Uveitis

Iridocyclitis, Iritis

What is Uveitis?

Uveitis is the inflammation of the uveal tract of the eye. Uveitis may involve any or all structures of the uveal tract including the iris (iritis), ciliary body (cyclitis), choroid (choroiditis), and the retina (retinitis). It is also described according to the part of the uveal tract affected (anterior, intermediate, posterior, or diffuse).

The inflammation is usually caused by an infection, diseases of the immune system, or injury. Diseases that involve other body systems (systemic diseases) cause 40% of all cases of uveitis. Uveitis may affect one (unilateral) or both (bilateral) eyes.

Uveitis occurs in three stages: acute, intermediate, and chronic. Uveitis may be one of two types. Nongranulomatous is least serious and may last a few days to weeks. Granulomatous is usually caused by an infection and can last months to years.

How is it diagnosed?

Symptoms of Uveitis

Symptoms may occur rapidly or slowly. The individual will present with one or more symptoms depending on which part of the uveal tract is inflamed.

  • The prime symptom of posterior uveitis is decreased vision.
  • Symptoms of anterior uveitis include moderate eye pain that may worsen on exposure to light, excessive tearing, blurred vision, and mild visual impairment.

Depending on the cause of the uveitis, there may be symptoms related to systemic diseases.

Physical exam: Anterior uveitis reveals cloudiness and cells in the fluid (aqueous humor) between the cornea and lens (anterior chamber). Tearing and decreased vision are usually present.

Redness surrounding a dull swollen iris and a small, irregular pupil with decreased light response are other common findings.

The physical signs of posterior uveitis include cells in the fluid of the interior eye (vitreous humor), cloudiness of the retina, and yellow, white and gray patches behind the retina. The decreased vision of posterior uveitis is the reason the individual seeks medical attention as pain is usually absent.

Tests: Aside from the visual testing of the physical exam, there are no other specific tests for uveitis. Any other tests would be determined by the suspected cause of the uveitis.

How is uveitis treated?

The treatment is determined by the cause of the uveitis and is undertaken only when there is a definite understanding of the diagnosis. A safe, early treatment is the use of mydriatic-cycloplegic eyedrops that dilate the pupil and prevent adhesions in the iris (synechiae).

Corticosteroids may be given orally or locally in certain cases of uveitis, but not until certain infectious diseases are excluded as possible causes.

Antibiotics may be prescribed in cases of infections. Photocoagulation may be necessary in severe cases.

Medications

Information Brand Generic Label Rating
Prednisone Deltasone Prednisone
Imuran Azathioprine
Prograf Tacrolimus
Voltaren Diclofenac
Indocin Indomethacin
Rheumatrex Methotrexate

What might complicate it?

Uveitis can result in the iris permanently adhering to the cornea or lens (anterior or posterior synechiae), clouding of the aqueous or vitreous humor, glaucoma, damaged or detached retinas and cataracts. Infections may spread to other areas of the eye.

Predicted outcome

If treated early, visual problems may be avoided. Complications can cause mild to severe permanent changes of vision. Uveitis may recur even if treated promptly or may persist in its chronic state for years.

Alternatives

Tumor, acute glaucoma, acute conjunctivitis, trauma, keratitis, and keratoconjunctivitis are among the other diagnoses that present with the signs and symptoms of uveitis.

Appropriate specialists

Ophthalmologist, retina trained ophthalmologist and rheumatologist.

Last updated 6 October 2011


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