The sooner the uveitis is diagnosed and treated, the more successful the outcome is likely to be.
Therefore, early diagnosis and appropriate treatment are crucial to achieve control of the disease and prevent visual loss.
Uveitis can affect people of all genders and ages, including children, young adults and adults.
It can be limited to the eye or be part of an inflammatory systemic condition affecting other parts of the body.
There are different causes of uveitis, including infections and autoimmune inflammatory diseases, when the body is attacked by its own immune system.
However, in some cases no underlying cause can be found and the uveitis is labelled as ‘idiopathic’, meaning that no aetiology has been detected.
The term ‘uveitis’ refers to a disease that specifically affects the tissue of the eye called the ‘uvea’, which includes the iris, the ciliary body and the choroid.
However, the disease is not limited to the uvea, but can also involve the retina, the optic nerve and the vitreous.
The iris is the coloured annular structure with the pupil in its centre. It regulates the diameter of the pupil and is responsible for controlling the amount of light entering the eye.
The ciliary body is the area between the iris and the choroid. It regulates the eye focus, controlling the shape of the lens, and is responsible for the production of aqueous humour, which maintains the intraocular pressure and hence, the shape of the globe.
The choroid is the tissue located between the sclera, the white part of the eye, and the retina. Being a vascular layer, the main function of choroid is to provide oxygen and nourishment to the retina.
The retina is the light-sensitive tissue lining the back of the eye, converting the light into neural signals, transmitted through the optic nerve to the brain for visual recognition.
The vitreous is the jelly-like substance filling the posterior cavity of the eye and holding its shape.
There are a wide range of potential causes for uveitis, including infectious, non-infectious and malignancy. However, in about 40% of the patients the disease remains idiopathic even after appropriate clinical assessment and investigation.
Non-infectious uveitis are associated with an immune-mediated process, including autoimmune diseases, which occurs when the immune system, which is the body’s defence against illness and infection, attacks a part of the body. The disease can be limited to the eye or be associate with a systemic disease affecting the eye and other parts of the body. More common autoimmune conditions that can be associated with uveitis include sarcoidosis, Bechet’s disease and spondyloarthropathies.
Many infectious diseases can cause uveitis. The most common infectious aetiologies include toxoplasmosis and herpes viruses. Less common cause include syphilis, tuberculosis and Lyme disease. In infectious uveitis ocular inflammation is the results of a systemic infection affecting the eye. The eye can be the only site affected or other parts of the body can manifest the disease. Therapy aims at treating the underlying infectious condition and cure the infection causing the uveitis.
Other potential causes of uveitis include malignancy, such as lymphoproliferative disorders, or trauma.
Symptoms can develop in one eye or in both eyes, and the onset can be gradual or sudden. However, in some cases uveitis patients are asymptomatic (no symptoms) or have minimal symptoms.
Usually anterior uveitis is associated with eye redness, pain and light sensitivity. Intermediate uveitis causes floaters and blurriness, while posterior uveitis can affect the vision leading to visual loss.
Contact a uveitis specialist if you think you have symptoms suggestive of uveitis.
Uveitis is a disease that can be treated.
Early detection and prompt treatment are important to prevent visual impairment.
Establishing the aetiology of uveitis is often a challenge. It is important to obtain a detailed ocular and medical history, together with an accurate ocular examination and eye imaging.
Laboratory tests and radiology imaging can be helpful in establishing the underlying cause of uveitis.
Contact
Ilaria Testi
The London Clinic Eye Centre
119 Harley Street
London W1G 6AU
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