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| WHAT IS UVEITIS? |
Uveitis is an inflammation of the inside of the eye, specifically
the layer of the eye called the uvea [comprising of the iris,
ciliary body and the choroid]. |
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| WHAT CAUSES UVEITIS? |
a. Infection - virus (eg. herpes) fungus (eg.
histoplasmosis)
b. Parasite - toxoplasmosis
c. Autoimmune Disease - This is when our immune
system recognises a part of our own body as foreign
d. Trauma to the eye, or even the other eye in
the past, can lead to Uveitis
e. Unknown - The commonest type, this may well
mean that the uveitis is of the autoimmune type. The word
"idiopathic" may often be used to describe this group.
f. Associated medical conditions - Ankylosing
Spondylitis, Juvenile rheumatoid arthritis and inflammatory
bowel disease.
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| Different types of
Uveitis [by describing the part of the eye that is affected] |
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| Anterior Uveitis |
This affects the front of the eye, normally the iris (iritis)
or the ciliary body (iridocyclitis). Iritis is by far the
most common type of Uveitis and also the most readily treated.
Iritis needs quite close monitoring because complications
such as raised eye pressure and cataracts can occur. |
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| Intermediate Uveitis |
This affects the middle of the eye, the ciliary body (cyclitis)
or the pars plana (pars planitis). |
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| Posterior Uveitis |
This affects the back of the eye. That part of the uvea is
called the choroid. An inflammation in the choroid would be
called choroiditis. The inflammation may also arise in, or
affect, the retina (retinitis) or in the blood vessels at
the back of the eye (vasculitis). |
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| Symptoms |
Redness of the eye
Pain
Avoiding.bright light
Blurring of vision and\or the presence of floaters (black
dots or wispy lines that move across the field of vision).
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| Diagnosis |
Tests and examinations
Because of the quite diverse types of causes of Uveitis and
also due to the many other medical conditions associated with
it, then you can expect to receive a number of tests and thorough
questioning. All these are straightforward and painless enough
but may seem far removed from your eye problem. It is important
to establish the correct type of Uveitis so that the best
treatment can be planned. |
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| HOW IS UVEITIS TREATED? |
One
of the most important things to remember about Uveitis is
that:
1. There are many quite different causes.
2. There are different types of Uveitis normally
depending on which part of the eye is affected ie. anterior,
intermediate or posterior |
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The
treatment of Uveitis aims to achieve the following:
1. Relief of pain and discomfort (if present)
2. To prevent sight loss due to the disease or
its complications
3. To treat the cause of the disease where possible.
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Like
the varied nature of uveitis, the treatment of it may differ
from case to case quite considerably. Corticosteroids are
often the mainstay of treatment but now are, importantly,
being joined by some other newer drugs, usually used along
with the steroids. Various eye-drops are used, particularly
to treat anterior uveitis. |
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| Treatment |
|
| To relieve pain and
photophobia |
Dilating
eye drops that relax the muscles of the iris and ciliary body.
(It is the movement of these inflamed muscles that causes
the pain). When these drops have taken their effect the pupils
will be dilated. |
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| To treat the inflammation |
Steroids
are used in the form of eye drops. Occasionally, but not often,
injections of steroids are used around the eye. These may
be uncomfortable but are straightforward and are done at the
Uveitis Clinic. Even more rarely steroid tablets are used.
The type of steroid treatment and the length it is used will,
again vary a lot for different people. Occasionally, a situation
may arise when rapid control of an acute episode of inflammation
is needed. This may be if the sight is threatened and a high
dosage of steroid needs to be delivered quickly. Side effects
of prolonged use of steroid drops can include raised eye pressure
which may cause glaucoma and cataracts, for which the eye
is closely monitored. |
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| Treatment of any associated
diseases |
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| To decrease the autoimmune
response of the body |
Cyclosporin
tablets may be used with/without steroids to reduce the dosage
of steroids or if side effects are a problem. |
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| HOW LONG WILL THE CONDITION
LAST? |
It
is possible that the condition may be around for several years.
The condition also varies in its severity enormously and can
be quite unpredictable in its course. The main aim of the
treatment is to thoroughly treat and monitor the inflammation
so that it causes minimal or no damage to the eyes as and
when the condition hopefully "burns out". |
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| WHAT WILL HAPPEN TO
MY EYES? |
This,
once again, varies considerably, but there is a growing confidence,
especially with the newer drug treatments, that the condition
can be stabilised over the long term. |
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| UVEITIS CLINIC |
Uveitis,
much more than most other medical conditions, offers a huge
challenge for patients to understand their condition. Uveitis
is complex. There are many different types of uveitis. There
are many different causes, there are different parts of the
eye which are affected, one or both eyes may be affected,
and the severity of the disease may be extremely variable.
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Even
two cases of uveitis with the same specific diagnosis e.g.
intermediate uveitis may be completely different for the patients
involved, and so require different treatment and may not have
the same outcome. |
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Our
centres run Uveitis Clinics for the special purpose of preserving
sight in conditions such as uveitis. |
|
1.
The patient receives specialized care provided
by our Uveitis specialists
2. Uveitis needs regular follow-up since the
condition can recur and cause loss of vision if poorly treated
or neglected
3. Our Uveitis Clinic is backed by a pathology
laboratory which specifically caters to the needs of Uveitis
patients
4. At the clinic we record images and maintain
records of your eye condition for comparison on following
visits. |
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