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UVEITIS
What is Uveitis?
Uveitis is the inflammation of the Uvea which is made up of Iris, Ciliary body and Choroid. If we think of the eye as a hollow, fluid-filled, 3-layered ball, then the outer layer is the sclera (a tough coat), the innermost is the retina, (the thin light- gathering layer), and the middle layer is the Uvea (the vascular layer).
What are the signs and symptoms of uveitis?
Signs and symptoms vary greatly depending on the type of uveitis. Anterior Uveitis is associated with eye pain, redness, blurring of vision and light sensitivity. Intermediate and Posterior forms of uveitis may more typically be associated with floaters, flashes of light and blurred vision.
What causes Uveitis?
The majority of cases of uveitis are idiopathic. This means that the process occurs without a specific identifiable cause or an associated disease elsewhere in the body. In some cases however, an underlying disease condition may be present.
Underlying causes of uveitis may be broadly categorized as allergy, infections, trauma, malignancy or other causes.
What are the signs and symptoms of uveitis?
Signs and symptoms vary greatly depending on the type of uveitis. Anterior uveitis is associated with eye pain, redness, blurring of vision and light sensitivity. Intermediate and Posterior forms of uveitis may more typically be associated with floaters, flashes of light and distortion vision.
Classification of uveitis :
1. Anatomic Classification
- Anterior uveitis (front compartment)
- Intermediate uveitis (middle compartment)
- Posterior uveitis (rear compartment)
- Pan uveitis (all compartment)
2. Clinical Classification :
- Acute uveitis (discrete time-limited episode)
- Recurrent uveitis (multiple acute episodes with resolution of inflammation in between episodes)
- Chronic uveitis ( ongoing long-term inflammation with incomplete resolution)
How is it diagnosed?
The eye needs to be examined very thoroughly to see what type of uveitis you have. This usually involves instillation of eye-drops to make the pupils wider so that the doctor can see into your eye more thoroughly.
It is equally important to see if there is evidence of any other underlying cause like Auto immune disorders, infections and trauma etc. This may involve a whole variety of tests like blood-tests, X-rays, scans, etc.
How is uveitis treated?
The findings in uveitis may be very similar, but the treatment varies significantly depending on the type and cause of the uveitis.
- In the case of allergy uveitis the treatment may involve the use of corticosteroids and/or immunosuppressive drugs.
- Infective uveitis requires treatment of underlying infection.
- Likewise uveitis may be a manifestation of a malignant condition. In this case, it is managed along with treating the underlying malignancy.
The treatment of some forms of uveitis may involve collaboration between ophthalmologists and other specialists such as rheumatologists, infectious disease specialists or oncologists.
Treatments of other complications in the eye secondary to uveitis may also require separate therapy such as for glaucoma, cataract, retinal membranes or macular edema (central retinal swelling).
WHAT SHOULD TREATMENT BE AIMED AT?
- Relieving pain and discomfort.
- Preventing sight loss due to the disease or its complications.
- Treating the underlying cause of the disease where identifiable.
WHAT ARE THE DRUGS USED TO TREAT UVEITIS?
- Steroids: Steroids make up the major part of uveitis treatment.
They are used in different forms:
- Eye drops As a general rule the treatment is started with stronger drops frequently to reduce the inflammation as quickly as possible. The treatment would then be "tapered off" gradually before being stopped. This is important because potentially the eye may be damaged by even short periods of inflammation if not treated vigorously enough.
- Peri-ocular injections. (Injections locally around the eye).
- Oral tablets
- Immunosuppressants
- Mydriatics (pupil dilators).
Are there any modifiable risk factors for uveitis? Unlike health conditions such as heart disease, diabetes and high blood pressure in which the modification of lifestyle may have a major impact on the disease, the causes of autoimmune uveitis are less subject to lifestyle modifications.
What are the complications of Uveitis?
- Cataract
- Glaucoma
- Macular oedema
WILL I GO BLIND?
Most patients with acute uveitis do not lose vision and treatment is aimed at controlling the inflammation to prevent any visual loss. The main causes of visual loss in patients with chronic uveitis are cataract, glaucoma or damage to the back of the eye from high pressure inside the eye, and macular oedema or 'waterlogging' of the retina due to the chronic inflammation. All these conditions are treatable.If not treated properly in time, the patient may become blind.
SHOULD I WORRY IF A CAUSE CANNOT BE FOUND FOR MY UVEITIS?
No. In many people, no obvious cause is found for their uveitis. In many diseases associated with inflammation, no underlying cause can be found either-the most common example being rheumatoid arthritis. In some patients, inflammation can be detected elsewhere such as sarcoidoisis in the lung, but we do not know the cause of that either.
Must Remember Facts
- UVEITIS is usually recurrent
- Early treatment is very Important
- Contact your Doctor once the symptoms start
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