Uveitis

Jump to: Symptoms | Diagnosis | Risk Factors | Treatment | Resources | References

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Uveitis is a group of inflammatory conditions that often affect the part of the eye known as the uvea. The uvea is the middle layer of the eye beneath the sclera. It is made up of the iris, choroid, and ciliary body.

Uveitis may affect one eye, both eyes simultaneously or alternate between the two eyes.

Uveitis can be caused by a bacteria, fungus, or virus infection in your eye (infectious uveitis), or it can be caused by eye injury or disease in other parts of your body (non-infectious uveitis).

Uveitis can also be described by location in the eye:

• Anterior uveitis (also called iritis and iridocyclitis) is inflammation of the front part of your eye, in the iris or the iris and ciliary body. This type of uveitis is more common and is usually the most symptomatic.
• Intermediate uveitis (also called pars planitis, cyclitis, vitritis) is inflammation of your ciliary body, behind your iris in the middle of your eye.
• Posterior uveitis (also called choroiditis or chorioretinitis) is inflammation of the choroid at the back of your uvea. It can also affect your retina or optic nerve. This is a rare type of uveitis but also the one most likely to cause permanent vision loss.
• Panuveitis is inflammation of all parts of the uvea. This type is uncommon but can be severe.

Early identification of symptoms, diagnosis and treatment are important to prevent vision loss and avoid complications.

Uveitis is also described by how quickly and often you experience symptoms:

• Acute (sudden onset over hours or days and limited time (≤3 months’ long)
• Chronic (>3 months’ duration characterized by relapse within 3 months of therapy termination)
• Recurrent (repeated episodes separated by disease inactivity ≥3 months, whether on or off treatment)

SYMPTOMS

Symptoms of uveitis vary depending on the site and severity of inflammation. They can occur suddenly and worsen quickly, or they can develop slowly and be more subtle. Some people do not experience any symptoms early in the disease.

Signs and symptoms include:

• Light sensitivity (photophobia)
• Eye pain
• Redness
• Small or irregular-shaped pupils
• Painless, dark, floating spots (floaters), especially with intermediate, posterior, and panuveitis.
• Blurred or decreased vision

Additionally, patients may have other symptoms like joint stiffness, rashes, and oral ulcers.

If you experience any of these symptoms, call your eye doctor immediately.

DIAGNOSIS

Eye exams and some special tests are used to diagnose and identify the type and severity of uveitis.

Eye exams usually include:

1. Visual acuity tests to check the clarity of your vision.
2. Ocular pressure tests to measure the pressure inside of your eye.
3. Slit-lamp examinations to look inside the front part of your eye using a special microscope.
4. Dilated eye exams to look at the back of your eye after dilating (widening) your pupil with eye drops.

Along with eye exams, your doctor may recommend eye imaging or photography to find inflammation or test fluid from your eye. Your doctor may also suggest a general medical examination to identify underlying medical conditions that may be causing uveitis.

risk factors and causes

People of any age can be diagnosed with uveitis, but it is most common in 20 to 60-year-olds. Uveitis can be infectious or non-infectious. In about 50% of cases, the cause of uveitis is unknown (idiopathic uveitis), but identifying the cause is not needed to begin treatment. Some health conditions put you at higher risk of developing uveitis, including:

• Autoimmune or inflammatory conditions (such as arthritis, inflammatory bowel disease, multiple sclerosis, sarcoidosis, ankylosing spondylitis, and Behcet’s disease)
• Infections (such as herpes, syphilis, and tuberculosis)
• Eye injury, trauma, or surgery
• Genetic disorders
• Cancer affecting the eye
• Medication side effects
• Cigarette smoking

TREATMENT

The goal of uveitis treatment is to reduce inflammation. Treatment may focus on the underlying infection or health condition of uveitis if it is known. Treatment plans can also include addressing your specific symptoms or complications of uveitis.

Treatments may include:

• Corticosteroids to reduce inflammation. Corticosteroids are the primary treatment for uveitis. They are prescribed as an eye drop, pill, or injection. A corticosteroid-releasing capsule may also be implanted into your eye with surgery. This allows for the slow release of medication for 2 to 3 years. Usually, anterior uveitis is treated with eye drops. Intermediate, posterior, and panuveitis usually require pills, injections, or surgical implants.
• Antibiotics, antivirals, or antifungals to treat underlying infections causing uveitis.
• Dilating eye drops reduce the pain of anterior uveitis by preventing spasms in your iris and ciliary body. These eye drops can also protect you from other complications and lower your risk of developing glaucoma.
• Immunosuppressants lower the immune response that is causing inflammation. Immunosuppressants may be used to address underlying autoimmune conditions, or when corticosteroids are not working, if uveitis affects both of your eyes, or if your vision is threatened.

You may need to continue treatment for months or even years, but early treatment usually leads to less vision loss and, in some cases, restoring of vision. All types of uveitis can come back (recurrent), so you should see your doctor if any symptoms reappear or become worse.

resourceS

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references

https://www.mayoclinic.org/diseases-conditions/uveitis/diagnosis-treatment/drc-20378739
https://www.allaboutvision.com/en-ca/conditions/uveitis/
https://rarediseases.org/rare-diseases/posterior-uveitis/
https://rarediseases.org/rare-diseases/pars-planitis/
https://rarediseases.org/gard-rare-disease/panuveitis/
https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/anterior-uveitis?sso=y
https://opto.ca/health-library/anterior-uveitis
https://www.clinicaltrials.gov/ct2/results?cond=Uveitis&term=&cntry=&state=&city=&dist=

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Updated November 22, 2021