Uveitis

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What is uveitis?
Uveitis is an inflammation of the middle layer of the eye called the uvea. This includes the iris, the ciliary body, and the choroid. Uveitis can occur in one or both eyes. Inflammation of the uvea may spread to involve other parts of the eye, including the cornea, the sclera, the vitreous body, the retina, and the optic nerve if not treated soon enough.

When our optometrists diagnose and treat uveitis, they may categorize it in different ways. Uveitis is often grouped by the part of the uvea it affects.
 

• Anterior uveitis

  • Anterior uveitis affects the front of the eye. It is often called iritis, because it mainly affects the area around the eye's iris. Anterior uveitis is the most common type of uveitis in children and adults.

• Intermediate uveitis

  • ​Intermediate Uveitis is an inflammation of the ciliary body, the front end of the retina, and the vitreous. The vitreous body is a clear gel-like substance that fills the inside of the eyeball between the lens and the retina. Intermediate uveitis is the least common type of uveitis. It is also known as cyclitis, pars planitis or vitritis.

• ​Posterior uveitis

  • Posterior uveitis is an inflammation of the choroid, retina, and optic nerve. The optic nerve is the path that carries images from the retina to the brain.

• Panuveitis

  • In some cases, inflammation can affect the entire uvea, called panuevitis. People with panuveitis may be more likely to experience vision loss from the condition. 

What are the symptoms of uveitis?

Anterior uveitis  is usually acute (i.e. comes on suddenly) and is associated with eye redness, pain (sometimes severe), light sensitivity and glare, blurred vision, and sometimes a smaller than normal pupil. 

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Intermediate, posterior, and panuveitis ​symptoms include floaters and blurry vision. These patients are more likely to have chronic (long-standing) inflammation, so the symptoms are not so acute. They are also more recurrent (multiple flare-ups) and the symptoms affect both eyes.

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Who develops uveitis?

Uveitis can affect anyone at any age, including children, working adults, and senior citizens. There is a higher prevalance in women and those in the fourth decade of life. 

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What causes uveitis?

Anterior uveitis can occur due to multiple reasons, including trauma to the eye, complications of other eye diseases, or general inflammatory health problems such as certain autoimmune diseases, lung diseases, sexually trasmitted infections, and others. In most cases, roughly 70%, there is no obvious underlying cause. 

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Inmost cases of intermediate uveitis, the cause is unknown. Sarcoidosis, multiple sclerosis, Lyme disease, or other inflammatory diseases may cause some cases of intermediate uveitis.

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In posterior uveitis, the underlying cause is often a result of an immune disease. Infections caused by the organism toxoplasmosis are the most common cause of posterior uveitis.

 

How is uveitis diagnosed?
Since the symptoms of uveitis are similar to those of some other eye diseases, our optometrists will carefully examine the inside of the eye, under bright light and high magnification, to determine the presence and severity of the condition. Our optometrists may also perform other diagnostic procedures and arrange for other tests to help pinpoint the cause, including checking the pressures of the eyes and performed a dilated exam with the use of eye drops. 

What is the treatment for uveitis?
The goal of treating uveitis is to treat the inflammation and check the eyes regularly to help prevent damage and vision loss. Our optometrists treat uveitis to relieve pain, prevent vision loss from inflamamtion and complications of uveitis, and treat the cause of the uveitis, if known. Treatment of uveitis must continue as long as there is inflammation. It is not possible to know how long uveitis will last.

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For anterior uveitis, prescription eye drops that dilate the pupils in combination with anti-inflammatory drugs (steroids) are usually needed. The strength of the medicine and how often you need to take it will depend on the level of inflammation in your eyes. Treatment may take several days, or up to a few weeks in some cases. The condition must be monitored closely by our optometrists who will regulate your medication. Sometimes drops to lower the pressure of the eyes will be prescribed as well. If anterior uveitis recurs, lab testing may be required to determine the cause of the recurrent inflammation. 

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For posterior uveitis, steroid injections or pills may be necessary. These patients are usually referred to an ophthalmologist, specifically a uveitis specialist. We want to perform lab testing to determine the cause of the posterior uveitis and then treat the underlying cause to prevent recurrences. 

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What is the prognosis of uveitis?

Vision loss from uveitis can usually be prevented if diagnosed and treated early. It is very important for our optometrists to try and determine the underlying cause of the inflammation. Treatment for the underlying cause will help prevent future occurrences of the episodes.

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If untreated, uveitis can lead to other eye problems and cause permanent visual damage.