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Uveitis

Definition

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

Alternative Names

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

Causes

Uveitis can be caused by autoimmune disorders. These diseases occur when the body's immune system attacks and destroys healthy body tissue by mistake. Examples are:

Uveitis can also be caused by infections such as:

Exposure to toxins or injury can also cause uveitis. In many cases, the cause is unknown.

The most common form of uveitis involves inflammation the front part of the eye. It is often called iritis because it most often only affects the iris. The iris is the colored part of the eye. In most cases, it occurs 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 eye. It involves primarily the choroid. This is the layer of blood vessels and connective tissue in the middle layer of the eye. This type of uveitis is called choroiditis. If the retina is also involved, it is called chorioretinitis.

Another form of uveitis is pars planitis. Changes involve 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 disease and possibly multiple sclerosis.

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 a weak immune system.

If you are over age 25 and have pars planitis, your provider will suggest a brain and spine MRI. This will 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.

If the uveitis is caused by a body-wide (systemic) infection, you may be given antibiotics. You may also be given powerful anti-inflammatory medicines called corticosteroids.

Outlook (Prognosis)

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

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

Symptoms that need urgent medical care are:

  • Eye pain
  • Reduced vision

Prevention

If you have a body-wide (systemic) infection or disease, treating the condition will prevent uveitis.

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; 2013: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; 2013:vol 4, chap 32.

Jap A, Chee SP. Pars planitis and other intermediate uveitis. In: Yankoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 7.21.

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; 20132:vol 4, chap 37.

Yanoff M, Cameron DJ. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 423.

Review Date:8/20/2016
Reviewed By:Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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