules or mutton-fat deposits - Conjunctivitis shows diffuse rather than perilimbal injection, no anterior chamber cells, and often discharge - Scleritis brings deep aching pain, pain on eye movement, scleral edema, and nonblanching dilated scleral vessels - Fuchs heterochromic iridocyclitis is almost always one-sided, low-grade and nonrelapsing, with fine diffuse keratic precipitates and iris atrophy with heterochromia - In acute angle-closure glaucoma, look for a sluggish, mid-sized fixed pupil, corneal clouding, and markedly elevated pressure, frequently above 40 mm Hg - Endophthalmitis is favored by disproportionate pain, lid edema, chemosis, rapid vision loss, dense vitritis, and recent trauma, surgery, or injection - Masquerade syndromes such as intraocular lymphoma, uveal melanoma, retinoblastoma, or metastasis can mimic uveitis with chamber cell/flare and vitritis Source StatPearls "Granulomatous Uveitis" - disease-level clinical article Status traced to the source above Rx: Topical corticosteroid, started by ophthalmology | Cycloplegic, for pain and to stop the iris sticking | Main treatment TOPICAL CORTICOSTEROID, STARTED BY OPHTHALMOLOGY 1. PREDNISOLONE [1st line] Adult 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. - Weeks, tapered by the ophthalmologist against slit-lamp findings; stopping early is what makes it recur Peds 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. 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. Why 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. Caution 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. Egypt ACETASEE 1% EYE DROPS (SUSP.) 5 ML RAMEDA 7.50 EGP PREDNISOLONE 1% EYE DROPS 5 ML PHARCO 13.20 EGP ORCHAPRED 1% SUSP. EYE DROPS 10 ML ORCHIDIA PHARMACEUTICAL INDUSTRIES > ... 38.00 EGP ECONOPRED PLUS 1% EYE DROPS 5 ML NOVARTIS > NO... 43.00 EGP PHARMA PRED 1% EYE DROPS (SUSP.) 5 ML RAMEDA > PHARCO 43.00 EGP PRED FORTE 1% EYE DROPS 5 ML ALLERGAN > SO... 43.00 EGP APICORTE FORTE 1% EYE DROPS AMMAN PHARMAC... 63.00 EGP OPTIPRED 10MG/ML EYE DROPS (SUSP.) 5 ML JAMJOOM PHARMACEUTICALS 54.00 EGP CYCLOPLEGIC, FOR PAIN AND TO STOP THE IRIS STICKING 2. CYCLOPENTOLATE [1st line] Adult 1 or 2 drops into the affected eye up to 4 times daily, or as required - Until the inflammation and the ciliary spasm settle, under ophthalmology review Peds 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. 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. Why 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. Caution 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. Egypt PENTOLATE 1% EYE DROPS 10 ML AMOUN 8.00 EGP SWIXOLATE 1% EYE DROPS 10 ML CHEMIPHARM 15.00 EGP COLIRCUSI CICLOPLEJICO 1% EYE DROPS 10 ML NOVARTIS > NOVARTIS SCIENTIFIC... 18.50 EGP PLEGICA 1% EYE DROPS 10 ML RAMEDA > HIKMA 27.00 EGP CYPENTOLA 1% EYE DROPS 15 ML RAMEDA > TALE... 44.00 EGP OFTAPANTINE 1% EYE DROPS 10*0.5 ML SDU GLOBAL ADVANCED PHARMACEUTICALS (... 64.00 EGP PENTOLEGIC 1% EYE DROPS 30*0.5 ML SDU ORCHIDIA PHARMACEUTICAL INDUSTRIES 84.00 EGP MAIN TREATMENT 3. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult 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. - Refer, with advice Peds The drug rows above are instilled, not dosed by weight. The referral threshold and the safety-netting are the same at any age. Source No dose - referral pathway, no medicine given in primary care Why 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. Caution 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. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)