**Question:** A patient has a miotic pupil, IOP = 25, normal anterior chamber, hazy cornea and a shallow anterior chamber in the fellow eye. Diagnosis is –
A. Glaucoma
B. Corneal edema
C. Uveitis
D. Hyphema
**Correct Answer:** C. Uveitis
**Core Concept:**
Uveitis is an inflammation of the uveal tissues (uvea) within the eye, which includes the iris, ciliary body, and choroid. This condition can lead to various ocular symptoms and signs, such as miotic pupil, elevated intraocular pressure (IOP), hazy cornea, and a shallow anterior chamber in the affected eye.
**Why the Correct Answer is Right:**
The correct answer is Uveitis (option C) because the clinical presentation mentioned in the question is consistent with this condition. A miotic pupil (small pupil due to constriction of the pupillary sphincter muscle), elevated IOP (25 mmHg), and a shallow anterior chamber are indicative of uveitis-induced inflammation and edema within the eye. Additionally, the hazy cornea is a common finding in uveitis.
**Why Each Wrong Option is Incorrect:**
A. Glaucoma (option A) is characterized by elevated IOP and optic nerve damage, not a miotic pupil and shallow anterior chamber.
B. Corneal edema (option B) is typically associated with decreased vision and a cloudy cornea, not a miotic pupil, elevated IOP, and shallow anterior chamber.
D. Hyphema (option D) is defined by a hemorrhage within the anterior chamber, which would result in a bloody instead of a miotic pupil and shallowness of the anterior chamber.
**Clinical Pearl:**
Uveitis should be considered in the differential diagnosis of patients presenting with ocular symptoms and signs such as those mentioned in the question. Prompt recognition and appropriate management of uveitis are crucial to prevent complications like secondary glaucoma, cataract formation, and vision loss. Collaboration between ophthalmologists and internists is often necessary to determine the underlying cause of uveitis and initiate appropriate systemic investigations and treatment.
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