Introduction  

Uveitis is a group of diseases that mainly cause the inflammation and irritation of the uvea. The uvea is the middle part of the eyeball with many eye-nourishing blood vessels.  Uveitis can also cause inflammation in the retina, optic nerve, lens and vitreous.
The disease can affect anyone at any age but is more prevalent among individuals between the ages of 20 and 60. It may be acute (lasts a short while) or chronic (lasts a while). Uveitis can cause damage to eye tissue. The damage may lead to permanent loss of vision.

Also Known As

  • Iritis
  • Choroiditis
  • Iridocyclitis
  • Pars planitis
  • Chorioretinitis
     

Sub-Types

  • Anterior uveitis - Part of the uvea at the front of the eye swells. This type begins abruptly and can last up to eight weeks. It is the most common type affecting mostly young and middle age individuals. Anterior uveitis can occur even among people with good health. It also occurs in both eyes. It is associated with other conditions such as gastrointestinal, skin, rheumatologic, lungs and infectious diseases.
  • Intermediate uveitis - The uvea in the centre of the eye gets inflamed. It affects the vitreous. The condition oscillates between getting better and worsening. The symptoms can stay for upto a week or last for years. The disease is mostly found in young adults. It also linked to disorders like multiple sclerosis and sarcoidosis.
  • Posterior uveitis - The swelling affects the back of the eye. The disease involves the retina and the choroid. It can develop slowly and last many years. Posterior uveitis is not as popular as the others.
  • Panuveitis uveitis - It describes a situation where all the above three types of uveitis are inflamed. One popular form of panuveitis is Behcet's disease which can significantly damage the retina.

Causes and Risk Factors

It is not clear what the exact cause of uveitis is. However, the following are some possible reasons:

  • Toxins that may penetrate the eye
  • Cancer that affects the eye, such as lymphoma
  • An autoimmune disorder such as sarcoidosis or ankylosing spondylitis
  • Trauma to the eye - Trauma may be caused by a blunt object, bruises, surgery and so on
  • Inflammatory diseases - They include lupus, rheumatoid arthritis or inflammatory bowel disease
  • Certain infections- These infections include herpes simplex virus, AIDS, shingles virus and Lyme disease. Parasites like toxoplasmosis are also a suspected cause

Risk factors may include people with particular genes. Smoking of cigars, cigarettes and pipes is also a risk factor. 
 

Signs & Symptoms

Symptoms of uveitis may include:

  • Blurry vision
  • Decreased vision
  • Redness in the eye
  • Sensitivity to bright light 
  • Suddenly spotting floaters - Specks moving in one’s field of vision
  • There may be pain in the eye or none depending on the type. For example, intermediate uveitis is not associated with pain
     

Diagnosis

The following tests will help to diagnose uveitis:

  • Blood or skin tests
  • Imaging tests such as X-rays
  • Examining fluids from the eye
  • A visual acuity test to assess how well one can read from a distant chart
  • A tonometer that measures the eye pressure after numbing the eye with drops
  • A physical body examination since uveitis may be connected to other diseases
  • A central nervous system evaluation to determine if the individual has multiple sclerosis
  • A slit-lamp examination together with the use of a dye called fluorescein to evaluate the retinal blood flow
  • A medical history where the eye care professional will inquire other health issues one may be having
  • A funduscopic exam where the professional will use an ophthalmoscope to check the back of the eye after dilating the eye using eye drops
     

Treatment 

Treatment of uveitis aims to reduce the inflammation, relieve pain, prevent further damage to the tissue and restore vision.

Medical Treatment

Treating uveitis promptly prevents the development of lasting problems. The eye doctor often works with a rheumatologist to help treat uveitis. Treatment also depends on the type of uveitis. 
Anterior uveitis is treated using corticosteroid eye drops to help dilate the eye and reduce pain and inflammation. It can also be treated with dark glasses. 
The doctor can treat the other conditions with injections around the eye or oral immunosuppressive agents. These are particularly effective if the disease affects both eyes. 
The doctor may prescribe antibiotics, antiviral medications or other medicines to treat infections associated with uveitis.

Surgical Treatment

Intermediate, posterior and panuveitis can benefit from time-released capsules. A surgeon implants them in the eye. The implanted capsule will slowly release steroid drugs into the eye for about three years. 
Vitrectomy may help remove some of the vitreous in the eye.

Prognosis/Long-term outlook

With prompt treatment, most cases of anterior uveitis resolve in a few days to a few weeks.
Severe forms of uveitis which include intermediate, posterior and panuveitis have a high likelihood of recurring. They can lead to blindness even with treatment.
Using steroids for long may produce side effects like the thinning of bones, weight gain, diabetes, cardiovascular disease, fluid retention and Cushing’s syndrome.
Some of the drugs used to treat uveitis may increase the risk of cancer.
Other complications may include retinal detachment, retinal edema, cataracts, irregular pupils and glaucoma.

Prevention/Follow Up

Treating systemic infections or diseases may prevent uveitis from developing.