Iritis and Uveitis

Overview

Uveitis is a general term that refers to inflammation inside the eye affecting one or more of the three parts of the eye that make up the uveal tract- the iris, the ciliary body and the choroid. Uveitis is the third leading cause of blindness in the United States. It is usually classified according to the structures that it affects, whether it is acute or chronic (lasting more than 6 weeks) in nature, and its underlying cause.

There are dozens of conditions that may cause uveitis. These include various infections, as well as underlying diseases. In deciding upon whether to initiate a diagnostic evaluation (i.e. order blood work and other tests), we will look at numerous factors, including a detailed medical history, what structures of the eye are inflamed, whether the episode is the first or a recurrent attack, and the severity of the inflammation. This is often likened to detective's work, and requires specialized knowledge in order to try to come to a final answer.

Many cases of uveitis are considered an autoimmune disease. The immune system generally protects us from germs or cancer. At times, however, it begins to attack parts of our own body, as if it were a foreign substance. There are numerous examples of autoimmune diseases, including rheumatoid arthritis, lupus, ulcerative colitis, ankylosing spondylitis, and Grave's thyroid disease. The eye may be attacked as part of a generalized systemic disease, or may be the only organ involved.

Signs and Symptoms

The symptoms of uveitis depend in great part on what part of the eye is involved- anterior, intermediate, posterior or diffuse (all parts)

Anterior:

• light sensitivity
• blurred vision
• redness around the iris
• pain that may range from aching to intense discomfort
• tearing

Intermediate:

• floaters
• blurred vision

Posterior:

• blurred vision
• floaters

Diffuse:

any combination of the above symptoms

Treatment

The appropriate treatment again depends upon which ocular structures are involved, the severity, and most importantly, the underlying cause. If the cause is related to an infection, then the appropriate antibiotics or antiviral medications are required.

Most cases are not infectious in nature, and therefore require anti-inflammatory medications. These most often include cortisone-like medications in the form of eyedrops, injections or pills. In severe cases, patients may require potent immunosuppressive medications, identical to those often used to prevent or treat transplant rejection.