What is Uveitis?

Uveitis is a serious eye condition that involves inflammation of the uvea, the middle layer of the eye that consists of the iris, ciliary body, and choroid. This condition can lead to severe complications, including vision loss if left untreated. Understanding uveitis, its causes, symptoms, and management options is crucial for timely diagnosis and treatment.

What is Uveitis?

Uveitis is an inflammatory disease affecting the uvea, but it can also impact other parts of the eye, such as the retina, optic nerve, and vitreous humour. The condition may occur suddenly or develop gradually and can affect one or both eyes. It is classified into different types based on the affected region:

• Anterior Uveitis: Inflammation of the iris (iritis) or iris and ciliary body (iridocyclitis). This is the most common form.

• Intermediate Uveitis: Inflammation of the vitreous body and adjacent structures.

• Posterior Uveitis: Involves inflammation of the retina and choroid.

• Panuveitis: Affects all parts of the uvea and is the most severe form.

Causes of Uveitis

Uveitis can be caused by various factors, including infections, autoimmune disorders, trauma, and environmental influences. Some common causes include:

1. Autoimmune and Inflammatory Diseases:

   • Rheumatoid arthritis

   • Ankylosing spondylitis

   • Sarcoidosis

   • Lupus

   • Behçet’s disease
     

2. Infections:

   • Herpes simplex virus (HSV)

   • Cytomegalovirus (CMV)

   • Tuberculosis

   • Syphilis

   • Toxoplasmosis
     

3. Trauma and Injury:

   • Eye injuries or surgeries can trigger inflammation.
     

4. Drug Reactions:

   • Some medications, such as bisphosphonates and certain antibiotics, can cause uveitis as a side effect.
     

5. Idiopathic Causes:

   • In many cases, the exact cause of uveitis remains unknown.

Symptoms of Uveitis

The symptoms of uveitis can vary depending on the type and severity of inflammation but may include:

• Eye pain and redness

• Blurred or decreased vision

• Sensitivity to light (photophobia)

• Floaters (dark spots or lines in vision)

• Tearing or excessive eye watering

• Eye discomfort or pressure

If left untreated, uveitis can lead to serious complications, including cataracts, glaucoma, retinal detachment, and permanent vision loss.

Diagnosis of Uveitis

A comprehensive eye examination by an ophthalmologist is necessary to diagnose uveitis. This may include:

• Slit-lamp examination to assess inflammation

• Dilated eye exam to evaluate the retina and optic nerve

• Ocular imaging tests like OCT (Optical Coherence Tomography) and fluorescein angiography

• Blood tests and imaging to identify underlying systemic causes

• Aqueous or vitreous fluid analysis in severe or unclear cases

Management and Treatment of Uveitis

Treatment for uveitis depends on its cause, severity, and the affected area. The primary goal is to reduce inflammation, alleviate symptoms, and prevent complications.

Medications:

1. Corticosteroids:

   • First-line treatment to reduce inflammation.

   • Can be administered as eye drops (prednisolone acetate), oral tablets, or injections.
     

2. Immunosuppressive Agents:

   • Used in severe or chronic cases.

   • Examples include methotrexate, azathioprine, and cyclosporine.
     

3. Biologic Therapies:

   • Target specific immune pathways, such as TNF inhibitors (infliximab, adalimumab).
     

4. Antiviral, Antibiotic, or Antifungal Medications:

   • Prescribed if an infection is the underlying cause.
     

5. Mydriatic Eye Drops:

   • Help dilate the pupil and prevent complications like synechiae (adhesions of the iris to the lens).

Lifestyle and Supportive Care:

• Wearing sunglasses to reduce light sensitivity.
  

• Avoiding triggers like allergens or specific medications if they worsen inflammation.
  

• Managing underlying systemic conditions with the help of a rheumatologist or specialist.
  

• Regular eye check-ups to monitor for recurrence or complications.

Surgical Interventions:

In cases of severe complications like cataracts, glaucoma, or retinal damage, surgical procedures such as vitrectomy or intraocular lens implantation may be required.

Prognosis and Prevention

The prognosis of uveitis depends on early diagnosis and prompt treatment. Mild cases of anterior uveitis often resolve within a few weeks with proper management, while chronic or severe cases may require long-term therapy.

To reduce the risk of developing uveitis:

• Seek prompt treatment for infections.
  

• Manage systemic autoimmune conditions effectively.
  

• Protect eyes from trauma and injuries.
  

• Follow medical advice and attend regular eye exams.

When to ask a Specialist

Uveitis is a potentially serious eye condition that requires early intervention to prevent vision-threatening complications. Understanding its causes, symptoms, and treatment options can help individuals seek timely medical care. If you experience persistent eye redness, pain, or vision changes, consult an ophthalmologist immediately for evaluation and treatment.