uveitis inflammation of the uvea

Uveitis is an inflammation of the uvea, located in the middle layers or the central part of the eye, between the white, front portion of the eyeball called the sclera, and the retina at the back of the eye. The uvea provides most of the blood to the retina. It is a rare disease that affects mainly young people of both sex and causes vision loss in many cases.

Classification of uveitis

A big problem with practitioners is that there are several types of uveitis, depending on the part of the uvea affected. The uvea has three parts – iris, ciliary body and the choroids. The nature of uveitis depends on the part or combination of parts affected. Therefore, the condition and treatment is different. The nature of uveitis and its treatment also depends on its intensity or clinical course, and whether one or both eyes are affected.

Uveitis is therefore classified in three ways. The International Uveitis Study Group classification is widely used. It is based on the site of the disease as follows:

Anterior uveitis when the iris or the ciliary muscles are involved
Posterior uveitis when the retina and the choroid is involved
Intermediate uveitis when the vitreous or the peripheral retina is involved
Panu uveitis when two or more of these segments are involved. In some cases, the whole uveal is affected.

On the basis of clinical course it is classified as follows:

Acute uveitis if it lasts less than 3 months
Chronic if it lasts more than 3 months
Recureent uveitis when it recurs after complete cure

On the basis of laterality it is classified as:

Unilateral uveitis when only one eye is affected but recurrences may occur in the other eye
Bilateral uveitis when both eyes are affected

These three types of classification and the symptoms of the disease are essential for correct diagnosis and treatment.

The most common form is the anterior acute uveitis or AAU. This form of uveitis is painful, involves the front part of the eye and is usually limited to the iris. Posterior uveitis is next most common type.

Symptoms

Depending on which part or combination of parts is affected, a combination of the following symptoms will be seen. The inflammation may be localized or diffused and there may be loss of peripheral vision.

Redness
Light sensitivity
Floaters
Blurred vision
Pain

These symptoms may appear without any pain. In addition, appearance of symptoms does not necessarily mean you have uveitis. For that, a thorough eye examination will be needed.

Causes

Uveitis may be caused by many factors. Some of the common ones are:

An autoimmune response from the body associated with rheumatism and spondilysis
Infections like syphilis or tubeculosis
Eye injury
Some cancers, like lymphoma, that masquerade as uveitis
Inflammatory conditions

Diagnosis

Diagnosis of uveitis can be quite difficult because of so many types of this disease. Your eye specialist will carry out a complete eye examination and question you in detail about your signs and symptoms and medical history.

If he suspects an underlying disease as the cause, then you may be referred to another specialist. For effective treatment, correct diagnosis is essential but in some cases of uveitis, the cause may not be found.

Treatment

Uveitis should be treated promptly since left untreated many complications may develop. These include glaucoma, optic nerve damage, cataract, retinal detachment and vision loss.

Treatment depends largely on the type of uveitis diagnosed. Often, your doctor prescribes anti-inflammatory medications, such as corticosteroids given as eye drops, tablets or by injection into the eye. If infection is the cause, antibiotics, antiviral medications or some other medicine may be given with or without corticosteroids to bring the infection under control. If uveitis is caused by an underlying condition, treatment will focus on treating that condition.

With proper treatment, anterior uveitis can resolve in a matter of days to weeks. Posterior uveitis, on the other hand, may last several months or years and could permanently alter your vision.

If your uveitis does not respond well to corticosteroids or becomes severe enough to threaten your vision, you may be given an immunosuppressive or cytotoxic agent. Vitrectomy, which is a surgery to remove the vitreous from your eyes, may be necessary for diagnosis and treatment of uveitis.

Uveitis can reappear after successful treatment. Consult your doctor immediately for treatment, because recurrent uveitis poses a high risk of macular edema and permanent loss of vision.