Uveitis Eye Inflammation

On this page: Types of Uveitis | Symptoms | Causes | Diagnosis | Treatments

Uveitis refers to a group of eye conditions caused by inflammation of the uvea, the middle layer of the eye. The uvea is located between the outer white-colored portion of the eye (sclera) and the innermost layer of the eye (retina). It is particularly susceptible to swelling since it hosts most of the eye’s blood vessels. The associated inflammation can impact the surrounding parts of the eye, including the lens, retina, optic nerve and vitreous.

Uveitis can affect one or both eyes, and is most common among people aged 20 to 50. Severity varies, meaning the condition may be short-lived, or be a long term / recurrent problem. In severe cases, uveitis can result in permanent vision loss.

For a brief introduction to uveitis, check out the following video, or continue reading below for more information about the types, symptoms and causes of uveitis, in addition to how the condition is treated.

Types of Uveitis

Although uveitis technically refers to a single condition, there are four separate classifications used to identify its specific nature.

Anterior uveitis: If the swelling of the uvea is towards the front end of the eye, it is classified as anterior uveitis. The associated symptoms may develop quickly and last upwards of 8 weeks, though it’s not uncommon for anterior swelling to go away and return frequently.

Posterior uveitis: If the swelling of the uvea is towards the back of the eye, it is classified as posterior uveitis. Unlike anterior uveitis, the posterior variant typically develops slowly and can linger for many years.

Intermediate uveitis: If the swelling of the uvea is towards the middle of the eye, it is classified as intermediate uveitis. The intermediate variant is something of a hybrid of anterior and posterior. The condition may only last for a few weeks or can linger for many years. As with anterior uveitis, the intermediate variant can be cyclical and potentially be worse on each re-occurrence.

Diffuse uveitis: If the swelling affects all areas of the uvea, it is classified as diffuse uveitis.

What are the Symptoms?

In general, uveitis causes redness, eye pain and blurred vision, but the exact symptoms depend on the specific type.

Symptoms of anterior uveitis can include sensitivity to light, eye pain and redness, and diminished visual acuity and contrast sensitivity.

The symptoms of intermediate and posterior uveitis are generally the same, and can include blurred vision and eye floaters. Unlike anterior uveitis, posterior and intermediate uveitis do not typically cause pain.

The symptoms of diffuse uveitis can include all of the above.

What Causes Uveitis?

Oftentimes it can be difficult to identify a specific cause because inflammation is a natural response to a wide variety of conditions.

Known causes of uveitis can include:

  • Trauma (injury to the eye)
  • Infection (herpes, Lyme disease, toxoplasmosis, syphilis, shingles, tuberculosis, west nile virus)
  • Cancer of the eye
  • Systemic inflammatory condition (Inflammatory bowel disease, lupus, arthritis, Crohn’s disease)
  • Autoimmune disorder (Sarcoidosis, ankylosing spondylitis)

Recent research also suggests that smoking can be a risk factor for uveitis (see our article on smoking and vision health) because it can cause inflammation in the eye’s blood vessels.

Diagnosis

In order to diagnose uveitis, an ophthalmologist examines the tissues inside the eye. Part of the diagnostic process may include additional testing to determine the cause (if possible).

Treatments for Uveitis

Steroids are often used to counter inflammation. Your doctor may prescribe a steroid eye drop to be administered on a set schedule. However, steroids may also be prescribed as a pill, or via injection. Typically, anterior uveitis is readily treatable with eye drops, whereas eye drops cannot penetrate the middle to posterior portions of the eye, requiring an alternative approach. A pill or injection of steroids and/or immunosuppressive agents may also be used if the condition affects both eyes.

Bausch+Lomb’s Retisert was the first FDA-approved surgical implant for the treatment of posterior uveitis. The small insert is placed in the back of the eye where it administers corticosteroid medication directly to the affected uvea from a small reservoir. The reservoir holds enough medication to treat the condition for a 30-month period.

Allergan offers a similar device (Ozurdex) that is also implanted for the sustained treatment of posterior uveitis. Although it contains a different type of corticosteroid than Retisert, it essential offers the same type of treatment.

Speak with a Qualified Eye Doctor

If you are experiencing symptoms of uveitis, schedule a consultation with a qualified ophthalmologist to undergo a comprehensive eye exam. As always, the sooner uveitis can be diagnosed, the better from a treatment point of view.