Uveitis

Uveitis is a general term for inflammation inside the eye, which can affect different parts of the eye, including the iris, retina, or choroid. Depending on the location of inflammation, it may be called:

Iritis (anterior uveitis): inflammation of the colored part of the eye (iris)

Vitritis (intermediate uveitis): inflammation in the middle of the eye

Pediatric Retina: Audina M. Berrocal, M.D.

Uveitis can impair vision and may cause complications in other parts of the eye if left untreated.

Symptoms of Uveitis

Symptoms often appear suddenly and can worsen quickly:

Causes of Uveitis

Uveitis can occur for many reasons:

Eye injury or surgery

Eye-specific inflammatory conditions: e.g., birdshot chorioretinopathy, pars planitis

Systemic inflammatory disorders: e.g., sarcoidosis, juvenile idiopathic arthritis, Crohn’s disease, ankylosing spondylitis

Infections: e.g., herpes zoster, syphilis, cat-scratch disease, toxoplasmosis, Lyme disease, tuberculosis, West Nile virus

Cancers affecting the eye: e.g., lymphoma

Lifestyle factors: Studies show uveitis is more common and severe in people who smoke. Quitting smoking may improve outcomes.

Untreated uveitis can lead to glaucoma, cataracts, or vision loss, so timely evaluation is essential.

Diagnostic Tests

Blood tests and X-rays

To check for systemic causes

Eye fluid analysis

Small samples may be taken to identify infections without major surgery

Eye angiography

Uses fluorescent dye to assess blood flow and inflammation in the retina or uvea

Eye photography

Measures retinal thickness and detects signs of inflammation; painless and quick

Treatments

Treatment is tailored to the type and cause of uveitis:

Oral medications: Anti-inflammatory or immunosuppressive drugs

Injected medications: Corticosteroids, slow-dissolving steroid pellets, or long-acting steroid devices

Vitrectomy: Removal of the vitreous (gel-like substance in the middle of the eye) for intermediate uveitis or to obtain samples for lab study

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FAQ

What is uveitis, and why is it sometimes called 'silent inflammation'?

Uveitis is inflammation of the uvea—the middle eye layer with iris, ciliary body, and choroid—causing pain, light sensitivity, floaters, or blurred vision if unchecked. It’s ‘silent’ because mild cases smolder without fanfare, yet flare-ups can scar the retina or raise pressure, leading to glaucoma. Triggers include autoimmune (like ankylosing spondylitis), infections (herpes), or idiopathic—it’s the eye’s way of yelling for help amid immune chaos.

What are the types of uveitis, and how do symptoms vary?

Anterior uveitis hits the front (iris), sparking red, achy eyes with glare aversion—most common, episodic. Intermediate affects the vitreous gel, causing floaters and blur without pain; posterior targets retina/choroid with vision distortion; panuveitis engulfs all, risking severe loss. Kids might show subtler signs like poor school focus, while adults note headaches—type guides urgency, as posterior needs faster imaging.

How is uveitis diagnosed in a clinical setting?

It kicks off with slit-lamp biomicroscopy revealing cells in the anterior chamber like dust in sunlight, plus dilated fundus checks for posterior involvement. Blood tests hunt infections (syphilis serology) or autoimmunity (HLA-B27), and OCT/angiography map swelling. No home kit—it’s pro territory, often with rheumatology input, to tailor therapy and dodge complications like cataracts.

What are the primary treatment strategies for uveitis?

Steroid eye drops taper inflammation fast for anterior flares, escalating to injections or oral prednisone for stubborn cases—80% respond initially. Immunosuppressants like methotrexate or biologics (adalimumab) prevent relapses in chronic autoimmune types, while antivirals tackle infections. Surgery rarely, for cataracts born of treatment; goal: quiescence, monitored by cell grading, restoring clear, pain-free sight.

Can lifestyle and prevention play a role in managing uveitis?

Dark glasses and humidity combat dryness, omega-3s (fish oil) may dampen inflammation per studies, and stress reduction via mindfulness curbs flares. If linked to IBD or psoriasis, treat the root—annual exams for at-risk folks (e.g., family autoimmune history) catch it early. With compliance, most control it long-term, but report new floaters pronto to safeguard vision’s future.