WHAT IS THE UVEITIS?

The uveitis is the inflammation of the uvea, the intermediate vascularized membrane, made up of the iris, ciliary body and choroid. Also, this is the most vascularized area of the human body.

The uveitis may be bacterial, viral, parasitic, mycotic or autoimmune. In addition, the uveitis may accompany the meningitis or rheumatic diseases.

CAUTION! The uveitis is among the top eye conditions which lead to blindness and it generally affects adults aged from 20 to 50.

CLASSIFICATION:

  • Anterior uveitis - is the most common form of uveitis, accounting for 40% to 70% of cases. Usually, the inflammation includes both the iris, and the ciliary body, being called iridocyclitis. Inflammation of the iris = iritis, ciliary body inflammation = cyclitis.
  • Intermediate uveitis - this type of uveitis affects the area around the ciliary body and the retinal edge. This type of uveitis is the least common (7 -15%).
  • Posterior uveitis - this type of uveitis is characterized by inflammation of the back portion of the eye, the choroid. In most cases of posterior uveitis retina is also affected. This form of uveitis (seen in 15% - 22% of all cases) usually begins slowly and can sevolve over a longer period of time, being more difficult to treat. The posterior uveitis is often associated with progressive loss of vision.

The uveitis can be classified as:

  • acute or chronic uveitis
  • granulomatous or non-granulomatous uveitis.

WHAT CAUSES UVEITIS?

The causes of early uveitis may be:

  • Germs: streptococcus, staphylococcus, tuberculosis bacillus
  • viruses: herpes, shingles
  • atypical bacteria
  • parasites: toxoplasmosis
  • mycoses: candida.

WHAT ARE THE SYMPTOMS OF UVEITIS?

Symptoms of early uveitis:

Subjective symptoms (which are described by the patient):

  • eye pain, which may increase in the light or with the effort to read; in chronic forms pain may be absent
  • photophobia;
  • low visual acuity

Objective symptoms:

  • perikeratic congestion (dilation of the conjunctival vessels)
  • Positive Tyndall
  • miosis (small diameter of the pupil)
  • posterior synechiae (the pupil appears irregular, especially when its dilation is attempted with mydriatic medication)
  • endothelial exudates and precipitates

HOW TO DIAGNOSE UVEITIS?

The diagnosis is based on clinical and slit-lamp examinations, therefore you should go and see a doctor.

The diagnosis is established based on the clinical appearance and laboratory tests. They are necessary to determine the cause of the uveitis (infectious, autoimmune, rheumatic diseases, etc.), although the results are negative in many cases.

HOW TO TREAT UVEITIS?

The uveitis is a treatable eye condition. Except for certain rare cases, the eye can recover.

The treatment is not difficult, but must be followed rigorously. If ignored, it can cause blindness, as the uvea is made up of vessels that supply the eye, and the inflammation of that part can affect all the eye tissues.

  • The ophthalmologist can prescribe eye drops (cortisone and mydriatic derivatives) to reduce the inflammation and pain. However, since the drops do not penetrate well to the back of the eye, this treatment is not effective in the case of posterior uveitis.
  • Etiological treatment (the cause of the disease) is personalised (e.g., broad-spectrum antibiotics, corticotherapy)
  • Periocular injections of steroids - are an uncomfortable form of treatment, but this can be especially effective in acute episodes of uveitis. The effect of this treatment is not long lasting (3 to 4 weeks).
  • Systemic or oral administration of steroids, other immune-stimulating or anti-metabolite drugs.. The drugs have a poor penetration into the eye and, thus, the systemic high dose required to treat uveitis is frequently associated with systemic side effects .

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