Uveitis

The uvea is the middle layer of the wall of the eye. It has three parts: the iris, the ciliary body and the choroid. Inflammation (or swelling) of any part of the uvea is called uveitis It has many causes, but they are hard to identify.

The symptoms of uveitis depend upon the area that is inflamed and the duration of inflammation. Acute iritis may cause a red eye with pain and sensitivity to light. Chronic and posterior inflammation may be painless but may cause symptoms such as floaters or decreased vision. These symptoms should alert you to seek expert medical attention promptly.

A careful medical history, including family, social and sexual history, is important in the uveitis patient. Evaluation of uveitis is directed toward the diagnosis and identification of possible underlying causes of the disease. Bacteria, fungi, viruses, protozoa or other agents along with abnormalities of the immune system can cause uveitis. Testing may involve blood tests, X-rays, special ocular studies or evaluation by other skilled medical consultants beyond ophthalmology.

A full medical evaluation may reveal an inflammatory disease that has involved other organs besides the eye. Examples of this include sarcoidosis, rheumatoid arthritis, syphilis, and related conditions. For these types of conditions, treatment for the underlying cause of the uveitis helps all parts of the body, including the eye.

In most cases, no obvious underlying cause is found for the uveitis. Treatment then is directed to the eye inflammation alone. Treatment may include drops or injections of cortisone medication around the eye. Sometimes it may be necessary to use oral drugs that suppress inflammation, such as prednisone or cytotoxic (chemotherapeutic) agents. Treatment may be prolonged for uveitis. Therefore, close follow-up with an ophthalmologist is important to keep the eye functional and to detect occasional side effects from the treatments.

How is uveitis treated?

Untreated uveal inflammation can lead to blindness. Cataract, glaucoma, retinal scarring, retinal detachment, optic nerve damage and atrophy or shrinkage of the eye are some of the potential complications of persistent uveitis. Many patients with uveitis have good vision as their disease is managed by medicines and eye drops.

A careful medical history, including family, social and sexual history, is important in the uveitis patient. Evaluation of uveitis is directed toward the diagnosis and identification of possible underlying causes of the disease. Bacteria, fungi, viruses, protozoa or other agents along with abnormalities of the immune system can cause uveitis. Testing may involve blood tests, X-rays, special ocular studies or evaluation by other skilled medical consultants beyond ophthalmology.

A full medical evaluation may reveal an inflammatory disease that has involved other organs besides the eye. Examples of this include sarcoidosis, rheumatoid arthritis and related conditions. For these types of conditions, treatment for the underlying cause of the uveitis helps all parts of the body, including the eye.

In most cases, no obvious underlying cause is found for the uveitis. Treatment then is directed to the eye inflammation alone. Treatment may include drops or injections of cortisone medication around the eye. Sometimes it may be necessary to use oral drugs that suppress inflammation, such as prednisone or cytotoxic (chemotherapeutic) agents. Treatment can be prolonged for uveitis. Therefore, close followup with an ophthalmologist is important to keep the eye functional and to detect occasional side effects from the treatments.