Uveitis

An Inflammatory Eye Condition

© Elaine Moore

May 4, 2007

Uveitis is an eye condition that can occur as an autoimmune disorder or as a result of injury, infection, or exposure to toxins. Uveitis is characterized by inflammation of the middle layer of the eye, which is known as the uvea. The uvea is composed of three structures:

• The iris—the colored structure of the eye surrounding the pupil
• The ciliary body—the muscle that supports the iris and focuses the lens
• The choroids- a layer containing the eye’s blood vessels located between the inner retina and the white of the eye (sclera)

As an autoimmune disorder, uveitis may occur alone or it may accompany other systemic autoimmune diseases such as rheumatoid arthritis, Bechet syndrome, sarcoidosis, Kawasaki disease, Reiter disease, psoriasis, ulcerative colitis, multiple sclerosis, systemic lupus erythematosus, or ankylosing spondylitis. Uveitis may also occur in AIDS, cytomegalovirus infection, syphilis, tuberculosis, Lyme disease, and in fungal infections.

Uveitis may cause inflammation of all three structures that make up the uvea. Alternately, only one of the structures may be affected. For instance, in the type of uveitis affecting only the iris, the condition is caller iritis, or anterior uveitis. Intermediate uveitis is also known as iridocyclitis, and posterior uveitis is known as choroiditis or chorioretinitis.

Types of Uveitis

The most common type of uveitis is anterior uveitis, which represents 75 to 90 percent of all cases, and involves inflammation in the front part of the eye. Anterior uveitis is characterized by flares lasting from a few days to a few weeks with appropriate treatment alternating with relapses. Posterior uveitis is generally a more serious condition, with inflammatory periods lasting as long as a year. In posterior uveitis permanent vision damage may occur even with treatment. Intermediate uveitis (vitritis or plans partitis) is caused by inflammation in the vitreous or fluid portion of the eye.

Symptoms of uveitis

Symptoms in uveitis are related to which of the uvea’s three structures are affected. Symptoms may have a sudden onset, and pain may not necessarily be present.

Symptoms include:

• Redness
• Light sensitivity (photophobia)
• Floaters
• Blurred vision
• Pain

Triggers and Complications

Uveitis may occur as a consequence of trauma to the eye, including eye surgery and infections, or it may occur as part of a generalized inflammatory process in systemic autoimmune diseases. Uveitis is often associated with disorders that have an HLA B27 component, such as ankylosing spondylitis and Reiter’s disease. Complications of uveitis include visual impairment, vision loss, glaucoma, cataracts, or retinal damage. In the United States, uveitis is responsible for about 10 percent of all cases of blindness.

Treatment

Early treatment is necessary to avoid the risk of permanent vision loss. Treatment options include steroid eye drops, injections, or pills taken orally and eye drops that dilate the pupil and reduce pain. In severe cases, chemotherapeutic immunosuppressants are used to suppress the immune system.

Resources:

Uveitis, Medline Plus Medical Encyclopedia, , August 8, 2006, accessed April 1, 2007.

The Uveitis Information Group, Shetland Isles, Royal National Institute of the Blind

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