Summary of ocular manifestations in IBD
| Ocular clinical sign | Prevalence (approximate) | Signs/symptoms | Parallel GI disease activity | Treatment (in order of severity) |
| Episcleritis | 29% | Eye redness, mild pain, tearing. No visual disturbance. | Yes | Cool compress, topical steroids. Treat IBD. |
| Scleritis | 18% | Redness (may appear blue/purple), severe ocular pain, may have visual disturbance. | No | NSAIDs, systemic steroids, immunosuppressive agents. |
| Uveitis | 1.5%–3% | Ocular pain, photophobia, visual blurring, tearing. Perilimbal redness, miotic pupil, synechiae. | No | Cycloplegic agent (eg, atropine) and topical steroids, systemic steroids, immunosuppressives. |
| Cataracts | 6%10 | Progressive worsening acuity, glare around light at night. | No | Surgical lens removal and replacement. |
| Optic neuritis1 | Unknown | Ocular pain worse on eye movement, unilateral, impaired acuity, dyschromatopsia (red-green), visual field defects. | No | Withdrawal of anti-TNFα agents, intravenous methylprednisolone. |
| Retinal vasculitis1 | <1% | Painless impaired visual acuity, flashes, floaters, scotomas, metamorphopsia. | Unknown | Topical/systemic steroids, immunosuppressive agents.21 |
GI, gastrointestinal; IBD, inflammatory bowel disease; NSAID, non-steroidal anti-inflammatory drug; TNF, tumour necrosis factor.