Symptoms & Diagnosis

An injury to the eye, a viral or bacterial infection, and some underlying diseases may cause uveitis. It can cause swelling and damage in the tissues of the eye. Untreated, it can lead to vision loss. It can affect one or both eyes.

The term uveitis is not only used to refer to an inflammation of the uvea, but to any part of the inside of the eye. It is not a single disease, and it has different causes.

Symptoms

Signs and symptoms of uveitis may include:

• General vision problems, including blurred or cloudy vision
• Floaters, spots in the eye that look like tiny rods or chains of transparent bubbles floating around in the field of vision
• Eye pain and redness
• Photophobia, an abnormal sensitivity to light
• Headaches
• A small pupil
• Alteration of the color of the iris

Symptoms can appear on gradually or rapidly.

Causes

The exact cause of uveitis is often unclear, but some factors increase the chance of it happening.

These include:

• Juvenile arthritis, psoriasis and other autoimmune disorders, such as rheumatoid arthritis
• Inflammatory disorders, such as Crohn’s disease, ulcerative colitis
• AIDS/HIV and other diseases that weaken the immune system

Infections that increase the risk of uveitis include HIV, brucellosis, herpes simplex, herpes zoster, leptospirosis, Lyme disease, syphilis, toxocariasis, toxoplasmosis, and tuberculosis (TB).

Uveitis may occur as a normal immune response to fight an infection inside the eye.

Diagnosis

An ophthalmologist, or eye specialist, will ask about signs, symptoms, and general medical history.

It is important to know whether the uveitis is caused by an infectious process or an underlying disease.

If another condition appears to underlie the uveitis, the ophthalmologist may refer the patient to a specialist to make sure that condition receives proper treatment.

The ophthalmologist will look at the eye with a special slit lamp. When the light hits the inside of the eye, the doctor can determine whether that area is clear or foggy.

If there is inflammation in the iris, patients may feel some pain when the pupil contracts, which is when light hits it.

If uveitis is present, white blood cells and protein in the eye fluid can be seen through the microscope.

The doctor may also order blood tests and x-rays.

Treatment

A patient with uveitis who receives prompt and appropriate treatment will usually recover. Without treatment, there is a risk of cataracts, glaucoma, band keratopathy, retinal edema, and permanent vision loss.

Antibiotics or antiviral medication will be used if there is an infection.

Corticosteroid medications are sometimes given as well, in the form of eye drops (prednisolone acetate), tablets, or as an injection into the eye. Steroids are effective in treating inflammation. Before giving corticosteroids, it is important rule out corneal ulcers by using a florescence dye test.

Immunosuppressants might be recommended if symptoms are very severe and there is a risk of vision loss, or if the patient has not responded well to other therapies.

Mydriatic eye drops dilate the pupil and help the eye to heal. It also helps with eye pain and stops the pupil from sticking to the lens. There may be blurred vision and unusual sensitivity to light, known as photophobia.