Vasculitis is a nonspecific term that encompasses a large and heterogeneous group of disorders that are characterized by inflammation of blood vessels. No uniform classification system for vasculitis exists, although subtypes are often categorized by the size of the vessels involved, the type of circulating immune complexes, and other histopathologic and clinical features. In many cases, damage to the blood vessels results in leakage of red blood cells and the development of palpable purpura on the skin. Other common cutaneous signs of vasculitis include skin ulcerations, Raynaud phenomenon, and livedo reticularis. It is important to distinguish a primary systemic vasculitis from one associated with medications, infection, malignancy, or a connective tissue disorder, as the best course of treatment may be different.

Several types of systemic vasculitis can affect the eye. Ocular complications can include uveitis, scleritis, keratitis, and optic neuropathy. Granulomatosis with polyangiitis can affect the eye in up to 40% of cases. Systemic lupus erythematosus, rheumatoid arthritis, Takayasu arteritis, and polyarteritis nodosa can all cause vasculitis with retinal and anterior segment involvement.

The lesions of vasculitis are often multifocal and/or bilateral. Ulceration, palpable purpura, and livedo reticularis may be present. Be sure to ask the patient about the presence of specific symptoms such as myalgias, arthralgias, hematuria, or neuropathy.