Uveitis and Ocular Inflammations

The eyeball consists of three layers of tissue enclosing the gel-filled vitreous cavity. These are:

• the outermost sclera, the wall of the eye
• the middle uvea, containing the iris, ciliary body and choroid
• the innermost retina, containing the nerve cells for sight

Uveitis refers to inflammation of the uvea, the pigmented middle layer that contains structures responsible for the flow of blood and nutrients to the eye. This condition commonly affects people between 20 to 50 years of age and early detection and treatment will help to preserve vision better.

CAUSES

• Trauma to the eye
• Viral infection eg herpes, shingles, mumps
• Bacterial infection eg syphilis
• Fungal infection eg histoplasmosis
• Generalized inflammatory disesase eg juvenile rheumatoid arthritis,
• Heredity

TYPES AND SYMPTOMS

Uveitis can be classified according to portion of the uvea that is affected and the symptoms will vary accordingly, although blurred vision and pain are common to all.

• Anterior uveitis, affecting the iris, the front of the uvea (iritis)
  Symptoms include light sensitivity, tearing, small pupil and redness around the iris. Pain is usually intense due to an increase in intraocular pressure.

• Intermediate uveitis, affecting the ciliary body, vitreous and retina (cyclitis)
  Symptoms include sudden onset of floaters and pain may not be present

• Posterior uveitis, affecting the choroid and optic nerve at the back of the eye (choroiditis/ retinitis)
  Blurred vision is usually the only symptom and pain if the optic nerve is involved.

• Diffuse uveitis, affecting all portions of the uvea.
  A combination of all the above-mentioned symptoms.

DIAGNOSIS

Uveitis is diagnosed by the eye doctor, using slit-lamp microscopy and ophthalmoscopy. Evaluation of visual acuity and measurement of intraocular pressure are also important. Blood tests and other investigations may also be carried out to find out the underlying causes.

TREATMENT

Topical eyedrops and /or oral medications are usually needed to reduce inflammation and increased intraocular pressure when present. In severe cases, injections may also be necessary.

COMPLICATIONS

After the inflammation has subsided, the following complications may occur in the eye:

• scarring
• cataract
• glaucoma
• formation of new blood vessels

These will have to be treated accordingly with lasers, surgery and medications.