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Uveitis : Types, Causes, Symptoms, Diagnosis and Treatment

What is Uveitis?

Uveitis is the inflammation of the eye that affects the eye’s middle layer. The middle layer is known as the uvea. The uvea is the middle layer of tissue in the wall of an eye, which consists of the choroid, ciliary body and the iris . When you see your eye in the mirror, you will see the iris (coloured part of the eye) and the sclera (white part of the eye ).

Uveitis can affect one or both the eyes and can affect people of any age. It can be caused due to an eye injury, an infection, or an underlying disease. If left untreated, it can cause permanent vision loss. Therefore, you should consult a doctor and get medical help as soon as possible.

What are the Types of Uveitis?

The type of uveitis depends on the inflamed part of the eye. Typically, there are four types of uveitis:

  • Anterior uveitis: It happens in the front of the eye and affects the coloured part of the eye called the iris. That’s why it is also known as iritis. It is a very common type of uveitis.
  • Intermediate uveitis: It usually affects the retina, which is just behind the pars plana and the vitreous (the gel present in the centre of the eye). Hence, it is also known as vitirits or pars planitis.
  • Posterior uveitis: This type of uveitis is very rare. It affects the retina, back of the eye and choroid. Hence, it is often known as choroiditis. 
  • Panuveitis: This affects the three major parts of the eye from the back to the front. It also causes extensive damage to the retina.

What are the Symptoms of Uveitis?

The symptoms depend on the part of the uvea that is inflamed. Some symptoms may occur suddenly and cause damage very quickly. In other cases, the symptoms may develop gradually. It can affect one or both eyes. Some signs and symptoms that you may have uveitis are:

  • Redness in the eye
  • Pain in the eye
  • Blurred or cloudy vision
  • Light sensitivity
  • Headaches
  • Decreased vision
  • Floating spots in your vision

Intermediate uveitis usually does not cause any pain and causes blurred vision and floaters in your vision. Some types of this condition do not show any symptoms and can only be detected during regular eye examinations. These can not be left untreated as they may lead to permanent vision loss in the future and affect your life adversely. 

What Causes Uveitis?

The cause of uveitis is often unclear in many cases. The inflammation might be due to an underlying disease or an infection. Some causes that affect your eyes and may result in uveitis are:

  • Medication side effect
  • An inflammatory or autoimmune disorder which affects other parts of the body like Crohn’s disease, sarcoidosis, systemic lupus erythematosus or ankylosing spondylitis 
  • An infection like herpes zoster, cat-scratch disease,  toxoplasmosis, syphilis or tuberculosis
  • Eye surgery or injury 
  • Very rarely, cancer that affects the eye like lymphoma

When Should You See a Doctor?

Usually, it is not a matter of concern. However, if you have extreme redness and dangerously high pressure in your eye, you need immediate medical help. You should contact an ophthalmologist who will ensure immediate control of inflammation and pressure in the eye.

What are the Complications of Uveitis?

Left untreated, uveitis can cause complications, including:

Retina scarring

Retinal swelling (macular edema)

Cataracts

Glaucoma

Optic nerve damage

Permanent vision loss

Retinal detachment

How Can You Prevent Uveitis?

One of the most important things for prevention is the early detection of the signs and symptoms. If the condition is detected early, timely action can be taken to control the inflammation and pressure in the eye. Some other ways that can help you prevent uveitis are:

  • Avoid smoking. Though smoking may not trigger uveitis, it can delay your recovery from the inflammation as it produces toxic chemicals in your body. 
  • Relax your body as stress can trigger uveitis and possibly worsen it. Get adequate sleep and give your eyes rest.
  • Eat a healthy diet as vitamins such as Vitamin C and E are very good for your eyes 
  • Avoid getting eye injuries and reduce infection exposure.

How Uveitis Diagnosed?

  1. Assessment of vision and the response of your pupils to light (with glasses if you usually wear them)
  2. A slit-lamp examination. It is a microscope that illuminates and magnifies the front of the eye with an intense line of light. This examination is important to identify microscopic inflammatory cells in the front of your eye
  3. Ophthalmoscopy. Also called funduscopy, this test involves dilating (widening) the pupil with eye drops and shining a bright light into your eye to examine the back of the eye
  4. Tonometry. An exam that measures the pressure inside the eye 

Your doctor may also suggest:

  1. Blood tests 
  2. Imaging tests, radiography, CT Scan or MRI scans 
  3. Optical coherence tomography (OCT) imaging. This test helps in measuring the thickness of retina and choroid to reveal inflammation in these layers 
  4. Indocyanine green angiography or Fluorescein angiography: In these tests, the doctor places an intravenous (IV) catheter in a vein of your arm to administer a dye, which will reach the blood vessels in your eyes thus allowing for photographs of blood vessel inflammation inside your eyes
  5. Analysis of aqueous or vitreous fluid from the eye
  6. Color photography of the inside of the eye (retina)

The treatment of Uveitis will depend on the cause and type of uveitis. 

  • If uveitis is due to an infection, it will be treated with antibiotics or antiviral medicines. 
  • If the cause is an underlying problem, the treatment will focus on that specific condition to cure uveitis. 
  • Your doctor may also prescribe eye drops that will reduce inflammation in the front of the eye, while corticosteroid injections may be required to treat inflammation in the back of the eye.
  • In some severe cases, medications to suppress the immune system may be prescribed.
  • Vitrectomy. A procedure to remove some of the vitreous in your eye. It is rarely used to diagnose or manage the condition
  • A medication-releasing implant. For those with difficult-to-treat posterior uveitis, a medication-releasing device is implanted in the eye. This device releases corticosteroids slowly into your eye for 2 – 3 years.

It is necessary to visit your doctor for follow-up examinations to ensure you do not have any complications in the future.

Conclusion

Usually, uveitis that affects the front of your eye heals more quickly than posterior uveitis. Regular follow-up examinations will help you reduce the side effects. If left untreated, uveitis can cause complications such as permanent vision loss, retina scarring, or cataracts. 

Frequently Asked Questions (FAQs)

How long does uveitis take to heal?

With proper treatment, it may clear up in two to five weeks. It will also depend on the type of uveitis and the severity of each case. It may take months to heal in some cases.

Is uveitis caused by stress?

Stress is one of the factors that increase the risk of uveitis. Stress increases the pressure on the eye and can lead to your inflammation worsening.

Can uveitis cause fatigue?

Yes, fatigue is a symptom of uveitis. Other symptoms include blurred and cloudy vision, eye pain, or eye redness. 

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