Inflammation of the Uvea – the middle layer of the eyeball – is called Uveitis. Uvea has many blood vessels that nourish the eye. Uveitis can damage vital eye tissue, leading to permanent vision loss. Uveitis symptoms often come on suddenly and get worse quickly. Early diagnosis and treatment are important to prevent complications and preserve vision.
Uvea is the middle layer of tissue in the wall of the eye between the Sclera (the outer white portion) and the Retina (the inner portion of the eye). Uvea consists of the following:
Uveitis can affect one or both eyes, and it can affect people of all ages, even children. A study found that the incidence and prevalence of disease was lowest in children and highest in patients 65 years or older. Women had a higher prevalence and incidence of uveitis than men.
There are 4 types of Uveitis depending on which part of the Uvea is affected
1. Anterior Uveitis
It affects the front of the eye (between the cornea and the iris) and the ciliary body. It is also called Iritis or iridocyclitis and is the most common type of Uveitis. It predominantly affects young and middle-aged people. Many cases occur in healthy people and may only affect one eye, but some are associated with rheumatologic, skin, gastrointestinal, lung and infectious diseases.
2. Intermediate Uveitis
It affects the ciliary body. The center of the inflammation often appears in the vitreous. It is also called Cyclitis and is commonly seen in young adults. It has been linked to several disorders such as sarcoidosis and multiple sclerosis.
3. Posterior Uveitis
It affects a layer on the inside of the back of your eye, either the retina or the choroid or both. This type of uveitis is often called choroditis or retinitis or chorioretinitis. There are many infectious and non-infectious causes to posterior uveitis.
4. Panuveitis (or Diffuse Uveitis)
This is a type of Uveitis when all three parts of the Uvea are affected by inflammation. Behcet’s disease is one of the most well-known forms of pan-uveitis and it severely damages the retina.
Intermediate Uveitis, Posterior Uveitis, and Panuveitis are the most severe and highly recurrent forms of uveitis. They often cause blindness if left untreated.
In addition to the above, blood tests and imaging tests such as radiography, CT and MRI scans may be required to confirm the cause of Uveitis.
As per the type of Uveitis, following is an overview of the treatment method:
Anterior Uveitis treatment
Use of eye drops containing steroids to reduce inflammation
Use of eye drops that dilate the pupil and have cycloplegic action to prevent muscle spasms in the iris and ciliary body
Intermediate Uveitis, Posterior Uveitis, and Panuveitis treatments
Along with the above treatment used in anterior uveitis, oral steroids are generally needed.
Sometimes they are treated with injections around the eye or at times intravitreal injections of sustained release medications like a steroid implant e.g. Ozurdex injection
Other immunosuppressive agents may be indicated in certain cases. A doctor must make sure a patient is not fighting an infection before proceeding with these therapies.
In advanced cases with severe inflammation, Vitrectomy – a surgical procedure – may be indicated
The focus of Uveitis treatment is primarily to reduce inflammation, reduce pain and contain any further damages to tissues. Corticosteroids remain the mainstay of treatment. While your Ophthalmologist will take care of the dosage and duration of the steroids and other immunosuppressants where indicated, it must be kept in mind that taking such medications for long term may produce side effects such as stomach ulcers, osteoporosis (bone thinning), diabetes, cataracts, glaucoma, cardiovascular disease, weight gain, fluid retention, and Cushing’s syndrome (a medical condition that develops due to exposure to high levels of hormone cortisol for a long time).
Disclaimer: All information, provided above is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Read our full disclaimer here.
