Health Resources

Ocular Inflammation (Uveitis)

2024/05/30
What is Uveitis?

Uveitis refers to the inflammation of the uveal tract, the middle layer of the eye which includes the iris, ciliary body and choroid.

What Is The Importance Of The Uveal Tract In Eye?

The uveal tract, located between the retina (innermost layer) and sclera (outermost layer), consists of several components:
  • The iris: Functions as a shutter, enlarging and constricting to control the amount of light entering the eye.
  • The ciliary body: Supports the muscles that allow the lens to change shape, focusing light onto the retina. 
  • The choroid: Rich in blood vessels that supply the eye with oxygen and nutrients.
For information on Paediatric Ocular Inflammatory Conditions, please click here (*HYPERLINK TO PAGE 9 PAEDIATRIC OPHTHALMOLOGY).
Types of Uveitis

What Are The Types of Uveitis?

 Given the diverse components of the uveal tract, uveitis types are categorised by the specific site of inflammation:
  • Anterior uveitis, also known as iritis or iridocyclitis, affects the iris or ciliary body. 
  • Intermediate uveitis, including vitritis and pars planitis, affects the middle part of the eye, that is, vitreous and pars plana.
  • Posterior uveitis, including retinitis, choroiditis, chorioretinitis and neuroretinitis, affects the retina and choroid. 
  • Panuveitis, when inflammation involves the whole uveal tract.
Symptoms and Signs
What Are The Symptoms of Uveitis?

Symptoms of Uveitis

What Are The Signs of Uveitis?

Below are pictures showing possible findings in some uveitis patients.

  • Irregular pupil from posterior synechiae

    Irregular pupil from posterior synechiae

  • Keratic precipitates

    Keratic precipitates

    Keratic precipitates

Causes

What Causes Ocular Inflammation?

  • Uveitis may result from a wide variety of causes, including including bacterial infections and viral infections, especially herpes viruses, fungal infections and parasitic infections such as toxoplasmosis;
  • Autoimmune diseases;
  • Severe injury to the affected eye or to the fellow eye in the past ( i.e., sympathetic ophthalmia);
  • Drug-related causes; 
  • Cancer, i.e., masquerade syndromes; and
  • Idiopathic origins.
How is it Diagnosed?

Ocular Inflammation Diagnosis

How Is Ocular Inflammation Diagnosed?

To diagnose uveitis accurately, an ophthalmologist will conduct a thorough eye examination, including vision assessment and fundus examination. Given the  association of uveitis with various medical conditions, additional investigations such as blood tests, skin tests, or X-rays may be necessary to determine the type and cause of inflammation. While these investigations involve time and some costs, they are crucial for an accurate diagnosis and to identify the underlying cause, enabling optimal treatment planning.

Given the potential connection between uveitis and systemic health, your ophthalmologist may seek expert opinions from your primary care physician or other medical specialists.

Treatments

Treatment

The treatment aims to: 
  • Relieve pain and discomfort 
  • Prevent vision loss from the disease and its complications 
  • Treat the underlying cause of disease where possible
Steroids are the main medication and may be administered as eyedrops or oral tablets, especially in severe cases, to reduce inflammation. Other medications may be prescribed as adjuncts to steroids. Pupil-dilating drops used to reduce pain can result in temporary blurring of vision.

What Are the Complications of Uveitis?

Left untreated, inflammation of the eye can permanently affect sight and even lead to blindness. Uveitis may result in the following complications:

  • Glaucoma (raised eye pressure) ;
  • Cataract (clouding of the native lens of human eyes);
  • Neovascularization (growth of new, abnormal blood vessels); and
  • Cystoid Macular Oedema (swelling of the macula).

These complications may occur in chronic and severe eye inflammation.  Specialist care is essential to appropriate management of your eye condition.

How Successful is Treatment of Uveitis? 

Treatment success varies based on the type of uveitis. While uveitis is technically incurable, treatment aims to suppress inflammation until the disease becomes inactive. The duration and recurrence of the disease are unpredictable, underscoring the importance of ongoing monitoring and specialist care.
Frequently Asked Questions (FAQs) about Uveitis

How do I know if I have uveitis?

Diagnosing uveitis based on symptoms alone can be challenging. Symptoms range from a red, painful eye to vision floaters. A comprehensive examination by an eye specialist is crucial for an accurate diagnosis.

What are the causes of uveitis?

Uveitis may be isolated, affecting only the eye, or part of a broader disease impacting other body areas. Your eye specialist will discuss necessary investigations during your consultation to identify the underlying cause.

My doctor started me on steroid eye drops. Are there any side effects I should be worried about?

Steroid eye drops are the mainstay of treatment in many patients with uveitis. While they may have some potential side effects, the benefits outweigh the risk. Left untreated, uveitis may cause permanent visual loss. Regular appointments with your doctor are essential to monitor for possible issues like early cataracts or elevated eye pressure.

My doctor says there is no cure for uveitis. Is that true?

For some patients experiencing recurrent uveitis episodes, permanent prevention may be challenging. However, medications can help reduce attack frequency. While a permanent cure might not be guaranteed, proper treatment and follow-up can prevent permanent visual loss in most cases. However, in most cases, with proper treatment and follow up, the disease does not cause permanent visual loss. If you sense a uveitis flare, seek an eye check-up promptly. Early treatment initiation is crucial, as delaying may prolong the required treatment duration. Timely intervention minimizes the risk of permanent visual loss.

How can I arrange to see a uveitis specialist in NUH?

Please contact us via central appointment line: 6908 2222 or email us at: [email protected]
Additional Uveitis Resources
Brochures

Ocular Inflammation

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