Uveitis

Index:

  1. What is uveitis?
  2. What are the symptoms of uveitis?
  3. What causes uveitis?
  4. How can uveitis be prevented?
  5. What is the treatment of uveitis?

What is uveitis?     

Uveitis describes inflammation of the uvea, the middle part of the eye made up of the choroidciliary body, and the iris. Uveitis can be either infectious or non-infectious. It is important to exclude infection before starting treatment.         

Uveitis can affect people of any age.

There are different types of uveitis depending on the part of the uvea affected:​ 

  • Anterior uveitis (iritis): is the most common type of uveitis and occurs in the front of the eye. Anterior uveitis is typically painful and causes the eye to be sensitive to light. Sometimes, anterior uveitis can be asymptomatic and only picked up after it has been present for some time.
  • Intermediate uveitis: this is where the bulk of the inflammation lies behind the lens and in front of the retina. It can develop at any age and occasionally does not require any treatment other than close observation.
  • Posterior uveitis (choroiditis): affects the back of the eye and may be related to an infection or an autoimmune process. It is typically sight threatening and treatment is advised. 
  • Panuveitis: is when all compartments of the eye are affected.

What are the symptoms?

Uveitis symptoms vary according to the part of the uvea that is affected. Anterior uveitis is more commonly painful than intermediate or posterior uveitis. Intermediate uveitis and posterior uveitis can cause floaters and loss of vision more commonly than anterior uveitis.    

What causes uveitis?

Uveitis may be caused by infection and autoimmune conditions, but may also be triggered by surgery or trauma.

The following infections are typically screened for: HIV, syphilis, tuberculosis, herpes, and toxoplasmosis. These infections are rare, but treatable and early identification is extremely important.

More commonly, uveitis is caused by a dysregulation in your immune system, whereby your immune cells recognise your eye as 'abnormal' and attack it.

How can it be prevented?     

You cannot really prevent uveitis, however, it is common for patients to have associated stress, illness, and tiredness with a flare up of their symptoms.

What is the treatment?

Treatment depends on the area of the eye affected. In anterior uveitis, most patients are managed with steroid eye drops. This may be either during a flare up of uveitis, or as maintenance therapy. 

Patients with intermediate, posterior, and panuveitis are more likely to require either systemic treatment or medication injected into the eye. After your eyes have been reviewed, the pros and cons of topical vs systemic treatment will be explained and discussed. It is difficult to generalise, but a treatment will usually be recommended that is most likely to be effective with the fewest side-effects.

As a general principle, eye inflammation is managed as proactively as possible with steroid drops, injections, or tablets. A period of inactivity is then maintained with medications that are safer and easier to take than steroids. Occasionally surgery is carried out if related complications arise, such as glaucoma or cataracts

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