What is Uveitis?
Uveitis is an inflammation of the uvea. The uvea is the middle layer of the posterior portion of the eye and is the iris in front of the eye. The uvea provides most of the blood supply to the inside tissues of the eye.
Signs and Symptoms of Uveitis
The symptoms of uveitis can appear suddenly and at times can progress rapidly over the course of a few days. The inflammation can occur in one or both eyes.
Red or blood shot eye
Pain in and around the eye
Photophobia or light sensitivity
Tearing or watering
Floaters described as dots, specks, cobwebs, or veils floating in the vision
The eye exam will show inflammation in the posterior portion of the eye. If the inflammation involves the choroid, it is called chorioditis. If the inflammation involves the choroid and the retina, it is called chorioretinitis. There may be white blood cells in the vitreous and also in the anterior chamber of the eye.
What Causes Uveitis?
In many cases of initial uveitis, there will be known cause found. In severe cases or chronic or recurrent uveitis, it is important to run tests to see if there is a cause or the uveitis.
Inflammatory and Autoimmune Diseases
Genetic Predispositions Related to Uveitis
HLA B27 is the most common gene. These include Ankylosing spondylitis, Reiters Syndrome, irritable bowel disease, psoriatic arthritis, and Crohn’s Disease.
HLA B15 related to Multiple Sclerosis.
Other Inflammatory Diseases
Sexually transmitted diseases
Ocular Histoplasmosis syndrome
Cat Scratch disease
Rocky Mountain spotted fever
Lymphoma (Hodgkin’s and non Hodgkin’s)
Diagnosis and Tests
The diagnosis is made by the eye doctor examining the eye and finding inflammation in the uvea and also in some cases the retina. It could only involve a small portion of the posterior eye or may involve a significant portion of the eye.
Pars planitis is a form of uveitis. The pars plana is the portion of the uvea that lies between the iris and the choroid. The inflammation is located only in the area of the eye (pars plana).
The eye doctor will take a detailed history to help determine if there is any underlying systemic disease that could be related to the uveitis. A battery of blood tests will be ordered. X-rays of the chest and lower back may be ordered. Also a skin test for tuberculosis may be performed. A MRI may also be ordered.
Prognosis and Complications
In rare circumstances uveitis can cause blindness. Uveitis needs prompt attention by an ophthalmologist in order to minimize any complications related to uveitis. Complications include:
Swelling in the retina
Scarring and atrophy of the retina and choroid
Treatment of Uveitis
If an underlying systemic disease is associated with the uveitis, it will need to be treated along with treating the uveitis.
Steroid eye drops are the primary form of treatment. Dilating eye drops may be used. In severe cases, oral steroids and steroid injections around the eye may be necessary. Other systemic medications may be needed depending on the cause of the uveitis. It is important that the treatment of the uveitis be complete before stopping the medications. Otherwise, it may flare back up. Close patient monitoring is important during the treatment to minimize any complications.