You are using an outdated browser. Please upgrade your browser to improve your experience.
Become a Fellow
ACP offers a number of resources to help members make sense of the MOC requirements and earn points.
Understanding MOC Requirements
Earn MOC points
The most comprehensive meeting in Internal Medicine.
April 11-13, 2019
Internal Medicine Meeting 2019
Prepare for the Certification and Maintenance of Certification (MOC)
Exam with an ACP review course.
Board Certification Review Courses
MOC Exam Prep Courses
Treating a patient? Researching a topic? Get answers now.
Visit AnnalsLearn More
Visit MKSAP 17 Learn More
Visit DynaMed Plus
Ensure payment and avoid policy violations. Plus, new resources to help you navigate the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Access helpful forms developed by a variety of sources for patient charts, logs, information sheets, office signs, and use by practice administration.
ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
© Copyright 2018 American College of Physicians. All Rights Reserved. 190 North Independence Mall West, Philadelphia, PA 19106-1572
Toll Free: (800) 523.1546 · Local: (215) 351.2400
This patient has uveitis, which is inflammation involving the middle structures of the eye (iris, ciliary body, and choroid). It usually presents with unilateral eye pain, redness, and photophobia. The characteristic finding on physical examination is circumferential redness around the border of the sclera and cornea (corneal limbus), termed ciliary flush, which represents dilated conjunctival vessels. Pupillary miosis is also often seen. Slit lamp examination commonly reveals inflammatory (“flare”) cells in the anterior chamber. Uveitis can either be idiopathic or occur as part of an underlying systemic condition, such as autoimmune disorders, arthritides associated with HLA-B27 antigen, infection (syphilis, tuberculosis, herpes simplex virus), malignancy, and sarcoidosis. This patient has symptoms suggestive of ankylosing spondylitis, including fatigue and low back pain that awakens her from sleep and improves with activity and NSAID therapy. Ankylosing spondylitis is a systemic condition that may be associated with uveitis.
Corneal ulcers are caused by trauma, contact lens wear, herpes simplex virus infection, bacterial infection, and connective tissue disorders (ankylosing spondylitis). Although corneal ulcers can occur in the setting of ankylosing spondylitis, this patient's ciliary flush is more characteristic of uveitis.
Patients with episcleritis typically present with redness, irritation, and tearing but not significant ocular pain. Additionally, the redness seen in episcleritis is usually more widespread rather than limited to the perilimbic region of the involved eye, making this an unlikely diagnosis in this patient.
Scleritis can be associated with autoimmune disorders; however, it typically presents bilaterally, involves redness across the entire sclera, and does not present with ciliary flush.
Uveitis is characterized by unilateral eye pain, photophobia, and ciliary flush; it is commonly associated with autoimmune disorders, arthritides associated with HLA-B27 antigen, infection, malignancy, and sarcoidosis.
Bal SK, Hollingworth GR. Red eye. BMJ. 2005 Aug 20;331(7514):438. [PMID: 16110072]
Back to the March International Newsletter