Uveitis
Introduction
Uveitis is a form of eye inflammation that primarily affects the uvea, the middle layer of tissue in the eye wall. However, uveitis can also involve other parts of the eye, including the lens, retina, optic nerve, and vitreous. Uveitis can be a serious condition, leading to permanent vision loss if not promptly diagnosed and treated. It can affect people of all ages, but primarily affects people between the ages of 20 and 60.
Classification
Uveitis is classified based on the anatomical location of inflammation within the eye. The main types of uveitis are anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis.
Anterior Uveitis
Anterior uveitis, also known as iritis or iridocyclitis, is the most common type of uveitis, accounting for approximately 80% of cases. It primarily involves the iris and the ciliary body.
Intermediate Uveitis
Intermediate uveitis, also known as pars planitis, primarily affects the vitreous and peripheral retina. It is often associated with systemic diseases such as multiple sclerosis and sarcoidosis.
Posterior Uveitis
Posterior uveitis primarily affects the retina and choroid. It is often associated with infectious diseases such as toxoplasmosis, as well as systemic inflammatory conditions.
Panuveitis
Panuveitis involves inflammation of all layers of the uvea, and often affects the lens, retina, optic nerve, and vitreous as well.
Causes
Uveitis can be caused by a wide range of factors, including autoimmune disorders, infections, injury to the eye, and exposure to toxins. However, in many cases, the exact cause of uveitis is unknown. This is referred to as idiopathic uveitis.
Autoimmune Disorders
Autoimmune disorders, such as rheumatoid arthritis, lupus, and Behçet's disease, can cause uveitis. In these cases, the body's immune system mistakenly attacks healthy tissues in the eye, leading to inflammation.
Infections
Infections can also cause uveitis. These can include viral infections such as herpes simplex or herpes zoster, bacterial infections such as syphilis or tuberculosis, fungal infections such as histoplasmosis, and parasitic infections such as toxoplasmosis.
Injury to the Eye
Physical injury to the eye, such as a blow, cut, or burn, can lead to uveitis. This is known as traumatic uveitis.
Exposure to Toxins
Exposure to certain toxins, such as those produced by some types of bacteria, can also cause uveitis.
Symptoms
The symptoms of uveitis can vary depending on the type of uveitis and the individual patient. However, common symptoms include:
- Eye redness
- Eye pain
- Light sensitivity
- Blurred vision
- Dark, floating spots in the field of vision
- Decreased vision
It is important to seek medical attention if you experience these symptoms, as untreated uveitis can lead to serious complications, including vision loss.
Diagnosis
The diagnosis of uveitis involves a thorough eye examination, which may include tests such as a slit-lamp examination, a fundoscopic examination, and ocular imaging studies. In some cases, laboratory tests may be performed to identify underlying causes of uveitis, such as infections or autoimmune disorders.
Treatment
The treatment of uveitis aims to reduce inflammation, alleviate pain, prevent further tissue damage, and restore any loss of vision. Treatment options may include corticosteroids, immunosuppressive drugs, biologic therapies, and in some cases, surgery.
Prognosis
The prognosis for uveitis varies depending on the underlying cause, the type of uveitis, and the patient's overall health. With prompt diagnosis and treatment, most cases of uveitis can be managed effectively.
Epidemiology
Uveitis affects approximately 2-5 people per 10,000 per year, and is responsible for approximately 10% of cases of blindness in the United States. It is most common in people between the ages of 20 and 60, but can occur at any age.