Introduction to Uvea
A normal human eye consists of 3 layers from which the middle layer is called the Uvea. And, Uveitis is the inflammation of any portion of the uvea. Uvea is one of the complex structures in the eye, and it is often classified by the part of uvea that is inflamed.
Iritis or anterior uveitis affects the front part of the eye and around the eye’s iris. Anterior uveitis is very common that makes up two-thirds of all uveitis. Iritis usually very acute uveitis and can be identified from its symptoms like light sensitivity, redness and pain in the middle part of the eye.
Anterior Uveitis is swelling in the ciliary body, the vitreous, and the front end of the retina. While Iritis, being the most common type of uveitis, covers almost two-third or 40-70% of it, intermediate uveitis makes up only 7-15% of cases, resulting in the least and rarest one. The other terms of uveitis are pars planitis, vitritis, or cyclitis.
More about Uveitis
It is the middle layer of the eyeball.
Solely responsible for taking care of the eye.
Carries blood vessels, nerves, pigment cells, and immune cells.
It extends from the front part of the eye to different parts.
The anterior part is often termed iritis, as it affects the area around the iris of the eye.
In the middle, is the posterior part of the ciliary body, and is called pars planitis
And, posteriorly, it is named the choroid.
Symptoms of Uveitis
Symptoms of uveitis depend on the location or the part of the eye, which is having some complications. Symptoms of anterior uveitis are painful red eye with a mild, blurring of vision. In intermediate and posterior uveitis, the symptoms are not the same as an anterior one.
Problems affecting the portion of the eye
Being one of the most common diseases that affect Uvea, it occurs due to an infection from a virus or bacteria. It can be a secondary condition that develops due to some other illness like rheumatoid arthritis, tuberculosis or syphilis and is called systemic Uveitis.
When should someone consult the eye doctor?
Some of the common symptoms of Uveitis are eye pain, severe sensitivity to light, redness, blurry vision, and floaters. When a person feels some of these symptoms, that is the perfect time to visit a doctor, immediately.
Examination of the exact cause
Once you visit a doctor, he/she may perform a series of tests on your eyes like eye pressure, visual clarity, and even dilate your eyes to check its inner health. If the tests reveal you have uveitis, more tests are prescribed to identify the root cause of this disease. The doctor may ask to share your medical history. Tests like X-Ray to check for tuberculosis and blood work would be done to identify other conditions.
Uveitis and its treatment
If the infection has happened only to the Uvea, simple treatment like eye drops, antibiotics, or corticosteroids would be given. In our hospital, there are well-experienced doctors available to treat Uveal diseases. The patient is given the best treatment, and utmost care is practiced to prevent the disease from spreading and safeguard his/her vision.
Our eye consists of 3 layers, and uveitis is infectious aetiologies of one of the parts of the uvea. Many cases of it are idiopathic in origin, and a patient dealing with this disease should be counseled immediately.
A rise in the ACE level is relatively nonspecific. The patient who would deal with sarcoidosis, chest x-ray comes 90% positive in such cases. And, if high suspicion for sarcoid exists and the chest x-ray comes normal, a stiff rise in both the ACE level and lysozyme level results more specific for sarcoidosis.
The laboratory tests such as a chest x-ray, QG or PPD, FTA-ABS (syphilis, RPR can come negative in up to one-third of cases of tertiary syphilis), lyme disease, CBC and a CMP. In case of anterior uveitis, the doctor always suggests you to perform HLA-B27. Cases of intermediate uveitis benefits from MRI if the tests result of system is suggestive of multiple sclerosis. Cases of posterior uveitis with chorioretinal spots may benefit from HLA-A29.
There are several cases of uveitis that would benefit a patient suffering from it. Doctors prescribe prednisolone acetate to decrease inflammation. For effective control of inflammation, a patient requires a longer taper of topical drops or oral medication.
According to the patient’s feedback and doctor’s research, usage of prednisolone acetate of patients suffering from juvenile idiopathic or rheumatoid arthritis has an acceptable safety profile at a dosage limit of thrice a day. If a patient requires four times a day or more to maintain dormancy, He/she should consult an ophthalmologist at an immediate basis.
Intermediate uveitis is often bilateral but not associated with macular edema (ME). Patients with ME can be monitored with clinical examination and OCT. In this case, patients will typically require oral medications. If there is no ME, patients can be watched without therapy. In the absence of this coexistent infectious cause, prednisone is usually the first therapy that is given to every patient.
Patients dealing with a history of inflammation, a full 3 months, or 1 quarter quiescence is essential before elective surgery. Prednisone is also found beneficial for patients to control the inflammation associated with intraocular surgery.