Uveitis

Uveitis is a term describing a set of inflammatory eye diseases impacting the uvea, the eye's middle tissue layer. The uvea, rich in blood vessels, plays a crucial role in eye health. Inflammation in this area can drastically affect visual quality, potentially leading to irreversible sight loss if left untreated. It's vital for individuals experiencing uveitis symptoms or those at higher risk to seek immediate consultation from a uveitis specialist for accurate diagnosis and effective treatment.

Classifying Uveitis

Uveitis varies in form and is classified by:

• Anatomical Classification: Involves inflammation in different eye chambers: anterior uveitis or iritis (anterior chamber), intermediate uveitis (interior chamber), posterior uveitis (posterior chamber), or pan-uveitis (all uvea layers, including sclera and conjunctiva inflammation).
• Causal Classification: Uveitis can stem from multiple causes:
  • Infections (viral, bacterial, protozoan, fungal, tuberculosis)
  • Autoimmune disorders (e.g., SLE, scleroderma, HLA-b27 gene-related diseases)
  • Secondary to other diseases (lymphoma, leukaemia)
  • Drug-induced (systemic or topical medications)
  • Trauma-related eye inflammation
  • Idiopathic (unknown cause)
• Acute Uveitis: This type can lead to rapid vision loss, such as in SLE patients with optic neuritis, which impairs blood flow to the retina.

Diagnosis and Initial Evaluation

Determining the inflammation's exact location and cause is critical for effective treatment. Diagnosis begins with a medical history review, which is crucial as about half of all cases are recurrent. This step is followed by physical examinations and laboratory tests, including blood tests and genetic susceptibility assessments. Some cases may require fluorescein dye injections for a detailed retinal examination.

Identifying Uveitis Symptoms

Symptoms vary depending on the type of uveitis, with anterior uveitis patients often experiencing:

• Eye Redness: Particularly near the cornea's edge, with possible teariness but no discharge.
• Blurred Vision: Severity depends on inflammation and complications.
• Sensitivity to Light.
• Eye Pain.
• Floaters: Dark, floating spots in the vision field.

Uveitis linked to other physical disorders may also include symptoms related to those conditions, like back pain in bone and joint diseases.

Approaches to Treatment and Potential Complications

Effective uveitis treatment hinges on addressing the root cause, controlling inflammation, and mitigating complication risks. This involves a comprehensive eye exam, medical history review, physical examination, and necessary laboratory tests for an accurate diagnosis and tailored treatment plan, which may include:

• Treating the Underlying Disease: Addressing the primary condition causing or coinciding with uveitis.
• Managing Non-Infectious Uveitis: Using steroid medications or immunosuppressants administered as drops, pills, or injections.
• Treating Infectious Uveitis: Prescribing medication to combat bacteria or viruses, either orally or through injections.
• Addressing Complications: Such as cataracts, macular pucker, glaucoma, and CSC.

Prevention and Self-Care for Uveitis Patients

With advancements in diagnosis technology and medical knowledge, uveitis management has become more precise. This includes preventive measures for at-risk patients, such as those with HLA-b27 gene-related anterior uveitis. In recurrent cases, medications like NSAID or sulfasalazine might be recommended to prevent disease recurrence.

Given uveitis's tendency to recur, lifelong management is often necessary. Understanding the disease's nature and causes is essential for effective self-care, reducing recurrence, and minimising further complications.

Seeking Specialist Care

If you're experiencing uveitis symptoms or believe you're at risk, it's crucial to consult with an ophthalmologist specialising in uveitis. A timely and accurate diagnosis followed by continuous treatment is key to managing this condition effectively.