Uveitis

What is a Uveitis? ‘Inflammation of the middle layer of your eye called the uvea.’

The uvea is the coloured part of your eye and it lies beneath the white part of your eye (the sclera). It has 3 parts: the iris (your pupil colour), the ciliary body (which is the clear fluid filling the front of the eye which is responsible for helping you focus) and the choroid (a part of the retina). If inflammation occurs in any of these parts of the eye (the uvea) it is called uveitis. The most common form of uveitis is anterior uveitis, this affects the iris and the ciliary body.

Anterior uveitis is sometimes caused by infection or injury but the main cause is due to inflammation in another part of your body. Less frequently it can occur following eye surgery and in some cases the cause is unknown. Eight per cent of the population are born with a genetic variant known as HLA B27 which makes those individuals more prone to this condition. Inflammatory systemic conditions such as Ankylosing spondylilits or Crohn’s disease make you more vulnerable to attacks of anterior uveitis because the immune system can become overactive in the eye.

Types of Uveitis:

  • Anterior – affects the front of the eye hence causing redness and pain and comes on quickly. This is the most common form of uveitis
  • Intermediate – affects the middle of the eye causing floaters and blurry vision
  • Posterior – affects the back of the eye and can cause poor vision
  • Panuveitis – affects front and back of the eye

How common is uveitis and who does it normally affect?

Uveitis is rare and occurs in around 2-5 people in every 100,000 in the UK every year. Individuals aged 20-59 are most affected.

Symptoms of uveitis:

  • Dull eye pain in one eye (in the eye or around the eye) which may be worse when you try to read or focus on something
  • Eye redness
  • Light sensitivity
  • Blurry or cloudy vision in one eye
  • Possible floaters (small shapes moving across your vision)
  • Some loss of ability to see to the side of your vision (restricted peripheral field of vision)

All of the above symptoms can come on suddenly or gradually over a few days. Generally, one eye is affected but occasionally both eyes are.

To alleviate your symptoms until you see an eye specialist consider the following:

  • Dark sunglasses if you are sensitive to light
  • Warm flannel to soothe the eye
  • Painkillers (such as Ibuprofen) to relieve the pain

Treating uveitis:

The main treatment is steroid eyedrops to help control the inflammation which are often prescribed alongside cyclopentolate eyedrops which help to relax the pupil by widening it thereby reducing the pain. Depending on the severity of the inflammation and whether the eye pressure is elevated, further drugs may be prescribed by your eye consultant. If infection is suspected then you may be prescribed antibiotics or antivirals.

In recurrent or persistent cases, further investigations, including blood tests and x-rays may be advised to look for underlying systemic inflammatory conditions. These tests will help to determine the cause and what treatment is needed.

It is important that uveitis is treated correctly and promptly to avoid any complications.

Some of the more common complications are:

  • Glaucoma (damage to the optic nerve)
  • Cataracts
  • Cystoid macular oedema (swelling of the back of the eye – retina)
  • Posterior synechiae (iris and lens stick together)

If you have had recurrent uveitis or your symptoms are not improving and you would like some expert advice, please book in to see our specialist, Mr P Kumar.

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