Uveitis
Uveitis is a potentially serious disorder of inflammation of the eye. Uveitis is characterised by inflammation of the uveal tract, which is the layer of tissue containing blood vessels and pigmented cells sandwiched between the retina and the outer coat of the eye (sclera). The condition can be either infectious or non-infectious.
Uveitis can occur suddenly (acute), or it can become a long-term condition (chronic uveitis). It can affect just one eye or both eyes.
Uveitis symptoms
The symptoms of uveitis usually come on suddenly and get worse quickly. However, sometimes they come on more gradually. Additionally, in some cases, uveitis doesn鈥檛 cause any symptoms at all, meaning the condition is only picked up during a routine eye exam. Symptoms usually differ according to whether the uveitis is anterior, intermediate or posterior.
Anterior uveitis usually presents with rapid onset of symptoms. When symptoms occur, they include:
- red eyes
- eye pain
- light sensitivity
- blurred vision
- floaters
Intermediate uveitis usually presents with a more gradual onset of symptoms. When symptoms occur, they can include:
- blurred vision
- floaters, described as specks, spots or squiggly lines that float across your vision
Posterior uveitis can present with rapid onset, or gradual onset of symptoms. When symptoms occur, they include:
- blurred vision
- floaters
- flashing lights
- shadows in the vision
- distortion of the vision
- patches of missing vision
What causes uveitis?
At AOA体育平台 Eye Centre, your uveitis specialist will assess symptoms, examine your eyes and perform investigations in order to identify which type of uveitis you have. This is very helpful in determining the cause.
There are a vast number of causes of uveitis, but they can be divided up into groups: infections, inflammation or immune-mediated conditions and rarely, a cancer which can mimic inflammation.
There is a very long list of conditions that can cause or are associated with uveitis. Some, but by no means all causes are described below, according to the classification above. In some cases, no cause of uveitis can be found and it is then termed 鈥榠diopathic鈥�.
- infectious causes 鈥� organisms can enter the front chamber of the eye either via the cornea (for example, following an injury to the cornea), via a scratch, a foreign body, surgery or through the bloodstream. Examples include herpes simplex virus, cytomegalovirus, varicella zoster (chickenpox or shingles), syphilis and tuberculosis.
- inflammatory or immune-mediated causes 鈥� Acute anterior uveitis is more common in patients who carry the HLA-B27 gene variant, and this often occurs in patients with ankylosing spondylitis. Likewise, anterior uveitis can occur in patients with Crohn鈥檚 disease and ulcerative colitis. Other causes include sarcoidosis and Behcet鈥檚 disease.
- infectious causes 鈥� tuberculosis, syphilis and Lyme disease
- inflammatory causes 鈥� sarcoidosis, multiple sclerosis or idiopathic
- cancer causes 鈥� lymphoma
This type of uveitis has the largest list of causes and only a few causes are described here, and this list is not exhaustive.
- infectious causes 鈥� bacterial, fungal infections or parasitic infections 鈥� for example, syphilis, tuberculosis, toxoplasmosis, toxocara and viral infections causing retinitis
- inflammatory and immune-mediated causes 鈥� sarcoidosis, Bechet's disease, multiple sclerosis, birdshot retinochoroiditis or idiopathic
- cancer causes 鈥� lymphoma or cancer-associated retinopathy
Uveitis diagnosis
An eye doctor will usually diagnose uveitis by taking a thorough medical history, performing an eye examination and reviewing diagnostic tests.
This usually involves an assessment of your vision or tonometry to measure the pressure inside your eyes.
Sometimes, a slit-lamp examination may be recommended. This uses a slit beam of light to examine the eyes from front to back. Usually, this will involve dilating (widening) the pupil with eye drops in order to fully examine the retina. In particular, your specialist will be looking for signs of intraocular inflammation.
The retinal exam is sometimes called a dilated fundus examination.
Your doctor may use imaging tests:
- optical coherence tomography (OCT)
- fluorescein and indocyanine green angiography
- optos fundus photography 鈥� This is a specialised photograph of the whole of the retina, which extends from the structures in the centre of the retina, including the optic nerve and macula, to the edge of the retina, called the retinal periphery. This produces a colour retinal photograph extending 200 degrees. AOA体育平台 Eye Centre has also invested in a state-of-the-art version of Optos that allows both colour photographs, angiography and also OCT of the whole retina. This test can be helpful in diagnosing and monitoring some forms of posterior uveitis.
Your specialist may also order or recommend:
- blood tests 鈥� to look for systemic signs of disease, inflammation, or infection, or to look for genetic markers linked with eye inflammation. This will help to identify the cause of your uveitis.
- radiology imaging 鈥� for example, chest X-ray, CT imaging of the chest and brain MRI imaging.
- referral to other specialist colleagues 鈥� to assist in the diagnosis when there is a suspicion that other parts of the body are affected by inflammation, infection, or cancer. Other specialists might include chest physicians, gastroenterologists, rheumatologists, dermatologists, oncologists, and neurologists. All the specialities are available at AOA体育平台 Eye Centre.
- a procedure to take a sample of fluid from the eye 鈥� this might be from the front chamber of the eye called the anterior chamber, or the middle chamber, called vitreous cavity. The sample would be sent to the lab to look for evidence of microorganisms, inflammation, or cancer.
Are you experiencing any of the symptoms of uveitis and want to be assessed? Book an appointment with one of our specialists today.
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Uveitis treatments overview
Treatment depends on the type, location (anterior or posterior), underlying cause and whether one or both eyes are affected. For conditions like Behcet鈥檚 disease, uveitis is treated as part of the broader systemic treatment.
Infections and inflammation
If caused by infection, treatments include antibiotics, antivirals, or antifungals. In cases of inflammation, anti-inflammatory drugs such as steroids or immunosuppressants are used.
Anterior uveitis is commonly treated with steroid eye drops, sometimes combined with pupil-dilating drops.
Advanced treatment options
For posterior uveitis, medications like oral steroids, immunosuppressants, or biologic drugs (e.g., Adalimumab) may be required.
Steroid-releasing implants are also an option to treat cystoid macular oedema, a serious complication of posterior uveitis.
Surgical intervention
In rare cases, a vitrectomy may be performed to diagnose or manage uveitis. This procedure involves removing some vitreous gel from the back of the eye through small incisions.