Uveitis: The Causes, Symptoms And Treatment

Uveitis is the inflammation of the middle layer of the eye, which is also referred to as uvea or uveal tract. The term uveitis is loosely used for any inflammation of the interior of the eye. The uvea comprises altogether the iris, the choroid of the eye, and the ciliary body. Irritation of the iris, now referred to as anterior uveitis, is the most ordinary type of uveitis. Between the sclera and the retina in the center of the eye is where the uvea is located. Its role is to supply blood to the retina.

Uveitis is an uncommon condition, which generally arises in middle-aged people, but anybody can suffer from it, and 10% of uvetis victims are children. Eyesight loss may occur when scars develop on the choroid and retina and the disease is left untreated. Vision loss also occurs when issues of the uveitis by itself or steroid treatment causes cataract, macular oedema and high intraocular pressure (IOP) resulting in glaucoma.

Causes of uveitis

The reason for uveitis is not known in numerous cases and in few cases Uveitis is Idiopathic, where the condition occurs suddenly. However, we know of some situations and circumstances that can lead to uveitis.

The below conditions may further the risk of developing uveitis:

1. Autoimmune disorders like JIA/JRA, rheumatoid arthritis, psoriasis etc
2. A blow to the eye or surgery that may have lead to an injury (traumatic uveitis)
3. AIDS, syphilis and herpes which weaken the immune system.
4. Infection
5. Certain cancers, like lymphoma, which have an indirect effect on the eye.

Symptoms of Uveitis

1. Blurred vision
2. Eye pain
3. Cloudy vision
4. Redness of the eye
5. General vision issues
6. Abnormal sensitivity to the eye or Photophobia
7. Change in the color of the iris
8. Pupils fail to dilate/constrict due to scar tissue

It is significant to note that children with JIA/JRA related uveitis tend not to have any signs and symptoms until vision loss occurs.

Treatment of Uveitis

Treatment of uveitis normally comprises of a prescribed steroid of some form, to lessen the inflammation. Your doctor may prescribe steroid drops, injections or pills based on the area of the uvea affected. Your doctor might use dilating drops to dilate the pupil, decreasing spasms of the muscles of the pupil and decreasing pain, but also preventing the lens from sticking. Your doctor may even prescribe drops to lessen the pressure in the eye.

If an infection is found, the patient will be prescribed either an antibiotic or an antiviral medication to limit the infection. Corticosteroids may be given in combination. This steroid medicine may be given as eye drops, tablets or by injecting inside the eye. It is imperative to rule out corneal ulcers by Florescence Dye Test (FDT) prior to giving corticosteroids.

Where steroids are not effective, or the uveitis becomes chronic, immunosuppressant therapy can be considered. Methotrexate is helpful for approximately 60% of sufferers, especially when used in conjunction with Ciclosporin or Tacrolimus. A substitute to methotrexate is Cellcept. Some patients do not respond to these treatments and biologics like Humira or Remicade may be considered.

Usually, with prompt and proper treatment together with close monitoring the possibilities of problems arising can be reduced. In case any problem occurs, they may include

1. Retinal detachment
2. Eyesight loss
3. Scar tissue
4. Macular edema
5. Cataracts
6. Glaucoma

If you happen to have any of the above symptoms of uveitis, fix up an appointment with your eye doctor, particularly if there is pain or reduced vision. If uveitis is identified it is vital to be treated by an ophthalmologist who specializes in uveitis, not one with a passing interest. An ocular immunologist is an expert who is further qualified to treat with and prescribe immunosuppressant drugs. It's vital to have a check-up of your eyes frequently even if you are not suffering from the above symptoms, as your optician may be able to spot any early signs of disease before you become aware of any apparent symptoms of uveitis.