What is Anterior Uveitis?
Uveitis is inflammation of the coloured part of the eye (the iris) and sometimes the structures associated with it.
What is Intermediate Uveitis?
Intermediate uveitis is commonly seen in young adults. The center of the inflammation often appears in the vitreous .It has been linked to several disorders including, sarcoidosis and multiple sclerosis.
What is Posterior Uveitis?
Posterior uveitis is the least common form of uveitis. It primarily occurs in the back of the eye, often involving both the retina and the choroid. It is often called choroditis or chorioretinitis. There are many infectious and non-infectious causes to posterior uveitis.
What is Pan-Uveitis?
Pan-uveitis is a term used when all three major parts of the eye are affected by inflammation. Behcet’s disease is one of the most well-known forms of pan-uveitis and it greatly damages the retina. Intermediate, posterior, and pan-uveitis are the most severe and highly recurrent forms of uveitis. They often cause blindness if left untreated.
What are the symptoms?
The symptoms can include some or all some of the following: Redness around the iris. Photophobia (sensitivity to bright light). Blurred/foggy vision especially when trying to read. Ache around the eye. The pupil (hole in the centre of the iris) may be a different shape in the affected eye. In most cases the symptoms will affect only one eye, although both can be affected at the same time.
What causes Uveitis?
In most people the cause is unknown. In a few cases it can be linked to inflammatory diseases that affect the whole body, for example ankylosing spondylitis, inflammatory bowel disease such as Crohn’s disease and ulcerative colitis. Occasionally it can be linked to infections or to a genetic predisposition but in about 50% of cases no definite cause is identified. If you have had more than one episode of anterior uveitis or disease affecting both eyes and there is no known cause your doctor may organise special blood tests or X-rays, but in normal circumstances no further investigations are needed.
FAQ's
What treatment will I be given?
1. To relieve pain and photophobia (sensitivity to light)
Dilating eye drops, such as atropine long acting eye drop or cyclopentolate short acting eye drop are used. These drops are used for variable lengths of time, depending on individual cases. The drops work by “paralysing” the muscles of the iris (it is the movement of these inflamed muscles that causes the pain).
While you are using these drops your vision will be blurred and you will still be sensitive to bright lights. Dark glasses may be of help. The effect of these drops can last for a few days even after you have stopped taking them. As these drops cause blurring of vision, you may be advised not to drive.
These drops are also useful because they help to prevent complications, such as the iris “sticking” to the lens (posterior synechiae).
2. To treat the inflammation
Steroids are used in the form of eye drops, usually prednisolone 1% or dexamethasone These drops are given very frequently (sometimes hourly) at the beginning of the treatment but are then slowly reduced over a number of weeks as your eye responds to the treatment.
The bottle of drops should be shaken vigorously before putting the drops in the eye as the active ingredient can settle down to the bottom of the bottle.
It is very important not to stop these drops before the doctor has advised as, although your eye may feel better, there may still be traces of inflammation left and stopping the drops too soon may cause it to suddenly get worse.
Occasionally, but not often, injections of steroids are used around the eye. These may be uncomfortable but are straightforward and are done at the Eye Outpatient Clinics.
How often will I need to be seen?
This depends upon the amount of inflammation and how your eye responds to the treatment.
Will it come back?
It is difficult to say, as everyone is different. A few people will just experience one attack during their lifetime. However, many people have more than one attack. This may be close in time to the original one or years apart. It may affect either eye.
What do I do if the symptoms come back?
If you experience similar symptoms in either eye, such as redness and/or sensitivity to light, you should contact the Eye Hospital immediately for further advice.
Can there be any complications or risks?
Cataracts. These are more common in people with uveitis, especially those who have had long term steroid treatment. Raised Eye Pressure and Synechiae. In anterior uveitis the pressure can be raised due to the inflamed iris “sticking” to the lens preventing the fluid from passing through the pupil. The drops that dilate your pupil help prevent this. It can also be due to the inflammation of the area where the fluid drains out of the eye. The other possible cause of a raised pressure is as a side-effect of the steroids used in the treatment. Macular Oedema. The Macula is the tiny part of the retina that is responsible for the central or detailed part of our vision. Fluid (oedema) in this area may cause problems with central vision. This can mean difficulty recognising people’s faces, reading, driving and finding that straight lines appear distorted.