Uveitis
Sometimes the body’s immune system produces a reaction against its own tissues. This can occur in many areas of the body, most often the joints or skin, and it can also affect the eye. When it does, the resulting condition is called uveitis.
What is uveitis?
Uveitis is inflammation of the uvea, the middle layer of the eye that includes the iris, ciliary body, and choroid. It is a broad term for a group of eye conditions involving inflammation inside the eye. It can affect one or both eyes, develop suddenly, or progress gradually. It is not a disease in itself but a sign of an underlying problem, which may be related to injury, infection, or autoimmune disease. In many cases, the exact cause remains unknown.
What are the types of eye inflammation?
Uveitis is classified by the part of the uvea affected:
- Anterior uveitis: Affects the front of the eye (iris). The most common form, often called iritis
- Intermediate uveitis: Affects the vitreous (gel-like fluid) and peripheral retina
- Posterior uveitis: Affects the back of the eye, including the retina and choroid
- Panuveitis: Inflammation throughout the entire uvea
Symptoms of uveitis
Symptoms can vary depending on which part of the uvea is affected, but common signs include:
- Eye redness
- Eye pain or aching discomfort
- Blurred or cloudy vision
- Sensitivity to light (photophobia)
- Dark floating spots in vision (floaters)
- Reduced vision
Uveitis vs conjunctivitis: What’s the difference?
While both can cause redness and discomfort, they are different conditions:
| Feature | Uveitis | Conjunctivitis |
|---|---|---|
| Location | Inside the eye (uvea) | Outer surface of the eye (conjunctiva) |
| Symptoms | Pain, light sensitivity, blurred vision, floaters | Itching, discharge, redness |
| Urgency | Urgent – can threaten vision | Often mild, but depends on cause |
| Treatment | Steroids, targeted therapy | Usually topical antibiotics or anti-allergy drops |
Causes of uveitis
Possible causes include:
- Autoimmune diseases, like rheumatoid arthritis or ankylosing spondylitis, sarcoidosis
- Infections, like herpes simplex, tuberculosis, syphilis, and toxoplasmosis
- Eye injury or surgery
- Inflammatory disorders without a known trigger
In many cases, the exact cause remains unknown.
Uveitis treatment
The goal of treatment is to reduce inflammation, relieve symptoms, and prevent vision loss. Treatment depends on the cause, location, and severity of the inflammation, but may include:
- Steroid eye drops or oral steroids to control inflammation
- Dilating drops to relieve pain and prevent scarring
- Immunosuppressive medication for autoimmune causes
- Antibiotics or antivirals for infection-related uveitis
Sometimes uveitis affects the back of the eye, involving the retina and the vitreous. When this occurs, the retina can become damaged and the vitreous may turn cloudy due to inflammatory proteins and cells. In severe cases, vitrectomy surgery may be required to remove the affected vitreous and repair retinal damage.
Prompt medical attention is essential, as untreated uveitis can cause glaucoma, cataracts, or retinal damage.
After treatment: How to tell if uveitis is healing
Signs that uveitis is improving may include reduced redness, less light sensitivity, and clearer vision. Your ophthalmologist will confirm healing by examining your eye for decreased inflammation during follow-up visits. Blurred vision can improve within days to weeks once inflammation is treated, but recovery time varies.
How long does uveitis last?
Acute uveitis: This type comes on suddenly, with symptoms developing over hours or days. With prompt treatment, the inflammation often resolves within a few weeks to a few months. Once healed, it may not return, although some people experience repeated acute episodes over time.
Chronic uveitis: This form lasts for many months or even years. Symptoms may be milder but persist over a long period, and the condition can flare up (relapse) after periods of improvement (remission). Chronic uveitis often requires ongoing monitoring and, in some cases, long-term medication to control inflammation and protect vision.
When it becomes urgent
Uveitis can become an emergency if symptoms appear suddenly or worsen quickly. Seek immediate medical attention if you develop sudden eye pain, redness, or rapid changes in vision such as new floaters, flashes of light, or loss of part of your visual field. These signs may mean the inflammation is affecting the retina or optic nerve, and prompt treatment is essential to protect your sight.
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