Uveitis is inflammation of the uvea or the middle layer of the eye. This condition is characterized by redness of one or both eyes , accompanied by pain and blurred vision .
The uvea is the middle layer on the inside of the eye consisting of the iris (the iris), the lining of the eye blood vessels (choroid), and the connective tissue between the iris and the choroid (ciliary body). The uvea is located between the white part of the eye (sclera) and the light-capturing part of the eye (retina).
Based on the location of inflammation, uveitis is divided into several types, namely:
- Uveitis in the front of the uvea (iritis or anterior uveitis), which is inflammation that occurs in the iris
- Uveitis in the middle uvea (uveitis intermedia or cyclitis), which is inflammation that occurs between the iris and the choroid
- Uveitis behind the uvea (choroiditis or posterior uveitis), which is inflammation of the choroid
- Uveitis throughout the uvea (panuveitis), which is inflammation of all parts of the uvea
Uveitis is also divided based on the duration of this disease. The following is an explanation:
- Acute uveitis, which is a type of uveitis that develops quickly and gets better in less than 3 months
- Chronic uveitis, which is when the inflammation lasts for more than 3 months
Causes of Uveitis
Uveitis often has no known cause and sometimes affects healthy people. However, most uveitis is related to autoimmune disorders , including:
- Rheumatoid arthritis , which is inflammation of the joints
- Psoriasis, which is inflammation of the skin
- Ankylosing spondylitis , which is inflammation of the joints in the spine
- Sarcoidosis , which is inflammation in various parts of the body, such as the lungs, lymph nodes, eyes and skin
- Kawasaki disease , which is inflammation of the walls of blood vessels
- Ulcerative colitis, which is inflammation in the large intestine
- Crohn's Disease , namely inflammation in the digestive tract, from the mouth to the anus
In other cases, uveitis is thought to result from a disease caused by a viral or bacterial infection, such as:
Apart from autoimmune disorders and infections, uveitis is also thought to be related to a number of factors below:
- Eye injury
- Eye surgery
- Eye cancer
- Toxic exposure
Uveitis symptoms may appear suddenly or develop gradually over several days. The symptoms can affect one or even both eyes.
Signs and symptoms of uveitis include:
- Red eye
- Eye pain
- Blurred vision
- The eyes become sensitive to light
- Black spots that appear in the visual field
- Decreased visual function
When to see a doctor
Check with your doctor if you experience the symptoms mentioned above. You are also advised to seek medical help immediately if you experience more serious complaints, such as:
- Severe pain in the eye
- Sudden blurred vision
Routine examinations to the doctor also need to be done if you are diagnosed with uveitis and have undergone treatment. This is because uveitis has a risk of recurrence even after treatment.
Diagnosis of uveitis
As an initial step for diagnosis, the doctor will conduct a question and answer regarding the complaints experienced and the patient's medical history, then proceed with a physical examination, especially in the eye area.
To confirm the diagnosis, the doctor will carry out further examinations in the form of:
- Vision test, to assess visual acuity and see the response of the pupils to light
- Tonometry, to measure the pressure in the eyeball
- Slit-lamp examination , to see if there are inflammatory cells in the front of the eye
- Funduscopy, to check the condition of the back of the eye
- Blood tests, to detect inflammation in the iris and cirrhotic bodies of the eye
- Scanning with a CT scan or MRI, to see the location or assess the severity of inflammation
- Eye fluid analysis, to assess the severity of inflammation
- Ophthalmic angiography , to detect inflammatory cells in the eye's vascular system
- Optical coherence tomography , to measure thickness and detect inflammatory cells in the retina and choroid
The focus of uveitis treatment is to reduce inflammation in the eye. There are several treatment methods that can be given by doctors, namely:
The following are several types of drugs that can be used to treat uveitis:
Corticosteroids Corticosteroids are prescribed by doctors to reduce inflammation and prevent eye adhesions.
Antibiotics or antivirals. In uveitis caused
by infection, the doctor will give antibiotics or antivirals to control it.
Immunosuppressive drugs Immunosuppressive
drugs are generally given when uveitis affects both eyes, treatment with corticosteroids is ineffective, or uveitis is getting worse and the patient is at risk of experiencing blindness.
Surgery is performed if the symptoms that appear are severe enough or treatment with drugs is not effective. Some of the surgical procedures that can be performed are:
- Vitrectomy, which is an eye surgery to take the vitreous in the eye
- Drug-releasing device implantation, which is an operation to implant a special tool that functions to slowly distribute corticosteroid drugs into the eye
In many cases, surgical removal of a drug release device is performed to treat difficult-to-treat posterior uveitis. The tool will generally be installed for 2–3 years.
If not treated immediately, uveitis can cause complications in the form of:
- Cataracts, namely cloudiness in the lens of the eye that causes blurred vision
- Glaucoma , which is damage to the nerves that connect the eye to the brain, which can lead to blindness
- Retinal detachment , which is a condition where the retina is separated from the lining of the blood vessels that provide oxygen and nutrients
- Cystoid macular edema, which is swelling in the retina
- Posterior synechiae, which are inflammation that causes the iris to stick to the lens of the eye
Prevention of uveitis
Prevention of uveitis is indeed difficult considering that most of uveitis has no known cause. However, if you have an autoimmune disease , take regular medication and control to prevent uveitis.
Treatment is also necessary if you have a bacterial or viral infection. Thus, the risk of experiencing uveitis or blindness can be prevented.