Uveitis

The eye is shaped much like a tennis ball, with three different layers of tissue surrounding a central gel-filled cavity. The outer most is the sclera (white coat of the eye) and the innermost is the retina (image-gathering tissue in the back of the eye much like the film in a camera). The middle layer between the sclera and retina is called the uvea, from the Greek word “uva” meaning grape. In the laboratory, it looks much like a “peeled grape.” When the uvea becomes inflamed, the condition is called uveitis (pronounced U’VE-I’TIS).

What is the importance of the uvea?

The uvea contains many of the blood vessels which nourish the eye. Inflammation of the uvea can affect the cornea, the retina, the sclera, and other vital parts of the eye. Since the uvea borders many important parts of the eye, inflammation of this layer may be sight-threatening and more serious than the more common inflammations of the outside layers of the eye.

What are the symptoms of uveitis?

Symptoms of uveitis include light sensitivity, blurring of vision, pain, and redness of the eye. Uveitis may come on suddenly with redness and pain, or it may be slow in onset with little pain or redness, but gradual blurring of vision.

Are there different kinds of uveitis?

Yes, when the uvea is inflamed near the front of the eye in the iris, it is described as iritis. If the uvea is inflamed in the middle of the eye involving the ciliary body, it is called cyclitits. If the inflammation is in the back of the eye affecting the choroids, it is choroditis.

What causes uveitis?

Uveitis has many different causes. It may result from a virus (such as shingles, mumps, or herpes), a fungus (such as histoplasmosis), or a parasite (such as toxoplasmosis). In most cases, the cause remains unknown.
Uveitis can also be related to disease in other parts of the body (such as arthritis) or come as a consequence of injury to the eye. Inflammation in one eye can result from a severe injury to the opposite eye (sympathetic uveitis).

How is uveitis diagnosed?

A careful eye examination by an ophthalmologist (medical eye doctor) is extremely important when symptoms occur. Inflammation inside the eye can permanently affect sight, and at times, lead to blindness.
An ophthalmologist will use instruments to examine the inside of the eye and often can make a diagnosis on that basis. In some circumstances, blood tests, skin tests, x-rays, and sometimes even specimens taken surgically from the eye, may assist the diagnosis. Since uveitis can be associated with disease in the rest of the body, an evaluation and understanding of the patient’s overall medical health is important. This may involve consultation with other medical specialists.

How is uveitis treated?

Prompt treatment is necessary to minimize any loss of vision. Eye drops, especially sterioids and pupil dilators, are medications used to reduce inflammation and pain. For deeper inflammation, oral medication or injections may be necessary. Complications such as glaucoma (high pressure in the eye), cataracts (clouding of the lens of the eye), or new blood vessel formation (neovascularization), also may need treatment in the course of the disease. If complications are advanced, conventional surgery or laser surgery may be necessary. Uveitis arising in the front or middle part of the eye (iritis or cyclitis) is commonly more sudden in onset, generally lasting six to eight weeks, and in early stages can usually be controlled by the frequent use of drops. Often, this type of uveitis cannot be given a specific cause. Uveitis in the back part of the eye (choroiditis) is commonly slower in onset and may last longer, and is often more difficult to treat.

Who can treat uveitis?

Only an ophthalmologist (medical eye doctor) is properly qualified to treat uveitis. Since uveitis is an inflammation inside the eye and is potentially sight-threatening, prompt treatment and proper diagnosis are essential. A case of simple “red eye” may in fact be a serious problem of uveitis. A “red eye” which does not clear up promptly should be evaluated and treated by an ophthalmologist.

An ophthalmologist is the medical doctor (MD or osteopath) who is educated, trained, and licensed to provide total care of the eyes. Total eye care includes performing comprehensive medical eye examinations, prescribing corrective lenses, diagnosing injuries and disorders of the eye, and using the appropriate medical and surgical procedures necessary for their treatment.

This information is provided by The American Academy of Ophthalmology.