Uveitis

Uveitis is a collection of ocular infectious and autoimmune diseases that cause inflammation of the uvea,
the vascular middle layer of the eye between the retina and the sclera, the white of the eye.

Inflammation from uveitis can affect one or both eyes and can also progress, causing damage to other parts of the eye. Other similar diseases include retinal vasculitis (inflammation of the retinal vessels) and scleritis (inflammation of the sclera).

Types of Uveitis

There are four types of uveitis that are categorized based on the location of the inflammation. The uvea is comprised of the iris, ciliary body, pars plana, and choroid.

• Anterior Uveitis is the inflammation of the iris and ciliary body
• Intermediate Uveitis is the inflammation of the ciliary body and pars plana
• Posterior Uveitis is the inflammation of the choroid
• Panuveitis is the inflammation of all layers

Symptoms

Common symptoms of uveitis may include:

• Eye redness
• Eye pain
• Light sensitivity
• Blurred vision
• Floaters (dark, floating spots in the vision)
• Decreased vision

Symptoms may present in one or both eyes and can become more severe over time. Occasionally, there are little or no symptoms.

Causes and Associations

Uveitis does not have a singular cause. After a thorough examination, the doctor will generate a

list of possible causes of the patient’s uveitis.

Uveitis is more likely to develop in patients who have a history of:

• Systemic inflammatory disease (e.g., inflammatory bowel disease, rheumatoid arthritis, lupus)
• Infections (e.g., shingles virus, herpes simplex virus, syphilis, tuberculosis)
• Eye injury
• Smoking

Testing

A comprehensive eye examination is important to assess uveitis, including vision testing, eye drops to dilate the pupils, and a complete examination of the front and back of the eye. It is best if a driver accompanies the patient to the eye exam as pupillary dilation may create near-vision blurring.

Typically, patients with uveitis will need blood work and/or radiology studies to assess for common infectious and autoimmune diseases that could be the cause of ocular inflammation. Occasionally, eye fluid samples will be taken and sent for analysis to assist with diagnosis.

People with uveitis may undergo various tests to evaluate their condition including:

• Optical coherence tomography (OCT)
• Fundus photographs
• Fundus autofluorescence (FAF)
• Fluorescein angiography (FA)
• Indocyanine green angiography (ICGA)

Treatment

Identifying the root cause of uveitis is important for determining the appropriate treatment . Uveitis resulting from infectious disease requires antibiotics or antivirals. If caused by an autoimmune disease, it is treated with medications that suppress the overactive immune system.

Several therapies are available to treat uveitis including anti-inflammatory eye drops, oral steroids or local steroids given around or into the eye.

As with all medications, there are potential side effects. Local steroid drops or injections may increase the risk of cataract formation and glaucoma. Oral steroids may worsen diabetes and high blood pressure, and should only be used at high doses for a limited amount of time. Immunosuppressive medication turns down the body’s overactive immune system and may increase the risk of infection.

All of these medications are carefully selected by the doctor to maximize the benefits and minimize the risks.

If you have any signs or symptoms of uveitis, contact us today to meet with a Mid Atlantic Retina specialist. Our team can work with you to protect your vision and minimize your complications.