AAO 2026: Can’t-miss uveitis diagnoses every clinician should know

Every new patient with uveitis should be dilated, according to Timothy Janetos, MD, an assistant professor of ophthalmology and uveitis specialist at Northwestern University Feinberg School of Medicine in Chicago, Illinois. At the American Academy of Ophthalmology (AAO) 2026 Annual Meeting in New Orleans, Louisiana, Janetos spoke with Ophthalmology Times about “Can’t-Miss Diagnoses in Uveitis: When Disaster Knocks on Your Door, Know How to Answer,” an instruction course he is teaching at the meeting.

What is the course about?

The course is designed for comprehensive and pediatric ophthalmologists and optometrists, who often see patients with new uveitis first. The goal, Janetos said, is to help them identify conditions that cannot be missed or that require prompt referral to prevent lasting damage or blindness.

Which uveitis diagnoses should not be missed?

In anterior uveitis, which Janetos covers, herpes disease is a frequent infectious cause. Human leukocyte antigen B27 (HLA-B27) anterior uveitis, the most common form, is often undertreated, whereas Fuchs uveitis syndrome is frequently overtreated. The course also covers:

• Pediatric uveitis, including tubulointerstitial nephritis and uveitis
• Posterior disease such as toxoplasmosis and sarcoidosis
• Masquerade syndromes, including intraocular cancer misdiagnosed as uveitis
• Drug-induced uveitis from agents such as checkpoint inhibitors

What warning signs suggest a more serious case?

Any case that does not respond to corticosteroids as expected, or that initially responds and then worsens, should prompt clinicians to reevaluate the diagnosis or refer the patient. “Okay, am I missing a diagnosis here? Is this actually infectious? Is it a masquerade?” Janetos said clinicians should ask.

How can infectious and noninfectious uveitis be distinguished at the first examination?

No single pathognomonic finding confirms infection, but several clues help. In anterior uveitis, elevated intraocular pressure, iris changes such as a dilated pupil or transillumination defects, and heavy anterior chamber pigment suggest an infectious cause. Retinal whitening or necrosis should be treated as infection until proven otherwise. A hypopyon after recent surgery should raise concern for endophthalmitis, and a history of injection drug use or sexual history can also point toward infection.

What is the key takeaway?

“Dilate every new uveitis patient,” Janetos told Ophthalmology Times. “You can’t call something anterior uveitis until you’ve dilated the patient and looked in the back of the eye.”

For more from the meeting, visit Ophthalmology Times’ AAO 2026 coverage.