Uveitis is inflammation of the middle layer of the eye, the uvea, and surrounding tissue. It can be painful, the eye or eyes may be red, and vision can be cloudy.
The term uveitis generally refers to a range of conditions rather than a single symptom. An injury to the eye, a viral or bacterial infection, and some underlying diseases may cause uveitis. It can cause swelling and damage in the tissue of the eye. Untreated, it may lead to vision loss and other issues. It can affect one or both eyes.
The term uveitis refers to an inflammation of the uvea and any part of the inside of the eye. Several types of uveitis exist with a number of potential causes.
It mainly affects people aged
What is the uvea?
The uvea, also known as the uveal layer, uveal coat, uveal tract, or vascular tunic, is the middle layer of tissue found in the wall of the eye. This layer within the eye helps with several functions, including absorption of light and focusing.
The uvea consists of several parts. These include the:
- iris — the colored part of the eye that surrounds the pupil
- choroid — which helps the lens focus
- ciliary body — a ring of muscle behind the iris that connects the retina to the sclera
The different types of uveitis affect different parts of the uvea, as described below.
Anterior uveitis is the most common form of uveitis. Also known as iritis, it affects the front part of the eye, and doctors identify it by noting white blood cells and fibrin in the anterior chamber (front part of the eye). Doctors think it results from inflammation of the iris. Iridocyclitis is similar, but it includes inflammation of the ciliary body.
Intermediate uveitis can be vitritis or pars planitis. Vitritis is an inflammation of the jelly-like part of the eye, the vitreous cavity. When there is no underlying cause for the intermediate uveitis, it is known as pars planitis.
Posterior uveitis is an inflammation of the retina and choroid. Posterior refers to the back of the eye.
Panuveitis is an inflammation in all layers of the uvea. This type of uveitis can affect other areas of the eye, including the lens, retina, optic nerve, and vitreous. It can cause reduced vision and blindness.
Signs and symptoms of uveitis can vary. Often, they
- floaters — spots in the eye that look like tiny rods or chains of transparent bubbles floating around in the field of vision
- eye pain and redness
- general vision problems, including blurred or cloudy vision
- photophobia, an abnormal sensitivity to light
Without treatment, uveitis can cause vision loss.
Uveitis can occur in anyone. The inflammation may be limited to the eye or linked with viral or bacterial infections, autoimmune disorders, and/or injury.
- HIV and AIDS
- herpes simplex
- Lyme disease
- tuberculosis (TB)
Autoimmune and inflammatory disorders may also cause uveitis. These include:
- rheumatoid arthritis
- Crohn’s disease
- ulcerative colitis
- ankylosing spondylitis
- Vogt-Koyanagi-Harada (VKH) disease
- multiple sclerosis (MS)
Injury to the eye is another possible cause of uveitis. Injury may be due to trauma or exposure to chemicals.
During an exam, an ophthalmologist will likely look at the eye with a special slit lamp. The key feature of uveitis is seeing white blood cells either in the anterior chamber or vitreous.
Other findings include bumps on the cornea, called keratic precipitates. If there is inflammation in the iris, patients may feel some pain when the pupil contracts, which is when light hits it.
Due to the number of potential underlying conditions that may cause uveitis, the opthalmologist may refer a person to a uveitis specialist or rheumatologist for a complete check-up and diagnosis of an underlying condition.
A person with uveitis who receives prompt and appropriate treatment will usually recover. Without treatment, the risk of cataracts, glaucoma, band keratopathy, retinal edema, and permanent vision loss increases.
According to the American Academy of Ophthalmology, the most common treatment for uveitis involves the use of corticosteroid drops to help reduce inflammation. In addition, a person may use eye drops to help open the pupils, which reduces swelling and pain.
- oral steroids in the form of pills
- injected steroids given either around or in the eye
- a surgical implant that provides small doses of steroids over time
A doctor may also recommend immunomodulator therapy or biologics to help reduce the immune system response. If an optometrist suspects an underlying autoimmune disorder, they will likely recommend that a person contact a rheumatologist for specialized care.
Which treatment a doctor recommends can vary based on the type of uveitis.
Treating anterior uveitis
Some common treatments for anterior uveitis include:
- eye drops to widen the pupil
- drops to reduce pressure on eyes
- topical corticosteroids
Treating intermediate and posterior uveitis
A doctor may use additional methods to treat intermediate and posterior uveitis, including:
- corticosteroids — injections, intravenous, implants, or oral
- antivirals, antibiotics, or other medications
- nonsteroidal anti-inflammatory drugs (NSAIDs) — to treat pain and swelling
- biologic agents
Prompt treatment and close monitoring can help reduce the risk of complications.
If they do occur, they may include:
- macular edema
- scar tissue
- retinal detachment, or detached retina
- vision loss
Several factors can increase a person’s risk of developing uveitis. Some common risk factors are:
- use of certain medications
- vitamin D levels
- living with an autoimmune disease, such as rheumatoid arthritis
In addition, females have a higher chance of developing uveitis than males.
Uveitis types can be either acute or chronic. Which subtype a person has can affect their recovery.
Anterior uveitis may be either acute (lasting a few weeks) or chronic (lasting for 3 or more months). Most cases of posterior uveitis are chronic, and it will typically take several months for a person to fully recover.
However, it is not possible to know exactly how long each case will last. A person should talk with their doctor about their outlook and follow all treatment recommendations to ensure recovery.
A person’s outlook is generally positive. Most people will not go permanently blind. People living with chronic forms of uveitis may develop other conditions, such as cataracts or glaucoma, that can cause vision loss.
A person can reduce their risk of developing permanent vision loss by following all treatment recommendations to reduce inflammation and pressure in the eye.
People living with an underlying condition, such as rheumatoid arthritis or MS, can help prevent uveitis by following their treatment plans and keeping their condition in remission.
The following helps answer some common questions about uveitis.
Is there a natural cure for uveitis?
Uveitis has no cure. Instead, treatment focuses on reducing swelling and inflammation. The use of immunomodulatory therapy can get the disease into remission, however.
A person may be able to use natural or complementary therapies to treat underlying conditions, such as rheumatoid arthritis or MS. However, a person should talk with their doctor about complementary therapies before starting a new therapy.
What is the difference between uveitis and conjunctivitis?
The main difference between conjunctivitis and uveitis is the layer of the eye that each condition affects. Conjunctivitis, also known as pink eye,
The causes can also vary. While uveitis may be the result of inflammation associated with an autoimmune disorder, conjunctivitis is typically the result of a bacterial, viral, or fungal infection. It may also occur due to an irritant or allergen getting into the eye.
While both can cause red, irritated eyes, conjunctivitis often does not cause vision issues. However, a person may experience watery eyes, a feeling that something is stuck in the eye, discharge, and irritation of the eye.
Uveitis can affect several parts of the middle layer of the eye. There are several types of uveitis based on the location it affects. A person may develop acute or chronic forms, which affects how quickly they can recover with treatment.
Treatment can vary, but the main focus is to reduce inflammation and swelling to prevent complications. People living with an underlying condition, such as MS, should work with their doctor to treat both conditions.