Uveitis and Iritis
Uveitis is an inflammation of the uvea, the portion of the eye that includes the iris, the ciliary body, and the choroid. The iris is the colored portion of the eye that controls the opening and closing of the pupil; the ciliary body is a muscle behind the iris that helps change the curvature of the lens so as to focus light rays; and the choroid is a layer of the eyeball containing essential blood vessels. When uveitis is primarily localized in the iris, it is called iritis or, when it affects the iris and the ciliary body, anterior uveitis. When it primarily affects the choroid, it is known as posterior uveitis.
Attacks of anterior uveitis, the most common variety, usually subside within a few days to a few weeks with no permanent damage; however, recurrence is common. Posterior uveitis may persist for months or years even with treatment and cause irreversible scarring of delicate structures within the eye, including the retina (the layer of nerve cells that converts light rays into nerve impulses). If left untreated, uveitis of either type may lead to permanent vision loss and complications, including glaucoma, cataracts, and retinal detachment. A rare form of uveitis occurs when an injured eye that is severely inflamed for several weeks triggers inflammation of the uvea in the uninvolved eye. This condition, known as sympathetic ophthalmia, can result in severe vision loss in both eyes and requires prompt medical attention. Uveitis is a relatively rare disorder and most often affects young adults.
What Causes Uveitis and Iritis?
- In most cases the cause of uveitis is unknown.
- An autoimmune reaction (in which the body’s natural defenses inappropriately attack healthy tissue) may be responsible.
- Bacterial, viral, and fungal infections are potential causes.
- Systemic disorders (those affecting entire organ systems of the body) such as rheumatoid arthritis, ankylosing spondylitis, toxoplasmosis, Crohn’s disease, ulcerative colitis, and sarcoidosis may cause uveitis.
Symptoms of Uveitis and Iritis
- Moderate to severe eye pain
- White blood cells and protein in the anterior chamber
- Aversion to light
- Blurred vision
- Spots in the field of vision
- Redness in the eye
- Pupils of different sizes or unusual shapes
- Pupil contraction
- Excessive tearing
Uveitis and Iritis Prevention
- There is no known way to prevent uveitis.
Diagnosis of Uveitis and Iritis
- A thorough examination by an ophthalmologist is necessary.
How to Treat Uveitis and Iritis
- A cycloplegic (iris-paralyzing) drug such as atropine sulfate may be administered. Immobilizing the inflamed iris and ciliary body may prevent scarring and alleviate pain somewhat. When such drugs are used, the pupil remains constantly dilated in one position, making the eye extremely sensitive to light; dark glasses are therefore recommended during the treatment period, even while indoors.
- Topical anti-inflammatory corticosteroid eye drops are usually prescribed. For more severe cases, oral or injected steroids may be required.
- Long-term steroid use increases the risks of cataracts and glaucoma, so frequent monitoring by an ophthalmologist is essential.
- Some causes of uveitis require cytotoxic drugs to treat the underlying disorder.
- Aspirin may help reduce inflammation and eye pain.
When to Call a Doctor
- Any persistent or serious eye pain and even the slightest loss of vision warrant a prompt examination by an ophthalmologist.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media