What is Uveitis? Uveitis Symptoms and Treatment
Uveitis is a common eye disease in society. Uveitis may cause symptoms such as eye pain, redness, and blurred vision. Untreated uveitis causes serious complications in the patient. What does uveitis mean? What causes uveitis? How is uveitis treated? You can find the answers to all these questions in the rest of the article.
What is Uveitis?
Uveitis is inflammation of the uvea layer located in the middle of the eye. uvea; It is located between the outermost sclera layer of the eye and the inner retina layer. The uvea contains many blood vessels, and these vessels provide nutrition to the retina layer, which contains the nerves that enable vision in the eye.
In the eye, structures called choroid, ciliary body and iris are also located in the uvea layer. The ciliary body changes the shape of the eye lens, allowing the lens to adapt to distance and near vision. The iris forms the colored part of the eye. The function of the iris is to adjust the amount of light entering the eye by dilating or contracting the pupil.
Inflammation of the ciliary body and iris, which are part of the uvea, is also called iridocyclitis. The choroid layer, another part of the uvea, also contains blood vessels that feed the retina. Inflammation of the choroid is called choroiditis.
Uveitis can be divided into different types depending on the area of the eye where the inflammation occurs. Types of uveitis:
Anterior Uveitis: In this condition, also called anterior uveitis, inflammation occurs in the front part of the uveal layer. Since the iris is the anterior part of the uvea, this inflammation usually affects the iris. The condition in which the iris becomes inflamed is defined as ‘iritis’. Iritis can occur in one eye or can affect both eyes. Iritis is the most common type of uveitis in society. Anterior uveitis is usually seen in people who do not have any comorbidities.
Intermediate Uveitis: This condition is also known as intermediate uveitis. In intermediate uveitis, the middle part of the uvea, that is, where the iris and ciliary body are located, is affected. The inflammation here is also called iridocyclitis. Although intermediate uveitis is usually seen in people who do not have any additional disease, intermediate uveitis may develop in those with autoimmune diseases such as multiple sclerosis (MS).
Posterior Uveitis: In this condition, also called posterior uveitis, the back part of the uvea becomes inflamed. The choroid part is located in this region and inflammation affects the choroid. Since the choroid hosts the vessels that feed the retina, inflammation occurring here can cause damage to the retina. Posterior uveitis usually causes more serious problems than other types of uveitis. Posterior uveitis may develop due to conditions such as infection and autoimmune disease. Among the types of uveitis, posterior uveitis is rarer than the others.
Pan-Uveitis: In this type of uveitis, all parts of the uvea are affected. Therefore, in pan-uveitis, features of other uveitis types can be seen together. Behçet’s disease can be given as an example of diseases that cause pan-uveitis.
Intermediate, posterior, and pan-uveitis types usually lead to more severe symptoms. Additionally, these types may cause recurrent uveitis. Recurrent uveitis progresses in attacks. In other words, first there is a uveitis attack in the eye, then the symptoms ease or disappear. Then there is a uveitis attack again. This cycle continues in this way.
What Causes Uveitis in the Eye?
It may not always be easy to find the underlying cause in patients diagnosed with uveitis. However, when the condition causing uveitis is determined; The most common are infections, autoimmune diseases and trauma.
Autoimmune diseases; It occurs when the immune system perceives the body’s own cells as foreign and attacks these cells. As a result, damage occurs in some parts of the body. In some autoimmune diseases, the immune system attacks the uvea layer of the eye, causing the development of uveitis. Autoimmune diseases that cause uveitis are as follows:
- rheumatoid arthritis
- Ankylosing spondylitis
- Psoriasis
- Ulcerative Colitis
- Kawasaki disease
- Behcet ‘s disease
- sarcoidosis
- Crohn’s disease
- Multiple Sclerosis (MS)
Infection may develop in the uveal layer. The immune system sends some cells to the uvea to fight infection. Substances released from these cells lead to the development of inflammation in the uvea. Infection-related causes of uveitis:
- herpes
- syphilis
- Tuberculosis
- toxoplasmosis
- histoplasmosis
- West Nile virus
- AIDS
- It can be considered as CMV (cytomegalovirus) retinitis.
Conditions such as trauma, injury, or damage to the eye may also cause uveitis. Exposure of the eye to various toxins is also among the causes of uveitis.
What are the Symptoms of Eye Uveitis?
Uveitis symptoms can be seen in one eye or in both eyes. Symptoms of uveitis may progress rapidly and become noticeable in a short time. Common symptoms of uveitis are as follows:
- blurred vision
- eye redness
- Sensitivity to light (photophobia)
- eye pain
- Seeing floating objects
Where the inflammation is in uveitis determines what symptoms the patient will experience. In acute anterior uveitis; Symptoms include eye pain and redness, blurred vision, sensitivity to light, and constriction of pupils.
The most common symptoms of intermediate uveitis are blurred vision and floaters. In intermediate uveitis, no pain is usually felt in the eye.
In posterior uveitis, decreased vision and even vision loss may occur in advanced stages.
Uveitis does not cause any symptoms in some people. Uveitis findings in these people can be detected during routine eye examination.
How is Uveitis Treated?
In order to diagnose uveitis, questions are first asked about the patient’s complaints. For example, the patient may be asked questions about when his/her symptoms started or what are the situations that increase or decrease their severity. The answers to these questions may contain important clues for diagnosing uveitis.
The next stage for the diagnosis of uveitis is examination. in examination
- The reflexes in the pupils are checked by shining a light into the patient’s eyes.
- Visual acuity is evaluated. For this evaluation, the patient is asked to read the letters or numbers on the card from a certain distance.
- The pressure inside the eye is measured with a procedure called tonometry. Before this procedure, numbing eye drops may be instilled into the patient’s eyes.
- With a biomicroscope, the structures in the front part of the eye are examined by magnifying them under light.
- The fundus examination is performed using a method called fundoscopy. Before this method, a drop is applied to the eye to dilate the pupils. Afterwards, the structures behind the eye are evaluated with the help of a special device (fundoscope).
These methods are often sufficient for the diagnosis of uveitis. However, in some cases, advanced tests such as OCT (Optical Coherence Tomography) and fluorescein angiography may be needed.
The main goal of treating eye uveitis is to reduce inflammation and improve vision. If uveitis develops due to another disease, the underlying condition should be treated first.
Medications are used first in the treatment of uveitis. These drugs can be classified as follows:
Anti-Inflammation: Patients may be given eye drops containing inflammation-reducing medications such as corticosteroids. However, in cases where the back of the eye is affected, the effectiveness of the drops decreases. In such cases, alternatives such as corticosteroid injection around the eyes or the use of oral corticosteroid tablets may be preferred.
Those That Control Spasm: In treatment, agents can be used to relieve eye pain by reducing spasms occurring in the iris and ciliary body.
Those That Eliminate Infection: Antimicrobial drugs can be given to patients in the treatment of uveitis caused by viral or bacterial infection.
Immunosuppressants: Strong immunosuppressive drugs can be started in the treatment of uveitis that occurs due to autoimmune diseases and cannot be controlled with corticosteroids.
Medications are often sufficient to treat eye uveitis. However, in uveitis that cannot be treated with medications and causes serious complications, surgical procedures can be considered as a treatment option.
Untreated uveitis; It can lead to very serious complications such as glaucoma, cataracts, optic nerve damage, and permanent vision loss.
Uveitis is a common eye disease. Uveitis usually does not cause any serious problems and can be cured with simple treatment. However, especially recurrent or chronic uveitis can cause serious health problems, including vision loss. For this reason, it would be beneficial for people showing symptoms of uveitis to consult an ophthalmologist without delay and have the necessary check-ups.
