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Uveitis : Causes, Symptoms and Treatment

Uveitis is inflammation that occurs in the uvea or the middle layer of the eye. This condition is characterized by one or both eyes that look very red because there are many veins in the uvea. Generally, uveitis is experienced by adults aged 20-50 years, but sometimes also experienced by children.

Uveitis

Types of Uveitis

The Uvea is the middle layer of the inside of the eye consisting of the iris (iris), the lining of the blood vessels (choroid), and connective tissue between the iris and choroid (ciliary body). The uvea is located between the white part of the eye (sclera) and the back of the eye that captures light (retina).

Based on the location of inflammation, uveitis is divided into several types, namely:

  • Uveitis in the front uvea (iritis or anterior uveitis). Inflammation occurs in the iris.
  • Uveitis in the middle uvea (intermedia uveitis or cyclitis). Inflammation occurs between the iris and choroid.
  • Uveitis in the rear uvea (choroiditis or posterior uveitis). Inflammation occurs in the choroid region.
  • Uveitis in all uvea (panuveitis). Occurs when all uvea layers are inflamed.

Uveitis is also divided based on the duration of the patient experiencing uveitis, namely:

  • Acute uveitis, which is a type of uveitis that develops in a period of less than 3 months.
  • Chronic uveitis, when inflammation occurs continuously for more than 3 months.

Causes of Uveitis

Uveitis is often unknown and sometimes experienced by healthy people. However, most uveitis is associated with autoimmune disorders, namely the condition when the body's immune system attacks the body itself. Some autoimmune conditions associated with uveitis include:

  • Rheumatoid arthritis, which is joint inflammation.
  • Psoriasis, which is skin inflammation.
  • Ankylosing spondylitis, which is joint inflammation of the spine.
  • Sarcoidosis, which is inflammation that occurs in various parts of the body, such as the lungs, lymph nodes, eyes and skin.
  • Kawasaki disease, which is inflammation of the blood vessel walls.
  • Ulcerative colitis, which is inflammation of the large intestine.
  • Croh’s Disease, which is inflammation that occurs in the digestive tract, starting from the mouth to the anus.

In addition, uveitis can also be caused by other things, such as:




Uveitis Symptoms

Symptoms of uveitis can appear suddenly or develop gradually over a period of several days. Uveitis symptoms include:

  • Pain around the eyes, especially when the eye is focused on one thing or object.
  • Blurred vision.
  • Red eye.
  • Eyes become sensitive to light.
  • There is a small dot that blocks vision.
  • Narrowing the field of view, namely the ability to see objects that are located on the side.

Diagnosis of Uveitis

As an initial step in the diagnosis, the doctor will examine the medical history and ask about the symptoms the patient feels.

Then, the doctor will do a physical examination, especially in the patient's eyes. After that, the doctor will do a follow-up examination to support the diagnosis. The follow-up examination includes:

  • Blood test.
  • Analysis of eye fluids.
  • Eye angiography, which is imaging to evaluate the blood flow of the eye.
  • Examination of photographic fundus eyes to measure retinal thickness and find out whether there is fluid in the retina.

Uveitis Treatment

The focus of uveitis treatment is to reduce inflammation in the eye. There are several treatment options that may be made by doctors, including:

Medicines, such as:

  • Medication to reduce inflammation. One form of anti-inflammatory drugs commonly given is corticosteroids. This drug works by inhibiting the body's immune system from releasing chemicals that might cause inflammation. Corticosteroids are available in various forms, namely eye drops, injections, and tablets or capsules.
  • Drugs to fight bacteria or viruses. If uveitis is caused by an infection, the doctor will give antibiotics or antiviral drugs to control the infection.
  • Drugs that affect the immune system or destroy cells. If uveitis occurs in both eyes, the patient may need immunosuppressive or cytotoxic drugs. This type of drug is needed if treatment with costicosteroids fails or uveitis is getting worse and the patient is threatened with blindness.

Operation. Surgery procedures may be performed if the symptoms that appear are severe enough or the drug method is not effective. The example is:

  • Vitrectomy, which is eye surgery to take vitreous in the eye.
  • Operation of planting a device on the eye. For patients with posterior uveitis that is difficult to treat, a tool will be planted in the eye to slowly channel corticosteroid drugs into the eye. This treatment generally lasts for 2-3 years.

The duration of treatment for uveitis usually depends on the type of uveitis and the severity of the symptoms. Posterior uveitis requires a longer healing process than anterior uveitis.

The possibility of returning uveitis is quite large. Immediately consult a doctor if symptoms appear again after going through the treatment period.

Complications of Uveitis

If not treated immediately, uveitis can cause complications in the form of:

  • Cataracts, which are changes that occur in the lens of the eye and cause blurred vision.
  • Glaucoma, which is damage to the nerves that connect the eyes to the brain. If not treated immediately, glaucoma can cause blindness.
  • Retinal detachment, a condition when the deepest layer of the retina contains nerves, detaches from the outer layer of the retina containing blood vessels.
  • Cystoid macular edema, which is swelling of the retina.
  • Posterior synechiae, that is inflammation that causes the iris to attach to the lens of the eye.

The risk of complications is higher if:

  • Aged 60 years and above.
  • Have intermedia uveitis or posterior uveitis.
  • Suffering from chronic uveitis.

Prevention of Uveitis

Precautionary measures for uveitis are difficult for healthy people because there is no known cause of uveitis. However, early detection and treatment can reduce the risk of permanent loss of vision.



References

References

1. Rathinam, SR. Babu, M. (2013). Algorithmic Approach in the Diagnosis of Uveitis. Indian Journal of Ophthalmology.

2. Mayo Clinic (2015). Diseases and Conditions. Uveitis.

3. Boyd, K. American Academy of Ophthalmology (2018). What is Uveitis?


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Is a health and wellness enthusiast. In him free time, she loves to travel and taste different types of teas.

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