Uveitis (Iritis)

Uveitis is an often painful inflammation of the uvea, which includes the iris, the coloured part of the eye. Often the eye appears red and is sensitive to light. There are a number of different causes and it is a condition that needs to be treated as soon as symptoms arise.What is uveitis?   Uveitis is a rare but serious eye disease involving inflammation of part of your uvea.  In severe cases, retinal scarring can result in permanent vision loss, so it is essential to get prompt treatment. The eyeball is made up of three layers; a tough, protective outer layer called the sclera (or white of your eye), an inner layer of photosensitive cells (rods and cones) called the retina, and a middle layer called the uvea.  The uvea is a layer of blood vessels, connective tissue and muscle and has a vital role in nourishing the underlying retina, producing the watery fluid in your eye, and controlling the light entering through your pupil.  Your iris (or coloured part of your eye) is part of your uvea and is often the part that becomes inflamed in uveitis. There are different types of uveitis, depending on where the inflammation is located.

• Anterior uveitis:  The front part of the uvea (the iris) is inflamed – also called iritis.
• Posterior uveitis:  The choroid is inflamed – also called choroiditis.
• Intermediate uveitis: The middle part of the uvea is inflamed.  Also called pars planitis, this condition often affects young men.
• Pan-uveitis: All parts of the uvea are inflamed.

What are the symptoms of uveitis? Uveitis symptoms are generally hard to ignore and require urgent attention from an eye specialist.  They may include:

• Moderate to severe, deep eye pain
• Redness – particularly a dark red flush on the white part of your eye next to your iris
• Blurry vision
• Light sensitivity – often severe
• In severe cases or where treatment is delayed, a hypopyon may be present. This is a pool of inflammatory cells that collects in the front chamber of your eye and is seen as a white layer of fluid sitting just in front of your iris.
• Floaters may also be present

How is uveitis diagnosed? Your primary care practitioner (optometrist or GP) will refer you urgently to an ophthalmologist if uveitis is suspected. A thorough eye-examination will be carried out, including a detailed ocular and general medical history.  A slit-lamp microscope examination will help diagnose the site of the uveitis.  Other tests will be preformed to assess your intra-ocular pressure and your vision. What causes uveitis? In many cases of uveitis, the cause is unknown, but it can be associated with a wide range of infections, inflammatory conditions and auto-immune disorders, including the following:

• Rheumatoid Arthritis
• Ankylosing Spondylitis
• Ulcerative Colitis
• Sarcoidosis
• HIV / AIDS
• Toxoplasmosis
• Tuberculosis
• Trauma

An important part of the treatment for uveitis is investigation for the presence of (and management of) these conditions.   Uveitis often presents more than once and may recur at various times throughout your life. How is uveitis treated?

• The mainstay of uveitis treatment is steroid (anti-inflammatory) treatment.  Your specialist may prescribe steroid drops, injections, or oral medication (pills) to address the inflammation. For choroiditis, an slow release device may be implanted inside the eye
• Your treating doctor may dilate your pupils to reduce eye pain
• If there is an under-lying condition, it will also need to be managed
• Occasionally, a surgical treatment may be required; a vitrectomy, where the jelly that gives your eye its shape is removed and replaced, may be necessary if the vitreous is very inflamed
• Uveitis patients may be hospitalised for treatment, especially if it is severe and a first episode

Uveitis is a serious eye disease, which left untreated can cause permanent vision loss. If you suspect you may have uveitis, visit your optometrist immediately.  It is difficult for the layperson (unless they have experienced previous episodes) to determine whether they have iritis or uveitis.  Making an appointment with The Eye Practice Optometrists (conveniently located in Sydney’s CBD), we will dilate your pupils and check your eyes from front to back.  We are therapeutically qualified, which means we can immediately start treatment, while at the same time make an appointment for you with a uveitis specialist, who will take over and get things right under control. Worried you might have uveitis or iritis? Call us on (02) 9290 1899 or make an appointment online today.