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'''For the WikiDoc page for this topic, click [[yourtopic|here]]'''
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'''For the WikiDoc page for this topic, click [[Uveitis|here]]'''


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{{Uveitis_(patient_information)}}


'''Editor-in-Chief:''' {{EEL}}
{{CMG}}; '''Assistant Editor(s)-In-Chief:''' Erin E. Lord
 
{{EJ}}
 
==What is uveitis?==


==Overview==
Uveitis specifically refers to inflammation of the [[uvea]].  The [[uvea]] consists of the [[iris]], [[ciliary body]], and [[choroid]], and it provides most of the blood supply to the [[retina]].  Uveitis may occur in either eye or both eyes.
Uveitis specifically refers to inflammation of the [[uvea]].  The [[uvea]] consists of the [[iris]], [[ciliary body]], and [[choroid]], and it provides most of the blood supply to the [[retina]].  Uveitis may occur in either eye or both eyes.


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* '''Anterior uveitis''' involves inflammation in the front part of the eye.  It is the most common form of uveitis, making up 40-70% of all uveitis cases<ref>http://www.preventblindness.org/uveitis/what/types.html</ref>.  It is often called [[iritis]] because it is usually only effects the [[iris]].
* '''Anterior uveitis''' involves inflammation in the front part of the eye.  It is the most common form of uveitis, making up 40-70% of all uveitis cases<ref>http://www.preventblindness.org/uveitis/what/types.html</ref>.  It is often called [[iritis]] because it is usually only effects the [[iris]].


* '''[[Intermediate uveitis]]''' (also known as '''cyclitis''', '''pars planitis''' or '''vitritis''') involves inflammation of the [[ciliary body]], the [[vitreous humor]], and the front end of the [[retina]].  This is the least common form of uveitis, constituting 7-15% of cases<ref>http://www.preventblindness.org/uveitis/what/types.html</ref>.   
* '''[[Intermediate uveitis]]''' (also known as '''cyclitis''', '''pars planitis''', or '''vitritis''') involves inflammation of the [[ciliary body]], the [[vitreous humor]], and the front end of the [[retina]].  This is the least common form of uveitis, constituting 7-15% of cases<ref>http://www.preventblindness.org/uveitis/what/types.html</ref>.   


* '''Posterior uveitis''' (also known as '''choroiditis''' if just the [[choroid]] is involved, or '''[[chorioretinitis]]''' if the retina is also involved) affects the back part of the [[uvea]] and involves primarily the [[choroid]], a layer of [[blood vessels]] and [[connective tissue]] in the middle part of the eye. It can also involve inflammation of the [[retina]] and [[optic nerve]].  It makes up 15-22% of all uveitis cases<ref>http://www.preventblindness.org/uveitis/what/types.html</ref>.  
* '''Posterior uveitis''' (also known as '''choroiditis''' if just the [[choroid]] is involved, or '''[[chorioretinitis]]''' if the retina is also involved) affects the back part of the [[uvea]] and involves primarily the [[choroid]], a layer of [[blood vessels]] and [[connective tissue]] in the middle part of the eye. It can also involve inflammation of the [[retina]] and [[optic nerve]].  It makes up 15-22% of all uveitis cases<ref>http://www.preventblindness.org/uveitis/what/types.html</ref>.  
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* '''Panuveitis''' is the inflammation of the entire [[uvea]], and it effects all layers of the [[uvea]].
* '''Panuveitis''' is the inflammation of the entire [[uvea]], and it effects all layers of the [[uvea]].


==What are the symptoms of uveitis?==
==What are the symptoms of Uveitis?==
Uveitis can affect one or both eyes. Symptoms may develop rapidly and may vary depending on the form of uveitis:<ref>http://www.preventblindness.org/uveitis/what/signsOfUveitis.html</ref><br><br>
'''Anterior uveitis'''
* [[Light sensitivity]]
* Eye redness, tenderness, or pain
* Difficulty focusing on objects


Uveitis can affect one or both eyes. Symptoms may develop rapidly and can include:
'''Intermediate and Posterior Uveitis'''<ref>http://www.preventblindness.org/uveitis/what/signsOfUveitis.html</ref>
* [[Floaters]]
* [[Blurry vision]]
* Difficulty focusing on objects
* Chronic inflammation lasting for at least six weeks


* [[Blurred vision]]
'''Panuveitis'''<ref>http://www.preventblindness.org/uveitis/what/types.html</ref>
* Dark, floating spots in the vision
* [[Floaters]]
* Eye pain
* [[Blurry vision]]
* Redness of the eye
* [[Vision loss]]
* Sensitivity to light ([[photophobia]])
 
Additionally, the symptoms may vary depending on the form of uveitis:<ref>http://www.preventblindness.org/uveitis/what/types.html</ref>
* '''Anterior uveitis''' causes pain, redness, and [[light sensitivity]].
* '''Intermediate uveitis''' causes [[floaters]] and blurry vision, and it generally leads to [[chronic inflammation]] (uveitis that lasts for at least six weeks).
* '''Posterior uveitis''' typically causes chronic inflammation that can recur and can last from a few weeks to years.
* '''Panuveitis''' causes [[floaters]], [[blurry vision]], and it is more likely to cause [[vision loss]] than the other forms.
 
==What are the causes of uveitis?==


Uveitis can have many causes, including injury to the eye and exposure to [[toxic substances]] such as acid.
==What causes Uveitis?==
Uveitis can also be caused by [[inflammatory diseases]], [[autoimmune disorders]] such as [[rheumatoid arthritis]] or [[ankylosing spondylitis]], or infection. However, in many cases the cause is unknown.
Uveitis can have many causes, including injury to the eye, viruses, bacteria, parasites, and exposure to [[toxic substances]] such as acid. Uveitis can also be caused by [[inflammatory diseases]], [[autoimmune disorders]] such as [[rheumatoid arthritis]] or [[ankylosing spondylitis]], or genetics. However, in many cases the cause is unknown.


Uveitis can be associated with any of the following:
Uveitis can be associated with any of the following:
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*'''Posterior uveitis''' may develop in people who have an [[autoimmune disease]] or who have had a [[systemic]] (body-wide) infection.  The most common cause of posterior uveitis is infections resulting from [[toxoplasmosis]] <ref>http://www.preventblindness.org/uveitis/what/types.html</ref>
*'''Posterior uveitis''' may develop in people who have an [[autoimmune disease]] or who have had a [[systemic]] (body-wide) infection.  The most common cause of posterior uveitis is infections resulting from [[toxoplasmosis]] <ref>http://www.preventblindness.org/uveitis/what/types.html</ref>


==Who is at risk for uveitis?==
==Who is at highest risk?==
 
People of all ages and both sexes can develop uveitis, although it is more common in women.  Additionally, people are more likely to develop uveitis as they age<ref>http://www.preventblindness.org/uveitis/what/risk.html</ref>.
==How to know you have uveitis?==
 
A complete medical history and eye examination should be performed. Laboratory tests may be done to rule out infection or an autoimmune disorder.


Persons over age 25 with pars planitis should have an MRI of their brain and spine to rule out multiple sclerosis.
==Diagnosis==
A complete [[medical history]] and comprehensive [[eye examination]] must be performed by an [[optometrist]] or [[ophthalmologist]] to properly diagnosis uveitis.  Laboratory tests may be done to rule out infection or an autoimmune disorder.


==When to seek urgent medical care==
Persons over age 25 with intermediate uveitis should have an [[MRI]] of their brain and spine to rule out [[multiple sclerosis]].


==When to seek urgent medical care?==
Call for an appointment with your health care provider if you have symptoms of uveitis (e.g. [[eye pain]] or [[reduced vision]]).  Uveitis requires an urgent referral and thorough examination by an [[optometrist]] or [[ophthalmologist]] along with urgent treatment to control the inflammation.
Call for an appointment with your health care provider if you have symptoms of uveitis (e.g. [[eye pain]] or [[reduced vision]]).  Uveitis requires an urgent referral and thorough examination by an [[optometrist]] or [[ophthalmologist]] along with urgent treatment to control the inflammation.


==Treatment options==
==Treatment options==
 
Generally speaking, uveitis is typically treated with [[glucocorticoid]] [[steroid]]s, either as topical eye drops (prednisolone acetate) or oral therapy with [[corticosteroids]].  In addition to [[corticosteroids]], topical [[cycloplegic]]s, such as [[atropine]] or [[homatropine]], may be used. In some cases an injection of PSTTA (posterior subtenon triamcinolone acetate) can also be given to reduce the swelling of the eye.<!--
Generally speaking, uveitis is typically treated with [[glucocorticoid]] [[steroid]]s, either as topical eye drops (prednisolone acetate) or oral therapy with [[corticosteroids]].  In addition to corticosteroids, topical [[cycloplegic]]s, such as [[atropine]] or [[homatropine]], may be used. In some cases an injection of PSTTA can also be given to reduce the swelling of the eye.
   --><ref>[[British National Formulary|BNF]] '''45''' March 2003</ref>   
<!--
   --><ref>[[British National Formulary|BNF]] '''45''' March 2003</ref>.  


If the uveitis is caused by a body-wide infection, treatment may involve [[antibiotics]] and powerful anti-inflammatory medicines called [[corticosteroids]].
If the uveitis is caused by a body-wide infection, treatment may involve [[antibiotics]] and powerful anti-inflammatory medicines called [[corticosteroids]].


[[Antimetabolite]] medications, such as [[methotrexate]] are often used for recalcitrant or more aggressive cases of uveitis.  Experimental treatment with [[Infliximab]] or other anti-TNFs' infusions may prove helpful.
[[Antimetabolite]] medications, such as [[methotrexate]] are often used for recalcitrant or more aggressive cases of uveitis.  Experimental treatment with [[Infliximab]] or other anti-TNF's infusions may prove helpful.


More specifically, the treatment regimen differs among the various forms of uveitis:
More specifically, the treatment regimen differs among the various forms of uveitis:


* '''[[Iritis]]''' is usually mild. Treatment may involve: dark glasses, eye drops that [[dilate]] the [[pupil]] to relieve pain, and [[steroid]] eye drops or ointment
* '''Anterior Uveitis''' is usually mild. Treatment may involve: dark glasses, eye drops that [[dilate]] the [[pupil]] to relieve pain, and [[steroid]] eye drops or ointment.  In the event that uveitis is unresponsive to drops and ointments, [[steroids]] may be injected next to the eye and rarely, [[steroid]] pills may be prescribed.  Additionally, if the uveitis causes an increase in [[eye pressure]], the doctor may lower the pressure to avoid damage to the [[optic nerve]] by prescribing eye drops.
 
* '''Pars planitis''' is often treated with [[steroid]] eye drops. Other medicines, including [[steroids]] taken by mouth, may be prescribed to help suppress the immune system.
 
* '''[[Choroiditis]]''' treatment depends on the underlying cause. Additional specialists in infectious disease or autoimmunity may be needed for such diseases as [[syphilis]], [[tuberculosis]], [[AIDS]], [[sarcoidosis]], or [[Behcet's syndrome]].


==Diseases with similar symptoms==
* '''Intermediate Uveitis''' and '''Posterior Uveitis''' treatment often depend on the underlying cause of the inflammation.  If the cause is non-infectious, treatment is administered to reduce inflammation, often through the use of [[corticosteroids]].  If the cause is infectious, treatment must involve an anti-infective agent. Additional specialists in infectious disease or autoimmunity may be needed for such diseases as [[syphilis]], [[tuberculosis]], [[AIDS]], [[sarcoidosis]], or [[Behcet's syndrome]].  Intermediate uveitis is often treated with [[steroid]] eye drops, whereas posterior uveitis would have to be treated with steroid pills, as eye drops and ointments cannot reach the back of the eye.


==Where to find medical care for uveitis==
==Where to find medical care for Uveitis?==
[http://maps.google.com/maps?f=q&amp;hl=en&amp;geocode=&amp;q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|uveitis}}}}&amp;sll=37.0625,-95.677068&amp;sspn=65.008093,112.148438&amp;ie=UTF8&amp;ll=37.0625,-95.677068&amp;spn=91.690419,149.414063&amp;z=2&amp;source=embed Directions to Hospitals Treating uveitis]
[http://maps.google.com/maps?f=q&amp;hl=en&amp;geocode=&amp;q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|uveitis}}}}&amp;sll=37.0625,-95.677068&amp;sspn=65.008093,112.148438&amp;ie=UTF8&amp;ll=37.0625,-95.677068&amp;spn=91.690419,149.414063&amp;z=2&amp;source=embed Directions to Hospitals Treating uveitis]


==Prevention of uveitis==
==Prevention of Uveitis==
 
Treatment of an underlying disorder may help to prevent uveitis in persons with a body-wide (systemic) infection or disease.
Treatment of an underlying disorder may help to prevent uveitis in persons with a body-wide (systemic) infection or disease.


==What to expect (Outlook/Prognosis)==
==What to expect (Outlook/Prognosis)?==
 
When left untreated, uveitis can lead to permanent [[vision loss]].  Additionally, a more serious, potentially life-threatening medical condition could worsen if the uveitis is caused by an underlying disorder that is left untreated.  Uveitis is estimated to be responsible for approximately 10% of the blindness in the United States.<ref>Sergio Schwartzman. Inflammatory eye disease: an expert interview with Sergio Schwartzman,MD Medscape Rheumatology 2007.</ref>
Uveitis is estimated to be responsible for approximately 10% of the blindness in the United States.<ref>Sergio Schwartzman. Inflammatory eye disease: an expert interview with Sergio Schwartzman,MD Medscape Rheumatology 2007.</ref>


However, with proper treatment, most attacks of anterior uveitis go away in a few days to weeks. However, relapses are common.
With proper treatment, most attacks of anterior uveitis go away in a few days to weeks. However, relapses are common.


Inflammation related to posterior uveitis may last from months to years and may cause permanent vision damage, even with treatment.
Inflammation related to posterior uveitis may last from months to years and may cause permanent vision damage, even with treatment.
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==Sources==
==Sources==
http://www.nlm.nih.gov/medlineplus/ency/article/001005.htm <br>
http://www.nlm.nih.gov/medlineplus/ency/article/001005.htm <br>


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[[Category:Patient Information]]
 
[[Category:Patient information]]
[[Category:Optometry]]
[[Category:Ophthalmology]]
[[Category:Ophthalmology]]
[[Category:Optometry]]
[[Category:Disease]]
[[Category:Emergency mdicine]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]

Latest revision as of 00:37, 30 July 2020

For the WikiDoc page for this topic, click here

Uveitis

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Uveitis?

Prevention

What to expect (Outlook/Prognosis)?

Uveitis On the Web

Ongoing Trials at Clinical Trials.gov

Images of Uveitis

Videos on Uveitis

FDA on Uveitis

CDC on Uveitis

Uveitis in the news

Blogs on Uveitis

Directions to Hospitals Treating Uveitis

Risk calculators and risk factors for Uveitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-In-Chief: Erin E. Lord

Overview

Uveitis specifically refers to inflammation of the uvea. The uvea consists of the iris, ciliary body, and choroid, and it provides most of the blood supply to the retina. Uveitis may occur in either eye or both eyes.

Uveitis may be classified into the following forms, depending on which part of the uvea is primarily affected by the inflammation:

  • Anterior uveitis involves inflammation in the front part of the eye. It is the most common form of uveitis, making up 40-70% of all uveitis cases[1]. It is often called iritis because it is usually only effects the iris.
  • Panuveitis is the inflammation of the entire uvea, and it effects all layers of the uvea.

What are the symptoms of Uveitis?

Uveitis can affect one or both eyes. Symptoms may develop rapidly and may vary depending on the form of uveitis:[4]

Anterior uveitis

Intermediate and Posterior Uveitis[5]

  • Floaters
  • Blurry vision
  • Difficulty focusing on objects
  • Chronic inflammation lasting for at least six weeks

Panuveitis[6]

What causes Uveitis?

Uveitis can have many causes, including injury to the eye, viruses, bacteria, parasites, and exposure to toxic substances such as acid. Uveitis can also be caused by inflammatory diseases, autoimmune disorders such as rheumatoid arthritis or ankylosing spondylitis, or genetics. However, in many cases the cause is unknown.

Uveitis can be associated with any of the following:

Additionally, the causes may vary depending on the form of uveitis:

  • Anterior uveitis may be associated with autoimmune diseases, but most cases occur in healthy people for unapparent reasons. The disorder may affect only one eye. It is most common in young and middle-aged people.
  • Posterior uveitis may develop in people who have an autoimmune disease or who have had a systemic (body-wide) infection. The most common cause of posterior uveitis is infections resulting from toxoplasmosis [9]

Who is at highest risk?

People of all ages and both sexes can develop uveitis, although it is more common in women. Additionally, people are more likely to develop uveitis as they age[10].

Diagnosis

A complete medical history and comprehensive eye examination must be performed by an optometrist or ophthalmologist to properly diagnosis uveitis. Laboratory tests may be done to rule out infection or an autoimmune disorder.

Persons over age 25 with intermediate uveitis should have an MRI of their brain and spine to rule out multiple sclerosis.

When to seek urgent medical care?

Call for an appointment with your health care provider if you have symptoms of uveitis (e.g. eye pain or reduced vision). Uveitis requires an urgent referral and thorough examination by an optometrist or ophthalmologist along with urgent treatment to control the inflammation.

Treatment options

Generally speaking, uveitis is typically treated with glucocorticoid steroids, either as topical eye drops (prednisolone acetate) or oral therapy with corticosteroids. In addition to corticosteroids, topical cycloplegics, such as atropine or homatropine, may be used. In some cases an injection of PSTTA (posterior subtenon triamcinolone acetate) can also be given to reduce the swelling of the eye.[11]

If the uveitis is caused by a body-wide infection, treatment may involve antibiotics and powerful anti-inflammatory medicines called corticosteroids.

Antimetabolite medications, such as methotrexate are often used for recalcitrant or more aggressive cases of uveitis. Experimental treatment with Infliximab or other anti-TNF's infusions may prove helpful.

More specifically, the treatment regimen differs among the various forms of uveitis:

  • Anterior Uveitis is usually mild. Treatment may involve: dark glasses, eye drops that dilate the pupil to relieve pain, and steroid eye drops or ointment. In the event that uveitis is unresponsive to drops and ointments, steroids may be injected next to the eye and rarely, steroid pills may be prescribed. Additionally, if the uveitis causes an increase in eye pressure, the doctor may lower the pressure to avoid damage to the optic nerve by prescribing eye drops.
  • Intermediate Uveitis and Posterior Uveitis treatment often depend on the underlying cause of the inflammation. If the cause is non-infectious, treatment is administered to reduce inflammation, often through the use of corticosteroids. If the cause is infectious, treatment must involve an anti-infective agent. Additional specialists in infectious disease or autoimmunity may be needed for such diseases as syphilis, tuberculosis, AIDS, sarcoidosis, or Behcet's syndrome. Intermediate uveitis is often treated with steroid eye drops, whereas posterior uveitis would have to be treated with steroid pills, as eye drops and ointments cannot reach the back of the eye.

Where to find medical care for Uveitis?

Directions to Hospitals Treating uveitis

Prevention of Uveitis

Treatment of an underlying disorder may help to prevent uveitis in persons with a body-wide (systemic) infection or disease.

What to expect (Outlook/Prognosis)?

When left untreated, uveitis can lead to permanent vision loss. Additionally, a more serious, potentially life-threatening medical condition could worsen if the uveitis is caused by an underlying disorder that is left untreated. Uveitis is estimated to be responsible for approximately 10% of the blindness in the United States.[12]

With proper treatment, most attacks of anterior uveitis go away in a few days to weeks. However, relapses are common.

Inflammation related to posterior uveitis may last from months to years and may cause permanent vision damage, even with treatment.

Possible complications of uveitis include:

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/001005.htm

  1. ↑ http://www.preventblindness.org/uveitis/what/types.html
  2. ↑ http://www.preventblindness.org/uveitis/what/types.html
  3. ↑ http://www.preventblindness.org/uveitis/what/types.html
  4. ↑ http://www.preventblindness.org/uveitis/what/signsOfUveitis.html
  5. ↑ http://www.preventblindness.org/uveitis/what/signsOfUveitis.html
  6. ↑ http://www.preventblindness.org/uveitis/what/types.html
  7. ↑ http://www.preventblindness.org/uveitis/what/types.html
  8. ↑ http://www.nlm.nih.gov/medlineplus/ency/article/001005.htm
  9. ↑ http://www.preventblindness.org/uveitis/what/types.html
  10. ↑ http://www.preventblindness.org/uveitis/what/risk.html
  11. ↑ BNF 45 March 2003
  12. ↑ Sergio Schwartzman. Inflammatory eye disease: an expert interview with Sergio Schwartzman,MD Medscape Rheumatology 2007.

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