Uveitis

Uveitis is a condition where there is inflammation inside your eye in the middle layer of tissue called the uvea.

The uvea is the layer of the eye between the sclera (the outside white part of your eye) and the retina (the tissue inside at the back of your eye).

The most common type of uveitis is anterior uveitis which affects the iris at the front of your eye (also known as iritis). Uveitis usually affects 1 eye, but it can affect both. It’s most common in people 20 to 60 years of age but can happen at any age.

Symptoms of uveitis can start suddenly and include blurry vision, redness of your eye, eye pain, sensitivity to light and floaters (dark spots or squiggly lines that float across your vision). You can lose some of your vision if uveitis isn’t treated, so see your healthcare provider straight away if you have any of these symptoms.

In many cases the exact cause of uveitis isn’t known. However, it can be caused by:

• autoimmune diseases such as ankylosing spondylitis, psoriasis, rheumatoid arthritis, inflammatory bowel disease, sarcoidosis and multiple sclerosis
• infection, such as  AIDS, cytomegalovirus infection, herpes zoster infection (shingles), toxoplasmosis or syphilis
• injury to your eye
• medicines (such as zolendronate)
• cancer that affects your eye, eg, lymphoma.

Smoking increases your risk of getting uveitis.

Uveitis is usually grouped according to the parts of the uvea that are affected.  

The uvea has 3 parts:

• the iris (the coloured part at the front of your eye)
• the ciliary body (which helps the lens of your eye to focus)
• the choroid (which connects the retina to the sclera).
  
  

Image credit: Depositphotos (labels altered)

The different types of uveitis are:

• Anterior uveitis (also known as iritis) – this affects the iris at the front of your eye and is the most common type of uveitis
• Intermediate uveitis – this affects the ciliary body and the vitreous (the fluid that fills the eye).
• Posterior uveitis – this affects the choroid and retina at the back of the eye.
• Panuveitis – this affects all parts of the uvea from the front to the back of the eye.

Common symptoms of uveitis include:

• blurred vision
• dark, floating spots in your vision (floaters)
• eye pain
• sensitivity to light (photophobia)
• redness of your eye.

The symptoms can occur in one or both eyes. See your doctor as soon as possible if you have any of the above symptoms.

Symptoms can develop quickly, in hours or days, or gradually over weeks or months. Sometimes uveitis doesn’t cause any symptoms.

If you’re concerned that you might have uveitis, it’s important to see your doctor or optometrist. If necessary, you will be referred to an eye specialist (ophthalmologist). Your optometrist or eye specialist will do a thorough eye examination to see if you have uveitis and to help find out what’s causing your eye symptoms.

You can also contact an eye specialist directly for this type of examination or to have your eyes assessed and treated.

If you have uveitis, your eye specialist may arrange for you to have further tests including X-rays or blood tests to find out the cause of your uveitis.

Uveitis can’t be cured but treatment can stop it from getting worse. Treatment aims to control the signs and symptoms and prevent complications. Treatment depends on the type of uveitis you have or if you have any underlying disease that’s causing your uveitis.

Treatment of uveitis may include:

• medicines to treat any infection you may have
• pain-relieving medicines
• steroids (eye drops, pills or injections around your eye) to reduce eye inflammation
• immunosuppressant medicines (pills) to reduce inflammation by targeting your immune system
• eye drops and ointment to dilate your pupil (the opening in the front of your eye in centre of your iris) and reduce inflammation.

In some rare cases, surgery may be needed.

Self-care

If you’re being treated for uveitis, it’s important to go to all your follow-up appointments so that your eye specialist can check your symptoms and see how well your treatment’s working.

It’s important to follow all the instructions your eye specialist gives you so you can reduce your risk of permanent vision loss. Ask them to explain anything you don’t understand.

When to get help

You should call your eye specialist or get urgent medical care if you have any of the following:

• worsening eye pain
• worsening vision, or sudden loss of vision (partial or total)
• seeing flashes of light
• worsening floaters or sudden appearance of floaters
• sensitivity to light (eg, brighter situations cause eye discomfort or pain).

Anterior uveitis is usually the least serious type of uveitis and goes away in a few days to weeks with treatment. However, you may get more attacks of uveitis in the future.

Posterior uveitis can last from months to years and can cause permanent damage to your vision, even with treatment.

Possible complications of uveitis include loss of vision, cataracts, glaucoma and retinal detachment.

Early diagnosis and treatment of uveitis gives you the best chance of a good recovery with no permanent vision loss.