A 28-year-old man with HLA-B27-positive ankylosing spondylitis presents with recurrent acute anterior uveitis. The characteristic pattern of his uveitis compared to HLA-B27-negative anterior uveitis is:

• A Bilateral simultaneous involvement with mutton-fat KPs
• B Chronic, low-grade, insidious onset without cells or flare
• C Posterior involvement with choroidal granulomas
• D Unilateral, acute, severe with fibrinous exudates and hypopyon, alternating sides ✓

Explanation

HLA-B27-associated acute anterior uveitis (AAU) characteristically presents as unilateral, acute, severe, fibrinous iritis with marked anterior chamber reaction, and may include hypopyon. Recurrences alternate between eyes (not simultaneously bilateral), distinguishing it from idiopathic bilateral AAU. The attacks are typically self-limited but may cause synechiae and secondary glaucoma with repeated episodes. Mutton-fat KPs with bilateral chronic course are characteristic of granulomatous uveitis (sarcoidosis, Vogt-Koyanagi-Harada, sympathetic ophthalmia). Treatment is aggressive topical steroids and cycloplegics.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.