Anterior uveitis and its relation to stress

Idiopathic recurrent acute anterior uveitis (RAAU) is a common reason for attendance at ophthalmic casualty departments. Patients who suffer with this condition may have multiple recurrent episodes which are often debilitating and necessitate time off work. If recurrences are identified early and treatment initiated rapidly, the inflammation can be minimised and settles quickly on topical treatment with a speedy functional recovery by the patient. It has been our clinical impression that some patients with RAAU relate recurrences of inflammation to psychological factors. Therefore stress could be a trigger factor for recurrence, and at such times, patients should be alert to the early signs of uveitis and seek prompt examination by an ophthalmologist. This study tests the hypothesis that stressful life events are associated with the onset of RAAU.

The number of stressful life events in patients presenting to the casualty department with RAAU in the month immediately preceding symptom onset was compared with a control group of patients with other ocular problems taken from the casualty department using the Holmes and Rahe scale and the Spielberger state-trait anxiety inventory.

35 patients with RAAU did not report a higher number of stressful life events or higher levels of anxiety compared with 29 controls in this study on both Holmes and Rahe scale and Spielberger state-trait anxiety inventory. Scores for both groups were comparable with those published for normal adults of the same age and sex.

Stress was not shown in this study to be involved in triggering the recurrence of idiopathic acute anterior uveitis.