Uveitis
Uveitis is an inflammatory condition that affects the eye or more specifically the uvea. The eye is shaped like a ball, hollow inside with three different layers of tissue surrounding a central cavity. The outer most layer is the sclera (white coat of the eye) and the innermost is the retina (the inner neural-lining of the eye). The middle layer between the sclera and retina is called the uvea. This layer is very rich in its blood supply. When the uvea becomes inflamed, the condition is called uveitis (pronounced U'VE-I-'TIS).
What Is The Importance of the Uvea?
The uvea contains many of the blood vessels which nourish the eye. The uvea consists of three parts; the iris, the cilliary body, and the choroid. Inflammation of the uvea can adversely affect the cornea, lens, the sclera, retina and other vital parts of the eye. Since the uvea borders many important structures in the eye, inflammation of this layer may be sight-threatening and more serious than the more common inflammations affecting the outside layers of the eye.
What Are The Symptoms Of Uveitis?
Symptoms of uveitis include light sensitivity, blurring of vision, pain, and redness of the eye. Uveitis may come on suddenly with redness and pain, or it may present with a slow and insidious onset with little pain or redness, but gradual blurring of vision. Sometimes uveitis can be accompanied by an increase in intraocular pressure (uveitic glaucoma) further increasing eye redness and pain.
Are There Different Kinds?
Yes, when the uvea is inflamed near the front of the eye (in the iris), it is described as iritis. If inflammation exists in the middle of the eye involving the ciliary body, it is called cyclitis. Inflammation in the back of the eye affecting the choroid, is called choroiditis.
What Causes Uveitis?
Uveitis has many different causes. It may result from a virus (such as shingles, mumps or herpes), a fungus (such as histoplasmosis, or a parasite (such as toxoplasmosis). It also can be associated with auto-immune diseases. Lab work may be helpful in establishing a diagnosis in about fifty percent of cases. In most cases, the cause remains unknown.
Uveitis can also be related to disease in other parts of the body (such as arthritis) or come as a consequence of injury to the eye. Inflammation in one eye can result from a severe injury to the opposite eye (sympathetic uveitis).
How Is Uveitis Diagnosed?
A careful eye examination is extremely important when symptoms occur. Inflammation inside the eye can permanently affect sight, and at times, lead to blindness.
Your eye doctor will use instruments to examine the inside of the eye and often can make a diagnosis on that basis. In some circumstances, blood tests, skin tests, x-rays, and sometimes, even specimens taken surgically from the eye may assist in establishing the diagnosis. Since uveitis can be associated with disease in the rest of the body, an evaluation and understanding of the patient's overall medical health is important. This may involve consultation with other medical specialists.
How Is Uveitis Treated?
Prompt treatment is necessary to minimize any loss of vision. Eye drops, especially steroids and pupil dilators, are medications used to reduce inflammation and pain. For deeper inflammation oral medication or even injections may be necessary. Complications such as glaucoma (high pressure in the eye), cataracts (clouding of the lens of the eye), or new blood vessel formation (neovascularization), also may need treatment in the course of the disease. If complications are advanced, conventional surgery or laser surgery may be necessary. Uveitis arising in the front or middle part of the eye (iritis or cyclitis) is commonly more sudden in onset, generally lasting six to eight weeks, and in early stages can usually be controlled by the frequent use of drops. Uveitis in the back part of the eye (choroiditis) is commonly slower in onset and may last longer, and is often more difficult to treat. These cases are best managed by retinal specialists.
Who can treat Uveitis?
Since uveitis is an inflammation inside the eye and is potentially sight-threatening, prompt treatment and proper diagnosis are essential. A case of simple "red eye" may in fact be the earliest sign of a more serious problem. A "red eye" which does not clear up promptly should be evaluated and treated immediately by your eye care physician.
An optometrist or ophthalmologist is educated, trained, and licensed to provide medical care of the eyes. Some eye doctors have specialized training in ocular diseases and uveitis which gives them an advantage in managing more complicated cases of this sight threatening disease.
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