About Uveitis
Uveitis is a complex eye disease that can occur in different age groups and results from inflammation of the uvea, the middle layer of the eye. The uvea includes important structures such as the iris, choroid, and ciliary body, and inflammation in this layer may affect the front, middle, or back segments of the eye.
The course of the disease varies from person to person; while some cases present with mild findings, others may develop rapid vision loss. Therefore, the diagnosis and treatment of uveitis should always be managed by an experienced ophthalmologist.
What Is Uveitis?
The uvea sits in the middle of the three layers that surround the gel-like vitreous at the center of the eyeball. Uveitis refers to inflammation that develops in any part of this layer. It may affect the iris, choroid, or ciliary body individually or together, and it is named differently depending on where the inflammation is located.
Due to the complex nature of the disease, the treatment protocol is individualized. Medication types and dosages are determined by the physician based on the severity of inflammation and the underlying cause.
Symptoms of Uveitis
When uveitis is concentrated in the anterior segment, it typically presents with marked redness, photophobia (light sensitivity), pain around the eye, blurred vision, and floaters. Posterior segment involvement often shows up as blurred vision or shadows in the visual field. If the central vision area is affected, there is a risk of sudden vision loss and permanent tissue damage.
- Eye redness and throbbing pain
- Light sensitivity and glare
- Blurred vision, spots, or floaters
- Shadows in the visual field and loss of contours
- Sudden decrease or loss of vision
Types of Uveitis
Uveitis is divided into four main groups based on where the inflammation is located in the eye:
- Anterior uveitis: Affects the iris and ciliary body; pain, redness, and photophobia are prominent.
- Intermediate uveitis: Involves the vitreous and pars plana; floaters and blurred vision are common.
- Posterior uveitis: Extends to the choroid, retina, and central vision; shadows in the visual field and reduced sharpness may occur.
- Panuveitis: A widespread form affecting all layers of the uvea.
Infections, autoimmune diseases, trauma, or genetic susceptibility can be triggers for any of these subtypes.
Causes and Risk Factors of Uveitis
Uveitis is not caused by a single factor; underlying systemic diseases or infections often coexist. Common causes include:
- Infections: Toxoplasma, herpes viruses, tuberculosis, syphilis, and similar pathogens.
- Autoimmune diseases: Behçet’s disease, rheumatoid arthritis, ankylosing spondylitis, sarcoidosis.
- Trauma and surgery: Eye injuries and previous operations.
- Genetic susceptibility: Immune variations such as HLA-B27 positivity.
- Systemic diseases: Inflammatory bowel disease, lupus, psoriasis, etc.
Diagnosis and Treatment of Uveitis
Uveitis is diagnosed through a comprehensive eye examination, biomicroscopy, intraocular pressure measurement, and when necessary imaging tests such as OCT, fundus photography, and fluorescein angiography. Blood tests and systemic evaluations help identify the underlying cause.
- Steroid therapies: Inflammation is suppressed with eye drops, oral tablets, or injections.
- Immunosuppressive and biologic agents: Immune modulation is used for resistant or systemic uveitis.
- Antimicrobial medications: Targeted treatment is applied for infectious uveitis based on the causative organism.
- Supportive treatments: Drops to control intraocular pressure, pain relievers, and pupil-dilating drops.
The treatment process is often long-term; the goal is to control inflammation while preserving visual function.
Uveitis Treatment Process
Steroids & Support Drops
To suppress inflammation, topical or systemic steroids, pupil-dilating drops, and IOP-control drops are used.
Biomicroscopy
The segment and severity of inflammation are determined.
Steroids Initiated
Rapid inflammation control is achieved with drops, injections, or tablets.
Response Monitoring
In responders, the dose is tapered gradually.
Rapid Inflammation Control
Immune Modulation
In chronic or systemically driven uveitis, immunosuppressants and biologic agents are introduced.
Systemic Assessment
Underlying conditions are identified through blood tests and consultations.
Medication Selection
Methotrexate, azathioprine, or biologics are planned individually.
Close Monitoring
Lab values and visual function are checked regularly.
Long-Term Stabilization
Which approach is right for you?
The type of inflammation, accompanying systemic findings, and your lifestyle are evaluated together.
Follow-Up and Lifestyle Tips
Even after uveitis treatment is completed, the risk of recurrence remains; therefore, check-ups at least every three months are recommended. Regular follow-up is essential to detect silent attacks early.
- Healthy lifestyle: Limiting smoking and alcohol, eating a balanced diet, and avoiding stress support the immune system.
- Protective measures: Use UV-filter sunglasses and protect eyes from harmful chemicals.
- Share systemic symptoms: Mouth ulcers, skin rashes, and joint pain should always be shared with your ophthalmologist.
- Do not skip follow-ups: Regular examinations should not be avoided, as the disease may recur silently.
To reduce uveitis risk, regular eye examinations and prompt evaluation of redness or visual changes are important.