Uveitis

Alternative Names

Iritis; Pars planitis; Choroiditis; Chorioretinitis; Anterior uveitis; Posterior uveitis

Definition

Uveitis is swelling and irritation of the uvea, the middle layer of the eye. The uvea provides most of the blood supply to the retina.

Causes

Uveitis can be caused by autoimmune disorders, including rheumatoid arthritis or ankylosing spondylitis. It can also be caused by infection or exposure to toxins. In many cases, the cause is unknown.

The most common form of uveitis is anterior uveitis. This involves inflammation in the front part of the eye. It is often called iritis because it usually only affects the iris, the colored part of the eye. The inflammation may be linked with autoimmune diseases, but most cases occur in healthy people. The disorder may affect only one eye. It is most common in young and middle-aged people.

Posterior uveitis affects the back part of the uvea. It involves primarily the choroid, which is a layer of blood vessels and connective tissue in the middle part of the eye. This type of uveitis is called choroiditis. If the retina is also involved, it is called chorioretinitis. You may develop this condition if you have had a body-wide (systemic) infection or if you have an autoimmune disease.

Another form of uveitis is pars planitis. This inflammation affects the narrowed area (pars plana) between the colored part of the eye (iris) and the choroid. Pars planitis most often occurs in young men. It is generally not associated with any other disease. However, it may be linked to Crohn's disease and possibly multiple sclerosis.

Uveitis can be associated with any of the following:

Symptoms

Uveitis can affect one or both eyes. Symptoms may develop rapidly and can include:

Exams and Tests

The health care provider will take a complete medical history and do an eye exam. Lab tests may be done to rule out infection or an autoimmune disorder.

People over age 25 with pars planitis should have an MRI of their brain and spine to rule out multiple sclerosis.

Treatment

Iritis (anterior uveitis) is most often mild. Treatment may involve:

Dark glasses
Eye drops that dilate the pupil to relieve pain
Steroid eye drops

Pars planitis is often treated with steroid eye drops. Other medicines, including steroids taken by mouth, may be used to help suppress the immune system.

Posterior uveitis treatment depends on the underlying cause. It almost always includes steroids taken by mouth. Additional specialists in infectious disease or autoimmunity may be needed for diseases such as syphilis, tuberculosis, AIDS, sarcoidosis, or Behcet syndrome.

If the uveitis is caused by a body-wide infection, treatment may involve antibiotics and powerful anti-inflammatory medicines called corticosteroids. See autoimmune disorders for information about treating such diseases.

Outlook (Prognosis)

With proper treatment, most attacks of anterior uveitis go away in a few days to weeks. However, the problem often returns.

Inflammation related to posterior uveitis may last from months to years. It may cause permanent vision damage, even with treatment.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Call your health care provider if you have symptoms of uveitis. Eye pain or reduced vision are urgent symptoms that need medical care right away.

Prevention

Treatment of an underlying disorder may help to prevent uveitis in persons with a body-wide (systemic) infection or disease.

References

Goldstein DA, Horsley M, Ulanski LJ II, Tessler HH. Complications of uveitis and their management. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2012:vol 4, chap 60.

Goldstein DA, Patel S, Tessler HH. Classification, symptoms, and signs of uveitis. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2012:vol 4, chap 32.

Nair UK, Cunningham ET Jr. Uveitis: Diagnostic approach and ancillary analysis. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2012:vol 4, chap 37.

Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 431.