What Is Uveitis
Uveitis simply means the inflammation of the part of the eye called the uvea. The uvea is also known as the uveal tract. It is a continuous layer of fibrous tissue that surrounds the eye. It is made up of three structures:
The iris — The iris is the doughnut-shaped portion of the eye that gives it its colour.
The choroid — The choroid is a membrane filled with small blood vessels that lines the eye.
The ciliary body — A thick ring of tissue that helps control the lens. It is attached to the iris, also to the front portion of the choroid.
Depending on which portion of the uvea is damaged, several terms are used to describe the disease. They are as follows:
Iritis (anterior uveitis) – Affects the iris and the front part of the uvea.
Iridocyclitis is a condition that affects the iris and ciliary body.
Intermediate uveitis (also known as pars planitis) is a condition that affects the uvea in the centre, between the retina and the ciliary body.
Posterior uveitis (choroiditis) – Affects the choroids and the posterior section of the uvea.
Diffuse uveitis is a condition in which the whole uvea is inflamed.
Iridocyclitis and anterior uveitis are the two most common types of uveitis. Posterior uveitis is an uncommon condition.
Many cases of uveitis are associated with autoimmune conditions such as juvenile rheumatoid arthritis, lupus, ankylosing spondylitis, multiple sclerosis, or sarcoidosis) or an infection (such as tuberculosis, toxoplasmosis, herpes, or sarcoidosis), syphilis, or CMV) are related to uveitis (especially in patients with AIDS).
A number of eye disorders, such as pars planitis, birdshot choroidopathy, and sympathetic ophthalmia, can cause uveitis but do not generally affect other areas of the body.
Uveitis is a rare adverse effect of several medications. The origin of up to half of the cases is unknown, although new research has connected specific genes to the disease's development. According to one theory, certain individuals are prone to uveitis because they possess genes that enable the immune system to attack the uvea, a process that can be caused by infection.
Symptoms
Uveitis symptoms differ depending on where the inflammation is located. Anterior uveitis is usually linked with severe symptoms, which might include:
Redness of the eyes.
Eye pain.
Light sensitivity.
A vision that is blurry.
Intermediate and posterior uveitis might present with more mild symptoms, such as moving specks or clouds in your field of vision known as floaters, as well as reduced vision.
Diagnosis
If your doctor suspects you have uveitis, you'll likely be sent to an ophthalmologist (eye specialist), who will do a comprehensive examination that includes:
Visual acuity testing is performed to determine whether or not your vision has deteriorated. This may be as easy as looking at a chart of the eyes.
A funduscopic examination, in which the pupil is dilated (widened) to allow the ophthalmologist to see into the eye and view the structures behind the eye.
A funduscopic examination, in which the pupil is dilated (widened) to allow the ophthalmologist to see into the eye and view the structures behind the eye.
The pressure inside the eye is monitored to ensure it has not increased to dangerously high levels.s. This painless test uses a tonometer, which blows a puff of air or softly pushes on the eye's surface and analyzes how the surface reacts.
This painless test uses a tonometer, which blows a puff of air or softly pushes on the eye's surface and analyzes how the surface responds.
A slit-lamp examination involves shining a tiny beam of light into the eye to allow a magnifying lens to examine the highlighted part of the eye carefully. Your doctor will dilate the pupil of your eye with eye drops. In the eye, a drop of fluorescein dye can be applied. The dye stains the eye's surface temporarily, making it more visible for doctors to see which layers of the eye are inflamed.
In addition, your doctor will ask for medical history and also examine you. He or she may request blood tests and X-rays based on the results (such as a chest X-ray to look for evidence of sarcoidosis). Because uveitis is frequently linked to a viral infection or an autoimmune disease, other diseases must be identified and treated.
Expected time of Improvement
Most patients with uveitis will improve within days or weeks of receiving therapy. The illness, however, might continue for several months. Chronic (long-term) types of the disease are inherently difficult and are prone to recurrence. If your uveitis has been effectively treated, you should plan to see your doctor every one to six months for follow-up appointments to ensure that the condition stays stable.
Prevention
There is no method to prevent uveitis other than avoiding certain infections like syphilis or HIV.
Treatment
The goal of uveitis treatment is to reduce inflammation and discomfort. If you have a bacterial infection, your doctor will prescribe antibiotics, and if you have a virus, your doctor will give antiviral medicines. Prescription eye drops or ointments containing corticosteroids to decrease inflammation are typically used to treat noninfectious uveitis. If the iris is affected by uveitis, eye medications to dilate the pupil may be administered to keep the iris from moving and causing pain. The eyes might become more sensitive to strong light, your doctor may advise you to wear sunglasses. In more severe situations, your ophthalmologist may recommend corticosteroid injections into the eye, oral corticosteroids, or immunosuppressive medicines. Methotrexate, cyclosporine, tacrolimus, azathioprine, and mycophenolate mofetil are examples of immunosuppressive treatments used to treat uveitis. Adalimumab (injected under the skin) or steroid implants surgically implanted into the eye are two newer alternatives for treating severe uveitis that has not responded to other treatments.
Any uveitis complications, such as glaucoma or cataracts, will need to be treated as well. Many patients will be seen by a team of doctors, including a general practitioner, an ophthalmologist, and maybe additional specialists (for example, an infectious disease expert or a rheumatologist).When should you see a Doctor?
If you have impaired vision, discomfort in one or both eyes, light sensitivity, or redness in your eyes, see your doctor.
Prognosis
The prognosis differs based on the kind of uveitis, its severity and length, if it responds quickly to therapy, and whether it is accompanied by an illness. The prognosis is typically favourable when diagnosed and treated immediately, and patients can expect to recover eventually. If left untreated, uveitis can lead to severe problems such as glaucoma, cataracts, or irreversible vision loss.
