Uveitis (Iritis)


Uveitis is an inflammation of the the uvea, the layer between the sclera and the retina, which includes the iris, ciliary body, and the choroid.


Structure of Eye

The eye is a 3-layered ball, 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 Uvea is made up of the iris, the ciliary body and the choroid. The iris is the colored structure surrounding the pupil, visible in the front of the eye. The ciliary body is a structure containing muscle and is located behind the iris which focuses the lens. The choroid is a layer containing blood vessels that line the back of the eye and is located between the inner visually sensitive layer, called the retina. The uvea provides most of the blood supply to the retina.

 

Inflammation in uveitis may involve any but not necessarily all of these three structures. Depending upon which structures are inflamed, uveitis may be further subcategorized into one of three main diagnoses, these include:

  • Iritis or anterior uveitis,

  • Iridocyclitis or intermediate uveitis, and

  • Choroiditis or posterior uveitis.





Causes

It may result from an infection such as a virus (e.g. herpes) or a fungus (e.g. histoplasmosis). It may be due to a parasite such as toxoplasmosis. It may be related to Autoimmune Disease This, essentially, is when our immune system recognizes a part of our own body as foreign. Trauma to the eye, or even the other eye in the past, can lead to Uveitis. In many cases the cause is said to be unknown. This may well mean that the Uveitis is of the autoimmune type. Uveitis, can lead to other ocular complications, which may produce vision loss, including glaucoma, cataracts, or retinal damage. Early detection and treatment is necessary to reduce the risk of permanent vision loss.




Symptoms

Depending on which part of the eye is inflammed in uveitis different combinations of these symptoms may be present.

  • Redness

  • Light sensitivity

  • Floaters

  • Blurry vision

  • Pain



How is uveitis diagnosed?

A careful eye examination by an ophthalmologist is extremely important when symptoms occur. Inflammation inside the eye can permanently affect sight or even lead to blindness, if not treated.

Your ophthalmologist will examine the inside of your eye. He or she may order blood tests, skin tests or x-rays to help make the diagnosis.

Since uveitis can be associated with disease of the rest of the body, your ophthalmologist will want to know about your overall health. He of she may want to consult with your primary care physician or other medical specialists.




Treatment

Like the varied nature of uveitis, the treatment of it may differ from case to case quite considerably.

The treatment of Uveitis aims to achieve the following:

  • Relief of pain and discomfort (where present) - Your eye doctor dilates, or enlarges, your pupil with eyedrops to relax your iris and relieve your pain. Dilating your pupils increases your sensitivity to light, so you may need to wear sunglasses for a few days. Your eye doctor may give you eyedrops, ointments, or oral medications to reduce swelling. Be sure you understand how to use these medications.

  • To prevent sight loss due to the disease or its complications

  • To treat the cause of the disease where possible- Often the cause of uveitis isnít known, and your eye doctor can only treat the symptoms. If the cause is known, treatment will depend on the underlying condition. Your eye doctor may refer you to your primary care doctor or another specialist for evaluation and treatment.

Iritis is usually mild. Pain caused by spasm of the pupil constriction muscle is relieved by drops to dilate the pupil. Dark glasses may be helpful. Steroid eye drops or ointment may be needed. More severe cases require a search for an underlying cause.

 

Pars planitis is often treated with steroid eye drops, but may be treated with oral steroids or another type of medication to suppress the immune system.

 

Choroiditis requires determination of the underlying cause, and treatment of the underlying disease. The underlying disease may be serious, and additional specialists in infectious disease or autoimmunity may be needed for such diseases as syphilis, tuberculosis, AIDS, sarcoidosis (an inflammatory disease characterized by granulomas that can produce many different symptoms) or Behcet's syndrome






Prevention
Treating any underlying disorders may help to prevent uveitis for some people with existing systemic diseases.


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