Uveitis precipitated by nonpenetrating ocular trauma

Although penetrating trauma is a well-recognized cause of uveitis, the role of nonpenetrating trauma in initiating uveitis is not defined. We analyzed the records of 496 patients seen at the uveitis clinic at our institution. Twenty-four of these 496 patients (4.8%) suspected that the cause of their intraocular inflammation was related to previous nonpenetrating trauma. In contrast, only one of 251 patients (0.4%) attending the general ophthalmology clinic for routine care provided a history of recent trauma or attributed the present ocular complaint to trauma (P<.02). Patients with posttraumatic uveitis were usually male (19 of 24, 79%), younger (31 ± 16 years) than the average patient examined in the uveitis clinic, and more likely to have unilateral disease. In ten (42%) of the patients the trauma was work-related. Bilateral inflammation was seen in eight (one third) of the patients and 17 of 28 patients (71%) had a considerable degree of inflammation posterior to the lens. Many patients had an identifiable cause of uveitis such as ankylosing spondylitis, Reiter's syndrome, sarcoidosis, or acute retinal necrosis; but most patients had no known predisposition. The role of nonpenetrating trauma in initiating uveitis has implications for diagnosis and treatment.