Uveitis (u-vee-I-tis) is a swelling of the uvea. It is the middle layer of the eye tissue.
The uvea is responsible for supplying blood to the retina, the light-sensitive tissue of the eye, which relays images to the brain to interpret.
The swelling of the uvea could be due to an injury, infection, or an autoimmune disease. The cause in some cases has been unidentified. It may affect adults or children in one or both eyes simultaneously.
An early diagnosis of this condition can prevent complications and permanent loss of vision.
Effective diagnosis is crucial to the treatment of uveitis.
The doctor when checking for uveitis based on the symptoms does a thorough evaluation of the eye after collecting the health history. It includes the following tests, which examine the complete affected eye:
Vision assessment: Vision assessment (with glasses if the patient has a number) and the response of pupils when exposed to light.
Tonometry: To measure the intraocular pressure inside the eye.
Slit-lamp examination: To identify microscopic inflammatory changes in the cells of the tissue in front of the eye.
Ophthalmoscopy: To examine the back of the eye by dilating the pupil of the eye using medicated eye drops.
If the doctor is not able to draw any conclusions from the above techniques of evaluations, further examination protocols as described below may be prescribed to help identify the underlying cause leading to uveitis:
Colour photography: This method is to study the retina and diagnose abnormalities if any.
Optical coherence tomography (OCT) imaging: This method is to check for inflammation in the retina and the choroid plexus of the eye.
Fluorescein or indocyanine green angiography: Fluorescein and indocyanine dye. They are administered intravenously using a catheter. Photographs of the blood vessels supplying blood to the eye are then taken. This allows the doctor to see any inflammation of the blood vessels associated with the eyes.
The vitreous fluid from the eye is aspirated to analyze and determine the cause course of treatment.
Blood tests may be advised if the doctor thinks the cause of uveitis is systemic.
Other imaging tests, CT or MRI scans, radiography may also be prescribed if the cause cannot be easily ascertained.
Sometimes the cause remains unidentified. The treatment regimen then is focused on controlling the inflammation in the eye to prevent damage, such as loss of vision.
The goal of treating uveitis is to reduce inflammation in the eye and any other part of the body.
The treatment may be a long one lasting for a few months to years depending on the intensity of the inflammation, and its response to the treatment regimen.
These forms of treatment use drugs to suppress the patient's immune system.
The doctor with scheduled visits along with regular blood tests closely monitors the condition, and the improvement thereafter.
Surgical and other protocols:
This procedure is used in rare cases.
The vitreous of the eye is removed for diagnosis or management of the condition. This vitreous is replaced by air, gas, or liquid, which the eye subsequently replaces with its fluid secreted gradually.
A medication-releasing implant:
A small capsule is implanted in the eye, especially for patients who have developed posterior uveitis that is difficult to treat.
The medication is a corticosteroid that is slowly released over an extended period of two to three years.
Patients treated for uveitis have the chances of developing cataracts subsequently, which will need surgery. Patients (about 30%) are also prone to increase intraocular pressure and eventually glaucoma.
The treatment duration for uveitis is dependent on the type of uveitis.
Uveitis affecting the posterior walls of the eye such as panuveitis, which includes choroiditis or retinitis, takes longer to recover compared to anterior wall uveitis or iritis.
Even after complete recovery, there are chances of uveitis recurring which need to be addressed with the doctor with immediate effect.
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