A full range of treatments for eye inflammation.
Uveitis is a broad term for a variety of conditions that cause inflammation in the middle layer of the eye. This layer, called the uvea, has three parts:
- Iris: the colored circle at the front of your eye that controls how much light enters the eye.
- Ciliary body: a structure with tiny muscles that adjust the eye’s lens, which focuses incoming light to produce a clear image.
- Choroid, the layer of blood vessels that give your retina the nutrients it needs.
The swelling and tissue damage associated with uveitis may affect one or more of these parts. Additionally, uveitis may be used to refer to inflammation of the lens, retina, optic nerve, or the vitreous – the gel-like substance filling the middle of the eye.
There are over 50 types of uveitis, depending on where the inflammation is located, including:
- Anterior uveitis affects the front of your eye, including your iris and ciliary body ies. Also called iritis, anterior uveitis is the most common type.
- Intermediate uveitis(pars planitis) affects primarily the middle of the eye, including the retina and blood vessels closest to your iris as well as the vitreous.
- Posterior uveitis affects the back of your eye, including the retina and choroid. It is also known as choroiditis.
- Panuveitis (diffuse uveitis) affects multiple or all parts of the uvea.
While all forms of uveitis should be taken seriously, intermediate uveitis, posterior uveitis, and panuveitis are the most serious and recurrent. Leaving these conditions untreated could result in permanent vision loss.
Uveitis can also be described as “acute short term” or “chronic long term.” Acute uveitis is commonly associated with eye injury, while chronic uveitis may be associated with an underlying health condition, such as an autoimmune disease.
Symptoms of uveitis may differ depending on the type and location of the inflammation. Symptoms may occur in one or both eyes, and they can develop suddenly or gradually. General symptoms of uveitis include:
- Eye redness
- Eye pain
- Light sensitivity (photophobia)
- Dark spots or “floaters” in the field of vision
- Blurry vision
- Decreased vision
Acute anterior uveitis is often accompanied by symptoms like eye redness, pain, photophopia, and blurred vision.
Intermediate uveitis symptoms include floaters and blurred vision, but it may cause pain.
Posterior uveitis may develop gradually and lead to vision loss over time. It is usually diagnosed during a routine eye exam.
Panuveitis may be accompanied by any of the above symptoms.
Come in to see us today if you are experiencing any of these symptoms. Quick action is the best way to prevent vision loss.
Uveitis is characterized by inflammation, which is how the body responds to infection or damage. Though this inflammation can have a variety of causes, systematic autoimmune disease and infection in particular may lead to recurrent or severe cases of uveitis.
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):
- Ankylosing spondylitis.
- Behcet’s disease.
- Crohn’s disease.
- Multiple sclerosis.
- Reactive arthritis.
- Rheumatoid arthritis.
- Ulcerative colitis.
Because these diseases affect other parts of your body, we will coordinate your care with your other physicians.
Infections may also be responsible for uveitis. When this is the case, your doctor may refer to it as infectious uveitis. Infections that may be associated with uveitis include:
- Herpes simplex virus.
- Varicella-zoster virus (chickenpox and shingles).
- Cytomegalovirus (CMV)
- Tuberculosis (TB).
- West Nile virus.
- Lyme disease.
- Cat scratch disease (Bartonella).
You may have an infection and not have any symptoms for it. If you know that you have been exposed to a virus, you should talk to your doctor about getting tested. That way, you can avoid uveitis and other unpleasant side effects.
In addition, uveitis can be caused by an eye injury, treatment with certain anti-cancer drugs, lymphoma (in rare cases).
Sometimes, the cause of uveitis cannot be identified. Regardless, uveitis can be very serious and, if left untreated, lead to poor vision or even blindness. Come see us today if your eye is red, inflamed, painful or if you experience vision loss.
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, your eye doctor will start by getting your medical history, which may help indicate the cause of uveitis. He or she will also perform a variety of tests to help diagnose the type of uveitis, such as:
- Visual acuity test. The common eye chart test measures how well you can see at various distances.
- Tonometry. This standard test measures your eye pressure (intraocular pressure).
- Slit-lamp examination. A split lamp is a tool that allows your doctor to closely evaluate multiple parts of your eye for inflammation
- Ophthalmoscopy. Using a tool called a fundoscope, your doctor will examine the back part of your eye for signs of posterior uveitis
Once the type of uveitis has been determined, your doctor will work with you to create a personalized treatment plan.
Corticosteroids: a group of anti-inflammatory medication, corticosteroids help treat uveitis by blocking the inflammatory response and reducing swelling. Corticosteroids can be administered in several forms:
- Eye drops: if your uveitis is at the front of your eye and isn’t caused by an infection, eye drops may be an appropriate way to administer the steroid medication. 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 you have intermediate or posterior uveitis, or if eye drops aren’t working, you may be given corticosteroid injections in your eye.
- Oral steroid pills: if your uveitis doesn’t respond to drops or injections, or your disease is in the back of your eye, you may be prescribed a pill to be taken by mouth
- Intravenous steroids may be needed occasionally.
Antispasmodic medications: relax your eye’s muscles and prevent spasms, which can help reduce pain. They can be administered in the form of eye drops as well.
Drugs to treat infection
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.
If an autoimmune disease is the underlying cause, you might need an immunosuppressant. These medications suppress your body’s immune reaction to stop inflammation.
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.
You need a
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
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