Uveitis


Contributed by Uveitis Information Group

Uveitis is an uncommon eye condition, which can occur when parts of the inside of the eye become inflamed. The “itis” in uveitis means inflammation.  Just as tendonitis is inflammation in a tendon, uveitis is inflammation of the uvea.

The Uvea

The eye is like a ball made up of fluid. The three main layers are the sclera (a tough outer layer), the retina (the inner layer, the retina (a thin light-gathering layer) and the middle layer, the Uvea.  The Uvea is made up of three main parts:

  • Iris – This is the round coloured part of the eye 
  • Ciliary body – This sits behind the iris
  • Choroid – This lies between the sclera and the retina

When a part of the uvea becomes inflamed, it is referred to as “Uveitis.”  Sometimes the inflammation occurs in the retina (not part of the uvea). To simplify things it is fine to think of any condition, which causes inflammation inside the eye as uveitis. Some eye specialists now prefer and use the term “intraocular inflammation”.

Types of Uveitis

It is very important to know which type of uveitis affects you as they can be very different from each other.  The inflammation can affect different parts of the eye. The most useful way of dividing uveitis is which part of the eye is affected (this is known as an Anatomical Classification):

  • Anterior uveitis - front of eye
  • Intermediate uveitis – middle of eye
  • Posterior  uveitis - back of eye       

Most people with uveitis will have only one of these but it is worth being aware of them all as inflammation can occur in both the front and back of the eye (this is called panuveitis).  Whatever the type and cause of the uveitis, they all should be able to go into one of the above groups. You may be told you have a condition in which the word uveitis doesn’t appear. Examples are Birdshot retinochoroidopathy (posterior), and Fuch’s heterochromic cyclitis (anterior). It is important still to be able to know which type of uveitis these are.  Thus, remember to ask your eye specialist/ophthalmologist exactly what type of uveitis you have.


Causes of Uveitis

Uveitis is inflammation inside the eye.  First there is one point to clear up; inflammation is not the same as infection.  An infection will cause inflammation but it is not the same thing. 

Uveitis can be caused by:

  • Some cases of uveitis are caused by infections
  • Most cases of uveitis are of the autoimmune type, in which a person’s defence system, the immune system, mistakes a part of ‘itself’ (in this case a part of the eye) as foreign.  The immune system then reacts to this part of the eye as though it is a ‘foreign’ virus or bacteria, for example, and inflammation results. 

This can be:

1. Linked with an associated medical condition, examples of these are sarcoidosis and some forms of rheumatoid arthritis. Most of these conditions are also autoimmune OR

2. The majority of people with uveitis are otherwise perfectly healthy and will have normal results to any investigations (this is called idiopathic).

  • Some cases of uveitis can be caused by eye trauma

Treatment for Uveitis

Treatment will depend completely on:

  • The type of uveitis
  • The exact diagnosis, severity etc
  • Whether there are complications

Treatment for Anterior Uveitis

Anterior uveitis is certainly the most common type and accounts for about 75% of all cases of uveitis.  It is usually a recurrent condition. Many patients with this condition will still be told they have ‘iritis’.  Strictly speaking, iritis is an inflammation of the iris only. Patients with anterior uveitis may have inflammation in the iris, anterior chamber, ciliary body or anterior vitreous.  Anterior uveitis is therefore a better term and ‘iritis’ should probably not be used in this general way.  However, many people and eye care professionals do use the term iritis.

Treatment of anterior uveitis is usually with eye drops only.  Two different eye drops may be used.

  • A corticosteroid eye drop is used to get rid of (suppress) the active inflammation.
  • A dilating drop is used to dilate the pupil. This is important to relieve pain but also to prevent important complications such as the pupil sticking to the eye lens.

Treatment for Intermediate and Posterior Uveitis

As the inflammation affects further back in the eye, then eye drops can not reach here. The steroids must reach the inflammation through other means for example tablets or sometimes injections around the eye. There can be many variations in treatment with increasingly nowadays other drugs called immunosuppressants being used along with steroids.

If you suffer from uveitis, it is extremely important to complete the treatment and to be monitored.  If the pain goes away with anterior uveitis, the inflammation can still be there, damaging the eye. For this reason treatment must go on for long enough.

If there is any doubt that there is a recurrence of symptoms or new visual signs, then always contact the your eye clinic or eye care professional the same day.

Please note that Uveitis is often incorrectly spelled "Uvitis."


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