Uveitis refers to a number of inflammatory disorders that most often affect the uvea (though other areas of the eye can be affected as well). The uvea is the middle layer of the eye, located between the sclera in front (the clear coating) and the retina in the back (the thin layer of tissue linked to the optic nerve). Rich in the blood vessels that supply oxygen to the eye, the uvea is particularly susceptible to inflammation (swelling).
As with other parts of the body, inflammation in the uvea occurs when there’s an immune response to infection or injury. White blood cells will rush to the site of a possible infection or toxin present, and this results in swelling, redness, and warmth as the immune system attacks the tissue that it believes to be at risk. Uveitis can be a reaction to something in the eye itself or a side effect from something affecting another part of the body.
Types of uveitis and their symptoms
The most frequent signs of uveitis include pain in the eye, redness, blurred vision, the appearance of ‘floaters’ in the field of vision, and light sensitivity. Uveitis can be acute (sudden and short-term) or chronic (recurring and long-term). The symptoms will depend on the type and cause of the inflammation, and where it occurs in the uvea.
In acute anterior uveitis, which can affect one or both eyes, symptoms include eye pain, blurred vision, sensitivity to light, the appearance of a small pupil, and redness. This type of uveitis occurs in the front of the eye and is most prevalent in young and middle-aged patients (20-60 years of age).
Intermediate uveitis does not usually cause pain, but results in blurred vision and floaters. This form of uveitis, which most commonly afflicts young adults, the swelling affects the vitreous (the centre of the eye).
Posterior uveitis is the least common type of uveitis, occurring at the back of the eye and often affecting the retina. It can be infectious or non-infectious, and can ultimately result in vision loss. Because of its location, it can only be detected during an eye examination.
Sometimes, uveitis can affect all three major areas of the eye. This is known as pan-uveitis.
If you are experiencing any of the above symptoms – pain, blurred vision, floaters, or redness — you should consult with an ophthalmologist right away.
Diagnosis and treatment
In order to make a diagnosis of uveitis, your doctor will perform a complete eye examination and take a thorough medical history. He or she may also order lab tests in order to determine if you have an infection or an autoimmune disorder (a condition in which the immune system attacks healthy cells). In certain cases, the ophthalmologist may do an evaluation of the central nervous system as well, to rule out a connection to other diseases.
Treatment can vary depending on the type of uveitis that is diagnosed. The initial objective of treatment is to reduce or eliminate swelling and pain, and longer term is to stop further damage to the eye tissue and help restore lost vision.
Steroidal anti-inflammatory medication is often prescribed, whether applied as eye drops, taken in tablet form, injected into or around the eye, or infused into the blood intravenously. It can also be administered in the form of a capsule that is surgically implanted in the eye. Long-term use of steroidal medicines can have serious side effects, so if the patient still needs a high dose after three months, the doctor will start another treatment program. If a patient with uveitis also has other medical conditions that are the cause of or affected by the condition, there are other options available, such as immune-suppressants or antibiotics.
Be sure to speak with your eye doctor if you have any questions or are experiencing unusual symptoms that could indicate uveitis.
This blog post is offered by Moorfields paediatric ophthalmologist Abu Dhabi