Uveitis is inflammation of the uvea—a delicate structure which lines the inner eye. The uvea is the middle layer of the three layers of the eye. It sits between the innermost layer, the retina, and the outermost layer, the sclera. The retina is the layer that receives light and turns it into signals the brain can read as vision. The sclera is the white protective layer.
The uvea also has three parts—the iris, the ciliary body, and the choroid. The iris is the colored part of the eyeball that controls the size of the pupil. The circular ciliary body sits behind the iris and secretes clear, watery liquid, or aqueous humor, into the front of the eyeball. The choroid resides along the back half of the eyeball and contains a rich network of blood vessels that support the overlying retina. There are different types of uveitis depending on which of these parts are affected:
- Anterior uveitis is inflammation of the iris. Another name for it is iritis. It is the most common form of uveitis.
- Intermediate uveitis is inflammation of the ciliary body. Cyclitis is another name for it.
- Posterior uveitis is inflammation of the choroid. Another name for it is choroiditis.
- Diffuse uveitis occurs when inflammation involves all uveal layers. Panuveitis is another name for this condition.
Uveitis symptoms include eye redness, light sensitivity, pain, and blurred vision, and can affect one or both eyes. Symptoms tend to start suddenly and may worsen quickly. Uveitis is serious because it can lead to blindness. In fact, it is the third leading cause of blindness in the United States.
Uveitis causes are numerous. In many cases, doctors have a hard time finding the exact cause. The most common causes are infection, injury, and autoimmune disorders.
People, especially women, between the ages of 20 and 50 are most likely to develop uveitis. However, it can affect children and teenagers too. Smoking increases the risk of developing it.
When uveitis is linked to an underlying condition, such as an autoimmune disease, treating the condition will help the uveitis. Doctors also use eye drops to relieve pain and decrease inflammation in the eye. Since some types of uveitis often come back or cycle on and off, follow-up appointments are necessary.
Seek immediate medical care if you have symptoms of uveitis. Early treatment is vital to prevent irreversible damage and permanent vision loss.
Usually, uveitis symptoms develop rapidly. They can also worsen very quickly and cause permanent damage. However, it is possible for symptoms to start gradually.
Uveitis can affect one or both eyes. The most common symptoms of uveitis include:
- Blurred or decreased vision
- Eye pain and redness
- ‘Floaters,’ or dark spots in your field of vision
- Sensitivity to light
Uveitis is a serious eye condition that can lead to permanent damage and blindness. Seek immediate medical care (call 911 if you need assistance) if you, or someone you are with, have symptoms of uveitis. Immediate evaluation by an ophthalmologist is necessary. Prompt treatment can prevent irreversible damage and vision loss.
In up to 50% of cases, doctors are unable to find the exact cause of uveitis. The most common causes are infection, injury, and autoimmune and inflammatory diseases. Infections can include shingles, Lyme disease, syphilis, tuberculosis, and parasitic diseases, such as toxoplasmosis. Injury can encompass trauma, surgery, and exposure to toxins. Autoimmune and inflammatory diseases that can cause uveitis include rheumatoid arthritis, inflammatory bowel disease (IBD), lupus, multiple sclerosis, and others.
A number of factors increase the risk of developing uveitis. However, not all people with risk factors will get uveitis. Risk factors include:
- Age between 20 and 50, although children and adolescents can also develop it
- Female gender
Reducing your risk of uveitis
It is not always possible to prevent uveitis. However, you may be able to lower your risk by quitting smoking. Research has shown a significant link between smoking and the risk of developing uveitis. In addition, if you have an autoimmune or inflammatory condition, effectively controlling it can help prevent uveitis.
The goals of uveitis treatment are to relieve symptoms and prevent permanent vision loss. If an underlying condition is present, treating it can relieve symptoms and protect your vision. Treatment will continue until all inflammation in the eye has resolved. This can take some time, as uveitis can last for several weeks or many years. Posterior uveitis can take a very long time to heal, as can any uveitis with severe inflammation.
Uveitis treatments can include:
- Anti-inflammatory medicines, usually corticosteroid eye drops. Sometimes, oral medicines or even shots (eye injections) are necessary to control the inflammation. There is also a steroid implant doctors surgically insert in the eye. It treats stubborn cases by steadily releasing corticosteroid medicine directly into the eye over 2 to 3 years.
- Antimicrobial medicines when an infection is present. This can include antibiotics and antiviral drugs.
- Immunosuppressant drugs to block the immune system response. These drugs may be necessary in severe cases that don’t respond to corticosteroids. Doctors may also use them when both eyes are affected.
Doctors may also prescribe eye drops to dilate or widen the pupil. This helps relieve pain with anterior uveitis. Wearing dark sunglasses can also reduce discomfort if eyes are sensitive to light.
Permanent vision loss is the most serious complication of uveitis. It leads to approximately 30,000 cases of blindness each year. These complications come in the form of cataracts, glaucoma, and irreversible optic nerve damage. Seeking prompt treatment offers the best chance of preventing these complications.
Uveitis also tends to recur. Regular medical care with an eye care professional is vital for monitoring eye health and vision following an episode of uveitis. This will help catch signs of uveitis remission (and other potential problems) early.