Uveitis

Uveitis is a form of eye inflammation. It affects the middle layer of tissue in the eye wall (uvea).

Uveitis:

What is Uveitis?

Most of the eye’s blood vessels are located in the uvea, the central layer of the eye. The uvea consists of the iris, the ciliary body, and the choroid and is situated between the white outer coat of the eye (the sclera) and the inner layer (the retina).

As a collective term, uveitis describes a range of inflammatory illnesses that cause uveal tissue swelling. It can cause impaired vision or total blindness by affecting the lens, retina, optic nerve, and vitreous, not just the uvea.

Uveitis may have its origins in conditions specific to the eye, or it may be a symptom of a systemic inflammatory disorder.

Although it can occur at any age, those between the ages of 20 and 60 are most likely to be affected.

The duration of uveitis can range from rapidly resolving (acute) to slowly progressing (chronic). Uveitis, especially in its severe stages, might recur frequently.

Symptoms of Uveitis Eye:

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Blurred vision

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Dark, floating spots/lines in the vision (floaters)

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Eye pain

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Redness of the eye

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Sensitivity to light (photophobia)

The signs and symptoms of uveitis depend on the type of inflammation.

Acute anterior uveitis may occur in one or both eyes and in adults is characterized by eye pain, blurred vision, sensitivity to light and redness.

Intermediate uveitis causes blurred vision and floaters. Usually, it is not associated with pain.

Posterior uveitis can produce vision loss. This type of uveitis can only be detected during an eye examination.

What are the Causes of Uveitis

What are the Causes of Uveitis Eye?

Inflammation is the body’s natural response to tissue damage, germs, or toxins. It produces swelling, redness, and heat and destroys tissues as certain white blood cells rush to the affected part of the body to contain or eliminate the insult. Any inflammation of the uveal tissue produces Uveitis. 

Uveitis may be caused by:

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An attack from the body’s own immune system (autoimmunity)

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Infections or tumors occurring within the eye or in other parts of the body

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Trauma to the eye

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Drugs and toxins

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Most of the times the cause remains unknown which is termed as idiopathic

Types of Uveitis?

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Anterior uveitis is inflammation of the iris (iritis) or the iris and ciliary body.

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Intermediate uveitis is inflammation of the ciliary body.

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Posterior uveitis is inflammation of the choroid.

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Diffuse uveitis (also called pan-uveitis) is inflammation of all parts of the uvea.

How do doctors/surgeons diagnose Uveitis Eye?

Diagnosis of uveitis includes a thorough patient’s medical history and a detailed examination of the eye to record the findings.

Further ancillary investigations , laboratory tests may be done to rule out an infection or an autoimmune disorder.

Eye examination includes:

An Eye Chart or Visual Acuity Test: This test measures whether a patient’s vision has decreased.

Ocular Pressure

A Slit Lamp Exam: A slit lamp noninvasively inspects the front and back parts of the eye

A Dilated Fundus Examination: The pupil is widened (dilated) with eye drops and then a light is shown through with an instrument called an ophthalmoscope to noninvasively inspect the back, inside part of the eye.

What are the complications of Uveitis?

Many cases of uveitis are chronic, and they can produce numerous possible complications, including clouding of the cornea, cataracts, elevated eye pressure (IOP), glaucoma, swelling of the retina or retinal detachment. These complications can result in permanent vision loss.

What’s the treatment for Uveitis?

Uveitis treatment aims to reduce inflammation and pain, restore any eyesight loss, and prevent additional tissue damage.

In cases where uveitis is traced back to an underlying ailment, that illness will be prioritised in therapy.

Anti-inflammatory medication is usually the first line of defence against uveitis. Anti-inflammatory eyedrops, including corticosteroids, may be the first line of treatment recommended by your doctor. Corticosteroid pills or an injection may be prescribed if they don’t work.

Antibiotics or antiviral medications may be helpful in relieving the symptoms of uveitis. In the case of infectious uveitis, your doctor may recommend antimicrobials, antiviral drugs, or other medications (with or without corticosteroids) to help bring the infection under control.

Immune-suppressing or cell-killing drugs. If your uveitis does not impact both eyes, does not react to corticosteroids, or worsens to the point where your vision is at danger, you may need immunosuppressive or cytotoxic drugs to treat it.

Surgical and other procedures

Vitrectomy. Surgery to remove some of the vitreous in your eye (vitrectomy) may be necessary to manage the condition.

Surgery that implants a device into the eye to provide a slow and sustained release of a medication. For people with difficult-to-treat posterior uveitis, a device that’s implanted in the eye may be an option. This device slowly releases corticosteroid medication into the eye for two to three years. Possible side effects of this treatment include cataracts and glaucoma.

Anterior Uveitis treatments

Anterior uveitis may be treated by: 

  • Taking eye drops that dilate the pupil to prevent muscle spasms in the iris and ciliary body (see diagram)
  • Taking eye drops containing steroids, such as prednisone, to reduce inflammation

Intermediate, Posterior, Panuveitis treatments

Injections near the eye, oral drugs, and sometimes surgically implanted time-release capsules inside the eye are commonly used to treat intermediate, posterior, and panuveitis. It’s possible to administer more immunosuppressants. Before beginning one of these treatments, a doctor should make sure their patient is not battling any sort of infection.

Glaucoma and cataracts are just two of the potentially devastating adverse effects of some of these drugs. Your doctor may want to see you for checkups and bloodwork every few months.