Uveitis is a general term that describes a group of inflammatory diseases which affect the middle layer of tissue in the eye — the uvea. The uvea contains many blood vessels that carry blood to and from the eye. Inflammation of the tissue in the uvea can significantly affect a person’s quality of vision and can even lead to permanent loss of sight if not properly treated. Anyone who suspects they may have symptoms of uveitis or are in the at-risk group should consult a uveitis specialist to receive proper diagnosis and treatment.
Uveitis can be classified into a number of categories, including:
- Anatomical classification: inflammation of the anterior chamber (anterior uveitis or iritis), interior chamber (intermediate uveitis) or posterior chamber (posterior uveitis); or inflammation of all layers of the uvea (pan-uveitis) including inflammation of the sclera and the conjunctiva.
- Classification according to the cause of the disease. There are a number of causes, including:
- Infection, including viral, bacterial, protozoan, fungal, and tuberculosis, etc.
- Autoimmune disorders, such as SLE, scleroderma, genetic diseases caused by the HLA-b27 gene
- Inflammation caused by other diseases, such as lymphoma, leukemia, etc.
- Drug-induced uveitis caused by systemic or topical drugs
- Inflammation due to trauma to the eye, such as an accident or a blow to the eye area
- Idiopathic, which is uveitis from an unknown cause
Additionally, there are also cases of acute uveitis, which can cause patients to have rapid loss of vision. This includes patients with SLE who have optic neuritis, causing a decreased or sudden insufficient blood flow to the retina, specifically the type that is considered a chronic inflammation which comes and goes and is constantly recurring.
The doctor must determine the exact location and the cause of the inflammation in order to provide treatment in a precise and timely manner. The first stage of diagnosis can be carried out by assessing the patient’s medical history, as about half of all cases are recurrent. This can be followed by physical examinations and other laboratory tests. These include blood tests and other forms of testing to determine genetic susceptibility to uveitis. Some patients may undergo a fluorescein dye injection for better evaluation and examination of the retina.
In cases of anterior uveitis, patients often experience the following symptoms:
- Eye redness, especially in the area near the edge of the cornea; often there is no eye discharge, but patients may still have teary eyes.
- Blurred vision, though how much or little depends on the severity of the inflammation and other complications.
- Light sensitivity.
- Eye pain.
- Dark, floating spots in your field of vision (floaters).
In the case of uveitis that is related to other physical disorders, symptoms of those conditions will be present as well, for example, back pain due to diseases of the bones and joints.
Uveitis treatment includes correcting the underlying cause or condition, controlling inflammation, and reducing the risk of complications. It is necessary for the physician to conduct a complete eye exam and thorough review of the patient’s medical history, along with a physical examination and other laboratory tests as deemed necessary in order to provide a precise diagnosis for continued treatment. Treatment can be generally summarized as follows:
- Treat the disease that is the underlying cause of or occurring simultaneously to the uveitis.
- If it is non-infectious uveitis, your doctor will likely give you steroid medications or immunosuppressants to help reduce inflammation. These can be prescribed as drops, pills or injections.
- For infectious uveitis, the doctor may prescribe drugs to help fight bacteria or viruses. These may come in oral or injection form.
- Treat the complications caused by the uveitis, such as cataracts, macular pucker (epiretinal membrane), glaucoma, CSC, etc.
What to Watch Out For, and a Few Recommendations for Patients
Today, both knowledge and technology used in the diagnosis of uveitis has developed and advanced significantly. This means that predictions of the disease are far more accurate and, in some cases, physicians are even able to monitor and provide the patient with medication to prevent the disease. For example, for patients with anterior uveitis related to the HLA-b27 gene who contract the condition more than 3 times per year, the doctor may consider prescribing NSAID medications or sulfasalazine in order to prevent recurrence of the disease.
Uveitis has a high chance of recurrence. Many patients have to live with the disease for their entire lives. Therefore, knowing the exact cause and understanding the nature of the disease is very important – and will help patients with caring for themselves properly, reduce the chances of recurrence, and minimize the possibility of further complications.
If you suspect you may be experiencing symptoms of uveitis or that you are in the at risk group, you should seek out consultation with an ophthalmologist who is a uveitis specialist so that you can receive proper diagnosis and continued treatment.