Uveitis

A health condition that causes inflammation of the uvea (including the iris, ciliary body, and choroid) is called uveitis. One of the possible complications if you develop a severe form of this condition and leave it untreated is blindness.

Most of the time, the cause of this condition cannot be identified, but some people develop it due to certain known health conditions that negatively affect multiple areas of the eye. While it can affect both eyes at the same time, it may also cause redness, pain, and irritation. If you develop a severe form of uveitis, it may lead to permanent loss of vision.

Generally, uveitis is a common condition that affects approximately 4 million people each year worldwide. However, in the U.S., this eye condition affects from 80,000 to 168,000 people every year. This disease is often diagnosed in adults.

Symptoms

The symptoms usually appear differently among people with uveitis because it depends on several factors. These include the severity and area of the eye that is affected by the condition, age, existing health problems, and preferences. Commonly, it affects the iris and ciliary body. Check below some symptoms of uveitis:

Eye pain, redness, or irritation
Blurred vision
Photophobia (sensitivity to light)
Swollen conjunctivae
Changes in the pupil shape (such as from a circle to an irregular shape)
Hypopyon (it occurs when white liquid begins to build up at the bottom of the front of the eye)

Those who develop intermediate (middle) or posterior (back) uveitis may experience other symptoms that affect their sight. Examples include:

Reduced vision
Missing sections or gaps in the vision field
An increase in myopia (floaters)

If you notice any of the previous symptoms, immediately contact your healthcare professional. Early diagnosis is essential to prevent permanent loss of vision.

Causes

This eye disorder may occur due to various reasons. For instance, approximately between 50% and 70% of diagnosed cases are idiopathic. It means that the exact cause of the disease cannot be identified. The rest of them can be caused by infections, systemic causes, injuries, and medicines. Check some examples below:

Infections

An infection often occurs when germs enter the body and begin to multiply and cause damage. Check below some types of pathogens that may lead to uveitis:

Viruses – These include varicella-zoster virus that causes chickenpox and shingles, herpes simplex virus (HSV), and cytomegalovirus (CMV).
Bacteria – Uveitis usually occurs in people who have bacteria that cause syphilis and tuberculosis.
Fungi – Some people may develop uveitis due to Candida or certain mold species (including Aspergillus).
Parasites – It is important to know that you may get some parasites (including from pets like cats and dogs) that may lead to uveitis. These include toxoplasmosis, toxocariasis, and cysticercosis.

Systemic Causes

While some people develop uveitis due to an injury to the eye, others may experience it as a symptom of another health condition. Check below some autoimmune and inflammatory diseases that are often linked to uveitis:

Sarcoidosis
Inflammatory bowel disease (IBD)
Lupus (systemic lupus erythematosus)
Tubule-interstitial nephritis (TINU)
Behcet’s disease

There is a DNA mutation (HLA-B27) that may also cause inflammatory arthritis conditions, which significantly increase the risk of developing uveitis. For example:

Ankylosing spondylitis
Axial spondyloarthritis
Enteropathic arthritis
Reactive arthritis
Juvenile idiopathic arthritis
Psoriatic arthritis

Injuries

Eye injuries that cause damage to the muscles or blood vessels of the uvea may also cause uveitis. In normal circumstances, the immune system causes an inflammation as part of the repair process. Sometimes, people may develop uveitis after an eye surgery, or even small changes in the eye structure can cause this eye disorder (such as those that happen due to inflammation).

Medicines

Check below some medicines that can cause uveitis:

Cidofovir
Rifabutin
Bisphosphonates
Brimonidine eye drops
Tyrosine kinase inhibitors

While the condition itself is not contagious, it may be a symptom of a contagious infection. For more details, discuss it with your healthcare professional.

Risk Factors

Mostly, it is not possible to determine what exactly causes uveitis, but physicians have identified some factors that may increase the risk of developing it. Check below some examples:

Autoimmune disorders (such as rheumatoid arthritis, multiple sclerosis, and others)
Infections (including syphilis, toxoplasmosis, and others)
Eye trauma or injury
Some medicines
Smoking
Genetics
Sex – Women are more likely to develop uveitis compared to men
Vitamin D deficiency
Pregnancy complications (such as eclampsia or pre-eclampsia)

What Are The Possible Complications of Uveitis?

The most serious complication of uveitis is complete vision loss. However, people with uveitis may also experience other complications. For example:

Glaucoma
High intraocular pressure
Macular pucker (epiretinal membrane)
Optic nerve swelling or damage
Synechiae (this complication occurs when the iris sticks to the cornea or lens)
Detached retina
Cystoid macular edema
Cataracts
Hypotony
Neovascularization

This document does not contain all possible complications of this eye disorder. Moreover, you can talk with your physician about ways to reduce the risk or prevent these complications.

How to Prevent Uveitis?

Generally, there is no sure way to prevent this condition because experts do not fully understand why it happens. However, the following tips may help reduce the risk. Examples include:

Regular eye examinations help identify any abnormalities early
Wear eye protection to reduce the risk of or prevent eye injuries
Get treatment for infections as soon as possible

Diagnosis

First, doctors will perform a physical examination to check for irregularities linked to the disease and ask some questions about the symptoms and medical history. They may also perform some tests to check for changes in the structures of the eye. These include optical coherence tomography (OCT), tonometry, visual acuity test, and slit lamp examination. However, doctors may order the following tests to check for the cause of uveitis. For example:

Blood tests – These tests help look for infections, immune markers, and other health problems.
Imaging tests – Doctors usually perform a chest X-ray or a brain MRI (magnetic resonance imaging).

Treatment

The condition usually goes away when the underlying cause is addressed. However, if you develop idiopathic uveitis, the treatment focuses on relieving the symptoms because there is no way to cure this condition. Check below some treatments often recommended to lessen the symptoms:

Pain relievers – These include over-the-counter (OTC) or prescription medicines that help reduce pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs) – This group of medicines is often recommended by doctors to reduce inflammation.
Condition-specific treatments – These include treatments for underlying causes, such as antiviral medicines, antibiotics, and others.

Frequently Asked Questions

When should I see my healthcare provider?

It is recommended to seek medical care if any of the following symptoms occur. For example:

Severe pain
Worsening vision or sudden vision loss
Flashes of light in the vision

What foods should be avoided by people with uveitis?

The following foods may cause inflammation, which may worsen the symptoms in people with uveitis. Examples include:

Processed and fried foods
Excessive sugars
Red meats
Nightshade vegetables
Dairy products
Hydrogenated oils and fats
Fast food
Alcohol
Sugary drinks

For more details, discuss it with your physician.

What conditions can be mistaken for uveitis?

For example:

Conjunctivitis
Scleritis
Corneal ulcers
Intraocular tumors
Certain autoimmune diseases
Infectious diseases
Acute angle-closure glaucoma
Retinitis pigmentosa

This document does not have a complete list of disorders that can be mistaken for uveitis. Ask your healthcare provider if you have additional questions.