Uveitis
/What is Uveitis?
Uveitis (pronounced you-vee-EYE-tis) is an inflammation of the tissues that occupy the middle layers of the eye. These layers are called the uveal tract or uvea. The uvea includes the iris (colored part of the eye), choroid (a thin membrane containing many blood vessels) and ciliary body (the part of the eye that joins these together).The uvea is a critical structure for vision because it contains the blood vessels that supply oxygen and nutrients to the critical parts of the eye. While uveitis is uncommon, affecting about 1 in 1000 adults and 1 in 2000 children, it can cause serious vision loss or blindness if not diagnosed early and treated aggressively.
Diagnosis
In some cases, a diagnosis can be made, based on patient history and on an eye examination, alone. Changes in vision are not always indicative of a clear diagnosis, so an evaluation of potential underlying causes is required. This may include a work-up, searching for inflammation, infection or infiltration (cancer). Laboratory tests including blood work, a TB skin test and X-rays are usually the starting point. Because uveitis may originate elsewhere in the body, your primary care doctor or a specialist may be required to conduct a complete medical exam.
Signs and Symptoms
The main signs of uveitis include eye redness, abnormal eye pressure levels, a cloudy film in the eye from inflammatory cells, retinal swelling and blood vessel leakage in the back of the eye. Symptoms include light sensitivity, eye pain, blurred vision, and floaters.
Uveitis may develop rapidly, and it is very important that you see your eye doctor (ophthalmologist or optometrist) for a complete eye examination if you develop any of the above symptoms. Be especially wary if a painful red eye does not clear up quickly. Left untreated, uveitis may permanently damage your vision.
Diagnosis
Uveitis has many potential causes, including viral infections, fungus, bacteria, parasites, peripheral inflammatory disease, or eye trauma. There are four types of uveitis and tests target specific diagnoses: Iritis is the most common form of uveitis. It affects the iris and is often associated with autoimmune disorders such as rheumatoid arthritis. Iritis may develop suddenly and may last up to eight weeks, regardless of treatment. Cyclitis is an inflammation of the middle portion of the eye and may affect the muscle responsible for focusing the lens. Cyclitis may develop suddenly and last for several months. Retinitis affects the back of the eye. It can progress rapidly, making it difficult to treat. Viruses, such as shingles or herpes, may cause retinitis. It can also be caused by bacterial infections, such as syphilis or toxoplasmosis. Choroiditis is marked by inflammation of the tissue layer, beneath the retina. It may also be caused by an infection such as tuberculosis or an autoimmune disease like rheumatoid arthritis or lupus. In a large number of cases, the cause of uveitis is not known. Reducing stress can be a helpful preventative measure.
Treatment
Because uveitis is serious, treatment needs to begin immediately. If infection is not the cause, your ophthalmologist may prescribe steroid eye drops, in order to reduce swelling, in combination with pain relievers. Antibiotics are used in patients with infectious uveitis and dark glasses are issued to ease light sensitivity. Complications of uveitis may include glaucoma, cataracts, retinal fluid build-up, vision loss and abnormal blood vessel growth – the latter of which might interfere with vision. Early diagnosis and treatment is critical. Newer treatments are now available that can restore vision in some patients with severe uveitis; we specialize in these therapies here at the Retina Macula Institute.