Uveitis is a wide range of inflammatory diseases in the eye, specifically in the uvea.
There are three primary layers of the eye: the sclera, the cornea on the outside, the retina on the inside, and the uvea on the middle, which are mainly blood vessels and connective tissue, including pigmented cells. The different parts of the uvea are the iris in the front, the ciliary body in the middle, and the choroid behind them, which is located around most of the eye. Sometimes Uveitis can affect different eye parts, such as the retina, vitreous, or optic nerve.
What are the different types of Uveitis?
They are based on the part of the eye that is affected. The anterior Uveitis is inflammation in the front of the eye, iritis, or iridocyclitis. Intermediate Uveitis is the inflammation of the middle part of the eye, called vitreous. Posterior Uveitis is inflammation of the back of the eye, called choroiditis, vasculitis, retinitis, neuroretinitis, or chorioretinitis.
What causes Uveitis?
Uveitis has many causes. Most cases are due to an autoimmune disease or infection, trauma, drug-induced Uveitis, and in rare cases, cancer.
What are the symptoms?
These may vary depending on the type of Uveitis and may occur in one or both eyes, which include: Redness, blurred vision, pain, and sensitivity to light are typical symptoms of anterior Uveitis. Floaters and flashes frequently occur with intermediate or posterior Uveitis. Any of the above symptoms can occur with any Uveitis. Some types of Uveitis often present without symptoms, such as Uveitis associated with juvenile idiopathic arthritis.
What are the “cells”?
The white blood cells are visible in the eye’s interior through a slit lamp examination when the Uveitis is active.
How is Uveitis diagnosed?
The first step in diagnosing Uveitis is through a complete history of the disease and medical review. This importance can not be overstated and is, unfortunately, sometimes overlooked. The examination reveals the type of Uveitis; clinical tests can help identify the characteristics or complications of Uveitis, such as vasculitis, macular edema, and glaucoma.
Blood tests are almost always done in search of the well-known causes of the type of Uveitis it presents. External references, images, and biopsies can be performed to evaluate the associated systemic disease. Finally, the response to treatment can sometimes help the doctor decide what type of Uveitis is likely to present.
What systemic diseases can occur with Uveitis?
Autoimmune diseases associated with Uveitis include different types of inflammatory arthritis, such as ankylosing spondylitis, reactive, rheumatoid, psoriatic, or juvenile idiopathic arthritis; Sarcoidosis, systemic lupus erythematosus; inflammatory bowel disease; and multiple sclerosis.
How to treat it?
The main goal of treating Uveitis is to get rid of the inflammation as quickly as possible. Corticosteroids are the basis of treatment for acute Uveitis of non-infectious causes and can be used in combination with antibiotics in some cases for infectious Uveitis. They can be given in the form of drops, injections around or inside the eye, orally, or by intravenous infusion, depending on the location and severity of the inflammation.
Other medications used for Uveitis include dilation drops, which help limit the sensitivity of light, pain, and scarring of the iris to the lens (synechiae). In addition, uveitis glaucoma can be treated with drops that reduce pressure in the eye.
Systemic therapy, orally. Intravenous injection is sometimes necessary to treat persistent cases of Uveitis that recur after being treated acutely with steroids. Medications with antibiotics or antivirals can be used, sometimes in the long term, to avoid hospital remission.
Surgery can be helpful in the diagnosis and treatment of Uveitis, just as cataracts can be removed to improve vision. Vitrectomy eliminates the gel center of the eye; it can be used to perform a biopsy and improve vision.
What are the complications?
Vision loss is the main complication of Uveitis. Uveitis is the third leading cause of preventable blindness worldwide. This may be secondary to other complications such as cataracts, glaucoma, macular edema, retinal detachment, low pressure in the eye (hypotonia), damage to blood vessels, scarring of the cornea, and retina or choroid. Some of them can be treated, but the damage can become permanent. Also, in treating Uveitis, corticosteroids can lead to their own set of complications. For this reason, inflammation must be treated aggressively before these complications occur.