Uveitis

A basic understanding of the eye helps clarify how your eye problem interferes with vision. In a manner similar to a camera, light enters in front of your eye through the cornea and lens. The light is then focused on the back of your eye on the tissue called the retina. In a sense, the retina functions like the film in a camera. From the retina, signals are transmitted to the brain, thereby creating sight. Activities such as reading, driving, and sewing, depend on good central vision. The central area of the retina is called the macula. If the macula is damaged by disease, this "straight ahead" vision is affected. The rest of the retina is responsible for side/peripheral vision and is generally not affected by this problem.

Essentially, there are three layers to the eye. There is the inside layer of the retina, which we already discussed. There is the outside layer, which is familiar to all of us as the white of the eye, which is called the sclera. Sandwiched between these two layers is a tissue abundant in blood vessels, called the choroid. When this choroidal layer becomes inflamed, we call the condition uveitis. There are many varieties of uveitis. Some types affect only the front or back part of the eye, while other types affect the entire eye. Though few of us are familiar with the tissue called the choroid, we all are familiar with the part of the choroid called the iris. The iris may be blue, brown, or green, and this structure imparts our eye color. When this is the main center of inflammation, we call this kind of uveitis, iritis. However, if the tissues just behind the iris called the ciliary body are also inflamed, we term this iridocyclitis. We reserve the term posterior uveitis or choroiditis for those conditions when the primary center of inflammation is in the back of the eye.

There are many causes of uveitis. In fact, certain bacterial, viral, and fungal can lead to uveitis. Uveitis may arise from or be related to auto-immune diseases. These autoimmune diseases are conditions in which the body actually attacks its own tissue. A thorough physical examination, including specific laboratory tests, may discover the underlying cause. However, unfortunately, most of the time we are unable to actually determine the cause of uveitis. Nonetheless, even if no underlying cause can be determined, most of these cases still respond nicely to medication.

How do you know if you have uveitis? Fortunately, most patients with uveitis become aware of symptoms. For some, the eye becomes red, painful, and sensitive to light. For others, vision simply becomes blurred. If having uveitis in one eye isn't bad enough, there are many cases of uveitis which involve both eyes. Fortunately, a thorough eye examination can allow the eye doctor to detect uveitis. In fact, the careful observer can even detect cases of uveitis that occurred in the distant past.

After a patient has an episode of uveitis, the main question that comes to mind is what should that individual expect for the future? Uveitis can go in a variety of directions. Many cases resolve after treatment and never occur again. Other patients have recurrent episodes in one eye and then the other. Unfortunately, there a group of patients in which the uveitis continues to smolder for many years and never completely resolves, which we term chronic uveitis. Obviously, uveitis is a serious problem and can be potentially sight threatening. Careful follow up examinations to assess the response to treatment is obligatory. Uveitis can result in glaucoma, cataracts, or retinal damage. Specifically, if the inflammation results in swelling of the macula and retina, central vision can be significantly compromised. For most patients, treatment can slow down or prevent the development of many of these associated conditions; but, for a small group of patients, these conditions cannot be prevented. Sometimes surgery, either cataract extraction or vitrectomy - removal of the jelly of the eye - can be used to restore vision or aid in diagnosis.

Since there are a multitude of conditions that can cause uveitis, there are many medications that may be selected to control the condition. The majority of patients are treated with steroids or cycloplegic agents. Steroids are drugs that fight inflammation. Cycloplegic agents are drugs that dilate the pupil and relax the iris. As a result, cycloplegic medications may significantly decrease the pain and also may help prevent the formation of scar tissue involving the iris. Though these medications are usually given in an eye drop form, they are sometimes administered by injection and less commonly systemically in a pill form. Each patient with uveitis requires individualized treatment with an individualized schedule of medications. The most important thing to remember is: with a thorough eye examination and regular follow up examinations, the risk of blindness can be minimized.

To learn more about uveitis and schedule a visit with an ophthalmologist in Atlanta, call us toll-free at 888-GA-RETINA.