Uveitis

Alternative names: Anterior uveitis, Intermediate uveitis, Posterior uveitis, Pan-uveitis, Choroiditis, Chorioretinitis

The term uveitis describes a group of inflammatory diseases that produce swelling, eye pain, distorted vision, and possible eye tissue damage.

There are four types of uveitis:

• Anterior uveitis occurs in the front of the eye and is the most common, least serious type.
• Intermediate uveitis occurs in the vitreous (the middle of the eye).
• Posterior uveitis is the least common form, occurring mainly in the back of the eye and often affecting both the retina and the choroid.  Also known as choroiditis or chorioretinitis.
• Pan-uveitis affects all three major parts of the eye.

Causes and Development

Uveitis is caused by an inflammatory response inside the eye.  Inflammatory cells can enter through the many blood vessels in the middle and at the front of the eye.  Examples include:

• Autoimmune disease, where the body is attacked by its own immune system
• Eye infection
• Infection elsewhere in the body
• Tumors occurring in the eye or other parts of the body
• Trauma/bruising to the eye
• Exposure to toxins that penetrate the eye

Sometimes the cause of eye inflammation is unknown.  Anterior uveitis is often caused by rheumatologic, skin, gastrointestinal, lung or infectious disease; Intermediate uveitis has been associated with various diseases, including sarcoidosis and multiple sclerosis; Posterior uveitis has many possible causes.

Signs and Symptoms

Uveitis causes vision problems by affecting the lens, retina, optic nerve, and vitreous.  It can affect one eye or both; symptoms can develop rapidly and may include:

• Blurred vision
• Decreased vision
• 'Floaters'
• Eye pain
• Redness of the eye
• Light sensitivity

Diagnosis and Tests

Diagnosis can involve physical examination, medical history, laboratory tests for infection, autoimmune disorders, central nervous system disorders, and eye tests (visual acuity, funduscopic exam, ocular pressure, slit lamp exam).

Treatment and Prevention

Treatment depends on the type of uveitis, and what is causing it.  Removing any underlying disease condition is obviously important, but the initial goal is to reduce and eliminate inflammation and pain, prevent further eye tissue damage, and restore any loss of vision if possible.  Treatment methods include:

• corticosteroid (eye drops, injections around the eye or inside the eye)
• immunosuppressive medication (taken orally)
• steroidal anti-inflammatory medication that (eye drops, pill, injection around or into the eye, intravenously, or slow-release capsule surgically implanted in the eye)
• other immunosuppressive agents

Complications; Seek medical attention if...

Although not normally a serious condition, uveitis can lead to slight vision loss or even complete blindness in severe cases.  Intermediate uveitis, posterior uveitis, and pan-uveitis are the most serious forms, often causing blindness if left untreated.

It is always important to see an eye specialist when any eye symptoms occur.