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Uveitis

The uvea is a layer of the eye that is composed of three parts: the iris, the colored portion of the eye that controls the amount of light entering the pupil; the choroid, a collection of blood vessels that deliver nutrients to the eye; and the ciliary body, holds the lens in place. Uveitis is a broad term that describes inflammation of any of these three parts.

Anterior uveitis is when the iris inflamed. In some instance, the ciliary body is as well. It is also known by iridocyclitis or iritis. It is the most common case of uveitis and can be chronically episodic or a single event. The most prevalent symptom is red eyes; in severe cases the entire sclera, the whites of your eyes, are completely bloodshot. Since the iris is inflamed, it cannot properly adjust the pupil. Because of this, the pupil may be an irregular size (large if it’s bright out or tiny if it’s dark). This causes night blindness, sensitivity to light, floaters, blurred vision, and can lead to headaches and eye pain. The weakened iris may also stick to other parts of the eye, causing an irregularly shaped pupil; this is called synechia. Collections of immune cells also begin to develop in the iris.

Intermediate uveitis is the inflammation of the ciliary body. Unlike anterior uveitis, it normally only affects one eye. Blurred vision and floaters are common. Pain and sensitivity to light are less common than in anterior uveitis. Deposits of immune cells can also be deposited in the ciliary body.

Finally, posterior uveitis is the inflammation of the choroid. In this case it is called choroiditis. Sometimes the retina is also inflamed; this is called chorioretinitis. Once again, eye pain, sensitivity to light, red eyes, floaters and blurred vision is common. This time however, patients report seeing flashes of light and excessive tear production. This is a particularly dangerous form of uveitis, as it is so close to the retina. Posterior uveitis should be treated immediately as it can lead to blindness.

Panuveitis is when all parts of the uvea are inflamed.

Uveitis has numerous causes. Infections such as Lyme disease, herpes, tuberculosis, and syphilis have uveitis as a side effect. Diseases like multiple sclerosis, Crohn’s disease, lymphoma and leukemia are also known to cause uveitis. Toxins can be detected by checking for signs of uveitis. Some medications also have it as a side effect. Eye injury can also lead to it, as well as making the eye more prone to retinitis pigmentosa or retinal detachment. There is also a genetic predisposition for it.

Steroid treatment can be used to reduce inflammation. Eye drops are used to treat anterior uveitis. These include steroids to reduce swelling and pupil dilators in order to reduce pain. All forms of uveitis could benefit from intraocular pressure-reducing drops.  Intermediate and posterior uveitis may need oral or injected steroids. There are some implants that can be attached to the back of the eye that can help reduce inflammation and recurrence of the disease.