Last updated on June 8th, 2017 at 06:53 pm
Uveitis (pronounced you-vee-EYE-tis) is inflammation of the uvea — the middle layer of the eye that consists of the iris, ciliary body and choroid. Uveitis can have numerous causes, including eye injury and inflammatory illness. Direct exposure to hazardous chemicals such as pesticides and acids used in making procedures likewise can cause uveitis.
The type of uveitis you have actually is classified by where inflammation takes place in the uvea:
- Anterior uveitis is swelling of the iris (iritis) or the iris and ciliary body.
- Intermediate uveitis is swelling of the ciliary body.
- Posterior uveitis is inflammation of the choroid.
- Scattered uveitis (likewise called panuveitis) is swelling of all areas of the uvea.
Numerous cases of uveitis are chronic, and they can produce many possible complications, including clouding of the cornea, cataracts, raised eye pressure (IOP), glaucoma, swelling of the retina or retinal detachment. These complications can result in permanent vision loss.
Uveitis occurs most often in people ages 20 to 50. A California study approximated that more than 280,000 individuals in the United States are impacted by uveitis each year, which is nearly 3 times greater than formerly thought.
The study, based on medical records from six northern California neighborhoods, likewise approximated that uveitis is the factor for 30,000 brand-new cases of loss of sight per year and up to 10 percent of all cases of loss of sight.
Anterior uveitis is the most typical kind, with an annual occurrence of about 8 to 15 cases per 100,000 individuals. This kind of uveitis impacts males and females equally.
What Causes Uveitis?
Uveitis has dozens of causes, including viral, fungal and bacterial infections. But, in many cases, the cause is unidentified.
Eye care specialists sometimes can determine the cause if there has actually been trauma to the eye, such as from surgery or a blow, or if you have a transmittable or immunological systemic condition.
A few of the numerous different systemic disorders that can cause uveitis consist of:
- intense posterior multifocal placoid pigment epitheliopathy
- ankylosing spondylitis
- Behcet’s disease
- birdshot retinochoroidopathy
- herpes simplex
- herpes zoster
- inflammatory bowel disease
- juvenile rheumatoid arthritis
- Kawasaki’s disease
- Lyme disease
- multiple sclerosis
- presumed ocular histoplasmosis syndrome
- psoriatic arthritis
- Reiter’s syndrome
- systemic lupus erythematosus
- Vogt-Koyanagi-Harada syndrome
Also, research released in the journal Ophthalmology shows smoking is a risk element for uveitis. “Cigarette smoke includes substances that promote swelling within the capillary, and this might add to body immune system disruption and uveitis,” stated University of California San Francisco (UCSF) researcher and eye doctor Dr. Nisha Acharya, one of the study authors.
Symptoms Of Uveitis
Symptoms of anterior uveitis include:
Intermediate and posterior uveitis typically are pain-free. Symptoms of these types of uveitis consist of blurred vision and floaters, usually in both eyes. Many people who establish intermediate uveitis remain in their teenagers, 20s or 30s.
Diffuse uveitis has a mix of symptoms of all types of uveitis.
Uveitis And Iritis Treatment
If your eye doctor determines you have uveitis, she or he will likely prescribe a steroid to minimize the inflammation in your eye. Whether the steroid is administered as an eye drop, pill or injection depends on the kind of uveitis you have. Due to the fact that iritis impacts the front of the eye, it’s generally treated with eye drops.
Posterior uveitis typically needs tablets or injections. Depending on your symptoms, any of these treatments may be used for intermediate uveitis.
Steroids and other immunosuppressants can produce numerous serious side effects, such as kidney damage, high blood glucose, hypertension, osteoporosis and glaucoma.
This is especially true of steroids in tablet kind due to the fact that the dosage need to be fairly high in order for enough of the drug to find its method to the back of the eye. So it is very important to follow your doctor’s dosage guidelines thoroughly and to keep visiting him or her frequently to keep track of the progress of the treatment.
Retisert (Bausch+Lomb) is the first surgical implant to acquire FDA approval for use in the treatment of chronic, non-infectious posterior uveitis in the United States.
Authorized in 2005, Retisert is a tiny drug reservoir that is implanted in the back of the eye and delivers continual quantities of an anti-inflammatory corticosteroid medication called fluocinolone acetonide to the uvea for about 30 months.
During FDA clinical trials, the recurrence of uveitis fell from 40-54 percent to 7-14 percent following Retisert implantation. The most typical side effects noted during those studies were cataract progression, increased intraocular pressure, procedural complications and eye pain.
In a later study, scientists found that surgical implantation of the Retisert device was equally effective as systemic corticosteroid medications for the treatment of non-infectious intermediate, posterior and diffuse uveitis over a duration of 24 months.
Ozurdex (Allergan) is another long-acting corticosteroid drug implant authorized for the treatment of non-infectious uveitis affecting the back section of the eye. Ozurdex implants include the steroid medication dexamethasone and are naturally degradable.
In addition to uveitis treatment, Ozurdex implants also are FDA-approved for the treatment of macular edema following retinal vein occlusion and for treatment for diabetic macular edema in adult patients who are pseudophakic or who are scheduled for cataract surgery.
If you have anterior uveitis, your doctor likely will recommend, in addition to steroids, pupil-dilating eye drops to reduce pain. You likewise may require eye drops to lower your intraocular pressure if you develop high eye pressure due to uveitis.
If you have a recognized systemic condition that might be contributing your uveitis, your doctor will treat that as well.