Uveitis

A full range of treatments for eye inflammation.

Uveitis is a broad term for eye inflammation, called so because the swelling most often affects the uvea, the middle layer of your eye. The uvea contains three important parts of the eye:

  • Iris, the colored circle at the front of your eye.
  • Ciliary body, which helps with lens focusing.
  • Choroid, the group of blood vessels that give your retina the nutrients it needs.

There are over 50 types of uveitis, depending on where the inflammation is located, including:

  • Anterior uveitis, the most common type. It affects the front of your eye.
  • Intermediate uveitis, which affects primarily the middle of the eye.
  • Posterior uveitis affects the back of your eye, including the retina and choroid.

Uveitis can be either acute, recurrent or chronic.

A variety of causes

 
Some cases of uveitis are caused by an immune system dysfunction. Autoimmune diseases cause your immune system to be improperly regulated, resulting in inflammation that attacks your organs and tissues. Sometimes, scleritis (inflammation of the white part of the eye) can also be associated with systemic autoimmune diseases. These conditions include:

  • Ankylosing spondylitis.
  • Behcet’s disease.
  • Crohn’s disease.
  • Ulcerative colitis.
  • Multiple sclerosis.
  • Psoriasis.
  • Reactive arthritis.
  • Rheumatoid arthritis.
  • Sarcoidosis.

Because these diseases affect other parts of your body, we will coordinate your care with your other physicians.

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In addition, uveitis can be caused by an eye injury, treatment with certain anti-cancer drugs, lymphoma (in rare cases) and some common infections (even though you may not have other symptoms of infection):

  • Herpes simplex virus.
  • Varicella-zoster virus (chickenpox and shingles).
  • Cytomegalovirus (CMV)
  • Tuberculosis (TB).
  • West Nile virus.
  • HIV/AIDS.
  • Syphilis.
  • Lyme disease.
  • Cat scratch disease (Bartonella).
  • Candida.
  • Histoplasmosis.
  • Toxoplasmosis.

If left untreated, uveitis can lead to poor vision or even blindness, so come see us today if your eye is red, inflamed, painful or if you are having loss of vision.

Your immediate treatment is important

 
You need to start treatment right away to prevent further damage and try to get back any eyesight you’ve lost. First, we will determine what kind of uveitis you have, which will guide your personalized treatment plan. Then we’ll discuss your options and begin treating you immediately with the best choice for your case, which can include a variety of treatments.

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  • Eye drops if your uveitis is at the front of your eye and isn’t caused by an infection. Your doctor may add mydriatic eye drops to take with your steroids, which dilate your pupil, relax your eye muscles, and ease pain.
  • Injections if your uveitis is in the middle or back of your eye, or if eye drops don’t work.
  • Oral steroid pills if your uveitis doesn’t respond to drops or injections, or your disease is in the back of your eye.
  • Intravenous steroids may be needed occasionally.

If an infection is the underlying cause, you may need to take an antibiotic or another medication to fight that infection. Your uveitis will improve as the infection is treated, but the associated inflammation may also need to be treated.

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If an autoimmune disease is the underlying cause, you might need an immunosuppressant to alter your immune system and stop the inflammation. These include:

  • Methotrexate.
  • Azathioprine.
  • Cyclosporine.
  • Tacrolimus.
  • Mycophenolate.

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You may need biologic drugs that target certain parts of your immune system to stop inflammation, called targeted therapies:

  • Adalimumab (Humira).
  • Infliximab (Remicade).
  • Rituximab (Rituxan).

If your uveitis is severe, returns after treatment or is caused by certain infections, your eye surgeon can perform the surgical procedure you need.

  • Vitrectomy, where your eye surgeon takes out part of the gel inside your eye, the vitreous, and replaces it with air, gas or liquid. Your eye will then fill up the space with its own aqueous fluid.
  • Implant surgery, where a tiny capsule is implanted into your eye, slowly releasing medication into the eye.
  • Cataract and glaucoma surgery may be needed as part of the management of your eye inflammation.

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You need a
personalized plan

 
Your case is unique, so your treatment plan should be as well. Our uveitis specialists will work with you to control the problem and begin restoring your eyesight as quickly as possible. Make an appointment today.

Uveitis Eye Care

Dr. Alan Palestine MD, Ophthalmologist | UCHealth

Your eyes are in good hands

 

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