Uveitis is an infection of the eyes. It affects the eye wall's middle layer of tissue (uvea).
Uveitis symptoms may appear unexpectedly and worsen rapidly. They include redness, discomfort, and impaired vision in the eyes. The illness can affect one or both eyes and persons of all ages, including children.
Uveitis can be caused by infection, damage, or an autoimmune or inflammatory condition. Many times, no reason can be found.
Uveitis can be severe, resulting in irreversible eyesight loss. Early detection and treatment are critical for avoiding problems and preserving your eyesight.
WHAT ARE THE SYMPTOMS OF UVEITIS?
Uveitis symptoms, signs, and features may include:
- Redness of the eyes
- Eye ache
- Sensitivity to light
- Blurred vision
- Dark, floating specks in your area of view (floaters)
- Decreased vision
Symptoms might appear suddenly and worsen fast, while they can develop gradually in rare circumstances. They can impair either one or both eyes. There are times when there are no symptoms and evidence of uveitis are discovered during a normal eye checkup.
The uvea is the middle layer of tissue in the eye's wall. It is made up of three parts: the iris, the ciliary body, and the choroid. When you look in the mirror, you will notice the white part of your eye (sclera) and the colored area of your eye (iris).
The iris is placed in the anterior chamber of the eye. Behind the iris lies a structure called the ciliary body. The choroid is a blood vessel layer located between the retina and the sclera. The retina, like wallpaper, lines the interior of the rear of the eye. The interior of the rear of the eye is filled with vitreous, a gel-like substance.
The type of uveitis you have is determined by the portion or components of the eye that are inflamed:
- Anterior uveitis affects the ciliary body and the interior of the front of your eye (between the cornea and the iris). It is the most frequent kind of uveitis and is also known as iritis.
- The retina and blood vessels right below the lens (pars plana), as well as the gel in the center of the eye, are affected by intermediate uveitis (vitreous).
- Posterior uveitis affects the retina or the choroid, two layers on the interior of the rear of the eye.
- Panuveitis occurs when all layers of the uvea, from the front to the rear of your eye, become inflamed.
WHAT ARE THE CAUSES OF UVEITIS?
The particular origin of uveitis is unknown in almost half of all instances, and the ailment may be classified as an autoimmune disease that solely affects the eye or eyes. If a reason is found, it might be one of the following:
- Sarcoidosis, ankylosing spondylitis, systemic lupus erythematosus, or Crohn's disease are examples of autoimmune or inflammatory disorders that affect other sections of the body.
- An illness, such as cat scratch disease, herpes zoster, syphilis, toxoplasmosis, or TB
- Side effects of medication
- Injury to the eye or surgery
- A cancer of the eye, such as lymphoma, occurs only very rarely.
WHAT ARE THE RISK FACTORS FOR UVEITIS?
People who have mutations in particular genes may be predisposed to uveitis. Cigarette smoking has been linked to more difficult-to-manage uveitis.
WHAT ARE THE COMPLICATIONS OF UVEITIS?
If left untreated, uveitis can lead to the following complications:
Swelling of the retina (macular edema)
Scarring of the retina
Glaucoma
Cataracts
Damage to the optic nerve
Detachment of the retina
Permanent blindness
HOW IS UVEITIS DIAGNOSED?
When you see an eye expert (ophthalmologist), he or she will most likely do a thorough eye exam and take a detailed health history. The following are typical aspects of an eye examination:
- Assessment of eyesight (with glasses if you regularly wear them) and pupil reaction to light.
- Tonometry. Tonometry is a test that measures the pressure within your eye (intraocular pressure). This exam may need the use of numbing eyedrops.
- Examination using a slit light. A slit lamp is a microscope that uses an intense line of light to magnify and illuminate the front of your eye. This examination is required in order to detect tiny inflammatory cells in the front of the eye.
- Ophthalmoscopy. This procedure, also known as funduscopy, includes using eyedrops to expand (dilate) the pupil and shining a strong light into the eye to inspect the rear of the eye.
Your doctor may also suggest:
- Color photography of the eye's interior (retina).
- Imaging with optical coherence tomography (OCT). The thickness of the retina and choroid is measured in this test to indicate inflammation in these tissues.
- Indocyanine green angiography or fluorescein angiography. In order to inject a dye, an intravenous (IV) catheter must be placed in a vein in your arm. This dye will reach the blood vessels in the eyes, allowing photos of blood vessel inflammation within the eyes to be taken.
- Assessment of aqueous or vitreous fluid from the eye.
- Blood tests.
- Radiography, CT or MRI scans, or imaging testing.
If the ophthalmologist suspects that an underlying problem is causing your uveitis, you may be sent to another doctor for a general medical check and laboratory tests.
It might be difficult to pinpoint a specific cause of uveitis. Even if no particular cause is found, uveitis can be successfully treated. In the vast majority of instances, determining the origin of uveitis does not result in a cure. To manage the inflammation, some type of therapy is still required.
WHAT ARE THE TREATMENTS FOR UVEITIS?
If uveitis is caused by an underlying ailment, therapy may be directed toward that illness. As long as the underlying cause is not infectious, the therapy for uveitis is usually the same. The objective of therapy is to minimize inflammation in your eye and, if present, other regions of your body. In other circumstances, therapy may be required for months or even years. There are several therapy methods available.
Medications
- Anti-inflammatory medications: Your doctor may initially prescribe anti-inflammatory eyedrops, such as a corticosteroid. Eyedrops are typically insufficient to cure inflammation that extends beyond the front of the eye, thus a corticosteroid injection in or around the eye, or corticosteroid tablets (given orally), may be required.
- Spasm-controlling medications: Eyedrops that dilate (widen) the pupil may be administered to manage iris and ciliary body spasms, which can help decrease eye discomfort.
- Antibacterial or antiviral medications: If your uveitis is caused by an infection, your doctor may give antibiotics, antiviral drugs, or other medications, with or without corticosteroids, to manage the infection.
- Drugs that affect the immune system or kill cells: If your uveitis involves both eyes, does not react well to corticosteroids, or gets severe enough to impair your vision, you may require immunosuppressive medicines.
Some of these drugs can cause significant eye problems, such as glaucoma and cataracts. Medications taken orally or via injection might cause negative effects in areas other than the eyes. You may need to see your doctor every one to three months for follow-up exams and blood testing.
Surgical or other procedures
- Vitrectomy: Surgery to remove portion of your eye's vitreous is seldom used to diagnose or treat the problem.
- A medication-releasing implant: A device implanted in the eye may be an alternative for those with difficult-to-treat posterior uveitis. For two to three years, this gadget gently distributes corticosteroid into the eye.
Cataracts typically form in patients who have not yet undergone cataract surgery. Up to 30% of patients will also require therapy for high ocular pressure in order to avoid the development of glaucoma.
The intensity of your symptoms and the kind of uveitis you have influence how quickly you recover. Uveitis in the rear of the eye (posterior uveitis or panuveitis, which includes retinitis or choroiditis) heals more slowly than uveitis of the front of the eye (anterior uveitis or iritis). Severe inflammation heals more slowly than moderate inflammation.
Uveitis might reoccur. If any of your symptoms persist or worsen, make an appointment with your doctor.