The term uveitis refers to the inflammation of the middle layer of the eye, secondary to an underlying disorder or acute infection. This condition needs prompt medical attention of best Eye Specialist in Lahore without which the patient has increased risk of complications and even visual loss. Read on to know more about uveitis, its symptoms, causes and treatment options:

What is uveitis?

The middle layer of the eye, called uvea, is not a single layer, but in fact composed of three parts—choroid, ciliary muscles and iris.

• Iris: it is the colored part of the eye around the pupil, controlling its size.
• Ciliary body: this structure with its suspensory ligaments controls the size of the lens and the light focusing on the retina.
• Choroid: this layer lies between sclera (outer white of the eye) and the inner retina. This layer is rich in blood vessels and supplies nutrition to the eye.

It is the inflammation of this middle layer of eye which constitutes uveitis. Based on the part of the uvea affected by disease, uveitis is further divided into subtypes, with different management options for each. Although anyone can experience uveitis, it is more common in the age group of 20 to 60 years.

The inflammation of uvea can be secondary to eye injury, surgery, viral and bacterial infections like herpes, tuberculosis and syphilis. In some instances, underlying autoimmune disorders—like inflammatory bowel disease and rheumatoid arthritis—predispose to uveitis.  

What are the types of uveitis?

The types of uveitis are:

• Anterior uveitis

When the front part of the uvea i.e. the iris is involved, the condition is called anterior uveitis. This is also referred to as iritis. On examination, this condition is identified through presence of inflammatory cells in the anterior chamber. This is the most common type of uveitis.

This type of uveitis is more common with certain underlying pathologies, including:

• Arthritis
  • Sarcoidosis
  • Inflammatory bowel disease
  • Herpes infection  

• Intermediate uveitis

If there is inflammation of the ciliary body as well as the vitreous, this condition is called intermediate uveitis. It is also the diagnosis of exclusion when no other underlying cause of uveitis is found. The underlying condition associated with this type of uveitis is:

• Sarcoidosis
  • Multiple sclerosis

• Posterior uveitis

If there is inflammation of the choroidal layer, the condition is called posterior uveitis. This condition can produce symptoms lasting for months or years. The potential causes of posterior uveitis include:

• Syphilis
  • Lupus (SLE)
  • Herpes infection
  • Tuberculosis  

• Panuveitis

As evident from the name, this is when all layers of the uvea are involved. If the patient suffers from Panuveitis, there is risk of disease progressing to other structures of the eye including the lens, optic nerve, retina and vitreous. This is the type which affects the vision most, and can result in reduced vision or blindness.

What are the symptoms of uveitis?

The signs and symptoms of uveitis have a sudden onset. However, both acute and chronic forms of this pathology exist and they can come and go gradually. These include:

• Eye pain
• Redness in the eye
• Headaches
• Floaters in the eye—dark spots floating in vision
• Cloudy or blurred vision
• Sensitivity to light, also known as photophobia

What are the management options?

Without proper management, patients with uveitis can go on to develop other complications such as cataracts, retinal edema, keratopathy, optic nerve damage, retinal detachment, retinal scarring and even risk of permanent visual loss.

The treatment regimen begins with:

• Anti-inflammatory corticosteroid medication: this is given primarily as eye drops. If the condition does not improve, they may be given as injections or for oral use.
• Pupillary dilators: eye drops that dilate the pupil are given to control pain in the eye due to spasm of the iris and ciliary body.
• Antimicrobials: antiviral and antibiotic eye drops are prescribed for controlling infections.
• Immune suppressants: are only prescribed at Ali Medical Centre for severe conditions.