Keratitis vs uveitis
Structured for Australian optometry practice.
Clinical decision support only
OptoGuide™ supports professional judgement and does not diagnose or replace clinician responsibility.
Quick answer
- Both keratitis and anterior uveitis can cause pain, redness, and photophobia, but the main distinction is corneal involvement versus intraocular inflammation.
- Staining defect, infiltrate, or opacity points toward keratitis; cells, flare, and consensual photophobia support uveitis.
- Visual reduction can occur in both, so slit lamp localisation is critical.
- Refer same day when either diagnosis is suspected and the picture is not mild or clearly explained.
Common causes
- Microbial or herpetic keratitis.
- Contact lens-related keratitis.
- Anterior uveitis with or without systemic association.
- Corneal surface disease mimicking deeper inflammation.
Red flags (must not miss)
- Corneal infiltrate, epithelial defect, or stromal haze.
- Cells and flare or irregular pupil.
- Marked photophobia with reduced vision.
- Contact lens wear or dendritic staining.
Use OptoGuide™ to guide this decision during consult.
What to check
- Fluorescein staining and corneal clarity.
- Anterior chamber reaction and consensual photophobia.
- Pattern of redness and ciliary involvement.
- Visual acuity and pupil findings.
- Contact lens history and recurrence pattern.
When to refer
- Same day for suspected keratitis or anterior uveitis.
- Urgent review when the diagnosis is unclear but corneal or chamber signs are present.
- Escalate early if vision, cornea, or intraocular inflammation is involved.
Initial management
- Localise disease to the cornea or anterior chamber before assigning a label.
- Document staining, chamber reaction, acuity, and photophobia clearly.
- Do not observe significant pain and photophobia without a clear benign explanation.
Clinical basis
This guidance reflects standard optometric clinical reasoning based on:
- Australian optometry clinical practice patterns
- Australian medicines regulation and PBS prescribing context
- Common ophthalmology referral standards
- Evidence-based clinical training and practice
Use OptoGuide™ during consult for structured clinical guidance.