Hypermature cataracts cause lens proteins to elicit inflammation.
Pathophysiology
Inflammation of uveal tract may involve iris ( iritis ), ciliary body ( cyclitis ), or choroid ( choroiditis ).
More commonly involves all 3 ( panuveitis ).
Breakdown of the blood-aqueous barrier causes anterior uveal tissue destruction.
Increased vascular permeability is mediated by histamine, serotonin, prostaglandins and leukotrines, and causes extravasation of plasma proteins, cells and fluid.
Iridal congestion, aqueous flare, hypopyon, keratitic precipitates and corneal edema develop along with cellular infiltration.
Inflammation causes muscular spasm giving miosis and pain.
Timecourse (incubation, duration)
Anterior uveitis therapy should last at least 2 months as the blood-aqueous barrier remains disrupted for about 8 weeks after insult.
Repair corneal tears. Consider referral to specialist if foreign body present.
Topical corticosteroids: Either Prednisolone acetate 1% - has best intraocular penetration. Or Betamethasone sodium phosphate 0.1%. Or Dexamethasone 0.1%.
Ensure that pupil is opening during the first consultation.
Treat for up to 10 days after resolution of uveitis
Use mydratics with care if secondary glaucoma
Either Systemic corticosteroid. Or Systemic non-steroidal anti-inflammatory drug (NSAID), eg carprofen .
Systemic antibiotics and antifungals .
Systemic cytotoxic drugs, eg cyclophosphamide , azathioprine if severe. Seek specialist advice before using.
Standard treatment
Treat any underlying disease.
Monitoring
Patients with severe anterior uveitis should be hospitalized for intial diagnostic workup and medical management.
Subsequent management
Monitoring
Tonometry for elevated IOPor to assess improvement, ie reduced IOP in uveitis. Concurrent use of systemic corticosteroids and NSAIDs risk of gastrointestinal side-effects.
Michau T M, Breitschwerdt E B, Gilger B C and Davidson M G (2003) Bartonella vinsonii subspecies berkhoffi as a possible cause of anterior uveitis and choroiditis in a dog.Vet Ophthalmol6 (4), 299-304. PubMed
Sansom J (2000) Diseases involving the anterior chamber of the dog and cat.In Practice22 , 58-70.
Huss B T, Collier L L, Collins B K et al(1994) Polyarthropathy and chonoretinitis with retinal detachment in a dog with systemic histoplasmosis.JAAHA30 , 217-224.
Hakanson N & Forrester S D (1990) Uveitis in the dog and cat.Vet Clin North Am Small Anim Pract20 , 715.
Crispin S M (1988) Uveitis in the dog and cat.JSAP29 , 429-447.
Vetstream contributor(s)
Dr Dennis E Brooks DVM PhD DipACVO , College of Veterinary Medicine, 2015 SW 16th Ave, University of Florida, PO Box 100126, Gainesville, FL 32610-0126, USA.
Dr David L Williams MA VetMB CertVOphthal PhD MRCVS , Department of Clinical Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK.
.
Consider referral to specialist if foreign body present.
decreased pain: moderate pupil dilation 
Use mydratics with care if secondary glaucoma