Uveitis

Uveitis

Uveal tract is the vascular middle coat of the eyeball. Inflammation of the uveal tract is called uveitis. It may be a single episode in some patients while in others it may have a tendency to be chronic and recurrent.

Uveal tract lies in between the sclera and retina and consists of the iris, the ciliary body and the choroid. Uveitis is a broad term which includes many different types of diseases involving inflammation of the uvea.

Types of Uveitis (Anatomical)

Anterior Uveitis: Anterior Uveitis affects the front of the eye, which means normally the iris (iritis) or the ciliary body (iridocyclitis). It is often also referred to as Iritis, which is an older term for Anterior Uveitis. It’s the most common and easily treated form of Uveitis. It should be monitored closely as it can give rise to complications such as raised eye pressure and cataract.

Intermediate Uveitis: Intermediate Uveitis is the next most common form of Uveitis, and affects the area behind the ciliary body (pars plana) and also the most forward edge of the retina.

Posterior Uveitis: Posterior Uveitis affects the area at the back of the eye, called the choroid. The choroid is rich in small blood vessels that supply blood to the retina. Often the retina is affected much more in this.

Types of Uveitis (by duration)

Acute: the Uveitis is of sudden onset and tends not to last very long (less than three months but usually around six weeks).

Chronic: The Uveitis lasts for more than three months and also comes back (relapses) within three months of stopping treatment.

Symptoms

  • Pain in eyes
  • Inflammation
  • Sensitivity towards light
  • Blurred/ decreased vision
  • Dark, floating spots in your field of vision (floaters)
  • Redness of the eyes
  • The symptoms of Uveitis may come on suddenly, and may not be accompanied by any pain. Alternatively if a patient has the above symptoms, it may not necessarily mean that she/he has Uveitis.

Causes

Uveitis may be caused by systemic diseases (such as Rheumatoid Arthritis and Sarcoidosis), auto-immune reaction to ocular antigens or due to a local infection caused by virus, bacteria, fungus or a parasite. However, in many cases the exact cause remains unknown.

Treatment

Uveitis Treatment Goals:

  • Relief of pain and discomfort (where present).
  • To prevent sight loss due to the disease or its complications.
  • To treat the cause of the disease where possible

Uveitis Treatment Options

Uveitis is mainly related to inflammation of eyes, and therefore, the prime focus of doctors is to control that inflammation. Different treatment options include:

Anti-inflammatory medication: To control inflammation occurring in patient’s eye, doctors prescribe anti-inflammatory medication (mainly corticosteroids). These medications can be given through eye drops (primarily for anterior Uveitis), oral pills or in the form of injections (primarily for posterior Uveitis).

  • Antibiotics or antiviral medication: Several antibiotics and antiviral medicines are given to patients along with corticosteroids to treat infection which causes Uveitis.
  • Immunosuppressive medication: Various Immunosuppressive agents are used by ophthalmologists to control Uveitis in some cases where it becomes difficult to treat patient’s eye with corticosteroids due to their side effects.
  • Surgical method: Vitrectomy is surgical approach used to remove jelly-like material of the vitreous membrane of eyes. This removed specimen can be utilized while diagnosis as well as treatment of this disease.

Main portion of your eye i.e. uvea affected with Uveitis determines the healing process and recovery of Uveitis. The back portion of the uvea takes more time to heal in comparison to the front portion of the eye.

FAQs

If the inflammation caused by Uveitis remains unchecked, it could cause sudden or chronic rise in eye pressure which could result in permanent nerve damage. It could also lead to damage of delicate retinal cells and corneal cells of the eyes and may also lead to cataract formation.

A prolonged usage of corticosteroids should be monitored by your ophthalmologist as it can lead to other side-effects. In case of advanced Uveitis, conventional surgery or laser surgery may be necessary.

There are no prevention measures as there are some cases which are idiopathic and do not have a known cause. We can take the following precautions to reduce the chances of having Uveitis.

  • Eye protection during daily activities like garden edging, drilling
  • Being extra cautious while lighting firecrackers
  • Taking vaccinations in a timely way
  • Following good hygiene
  • Taking regular health checkups

Several autoimmune diseases and other traumatic injuries can be a main reason for Uveitis. Diseases like AIDS, CMV retinitis, herpes zoster infection, psoriasis could also result in Uveitis. Uveitis due to Reactive arthritis, tuberculosis and ulcerative colitis could lead to severe loss of vision.

Before confirming that a patient is suffering from Uveitis, doctors usually prefer to examine his medical history in detail. Later, the eye is properly examined using some instruments and then few ophthalmic investigations are performed which may include:

  • Blood and skin tests
  • Analysis of fluid from the eye
  • Angiography, which is photography to evaluate the retinal blood flow
  • X-rays and CT scans
  • Photography to measure the thickness of the retinal tissue and to check if there is presence of fluid in or under the retina.
  • Sometimes an underlying condition can be the cause for the Uveitis, in which case your eye doctor may refer you to another doctor for examination and tests.

This, once again, varies considerably but there is a growing confidence especially with newer drug treatments that eyesight can be stabilised over the long-term. Uveitis as a disease should be regarded as incurable in the sense that it will never completely go away but it can be managed.

Yes, follow ups ensure right and timely treatment and safeguard against complications. An early diagnosis and treatment of Uveitis will often result in it resolving without serious complications.

Take the medicines as advised by the doctor; do not start or stop the medication on your own.

If you forget to use your eye drops, use them as soon as you remember. Then get back on schedule for the next dose.

Schedule your medication intake around your daily routine, like when you wake up in the morning, at meal times or at bedtime