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Uveitis

Page contents

  • What is Uveitis?
  • The different types of uveitis
  • Causes of Uveitis
  • Uveitis symptoms

What is Uveitis?

Uveitis refers to inflammation of the middle layer of the eye, which is called the uvea (or uveal tract). It can occur as a consequence of a multitude of causes and can affect anyone It particularly affects people of working age, commonly those aged between 20 to 59, but can also occur in children. Uveitis can result in further ocular complications, including cataracts and glaucoma. However, most cases recover well with treatment. Early diagnosis of uveitis is very important, as the sooner the condition is treated, the more successful the outcome is likely to be.

The uvea is made up of the iris (the coloured part of the eye), the ciliary body (a ring of muscle behind the iris) and the choroid (a vascular layer of tissue that supports the retina). Uveitis is a rare condition, with only around 2-5 in every 10,000 people in the UK being affected by it each year. It may be Idiopathic (autoimmune) or associated with an underlying systemic disease or infection. It can also follow an injury or,rarely, ocular surgery. If uveitis is not treated, the eyesight can be seriously damaged.

Uveitis usually causes a red, painful eye with cloudy vision. These symptoms may vary in intensity from mild to severe. The most typical form causes a red eye which is associated with a dull ache around the eye.

The different types of uveitis

The type of uveitis may be categorised according to which part of the eye is affected:

  • Anterior uveitis: Refers to inflammation of the iris (iritis) or inflammation of the iris and the ciliary body (iridocyclitis). It is the most common type of uveitis, accounting for 75% of cases in adults.
  • Intermediate uveitis: This affects the area behind the ciliary body and the retina. It tends to occur in children, teenagers and young adults.
  • Posterior uveitis: This is a severe form of uveitis which affects the back of the eye i.e. the choroid and the retina, and can seriously affect vision.

Panuveitis is a type of uveitis that affects the entire uveal tract i.e. inflammation of both the front and the back of the eye at the same time. This form of uveitis can be sight threatening and should be reviewed without undue delay

Uveitis may also be categorised in accordance with the length of time that it lasts.

  • Acute uveitis lasts for a few weeks and can recur
  • Chronic uveitis lasts for more than three months, with symptoms that can vary over time.
  • Recurrent uveitis is when there are repeat episodes of inflammation in the eye, with gaps of a few months between each.

Causes of Uveitis:

The cause of uveitis is often unknown, with approximately 40% of patients not having a determined cause after clinical investigation. Many cases are linked to the immune system, when it becomes overactive in the eye for unknown reasons. Uveitis can also be caused by infection, injury or surgery, although this is less common.

Uveitis is broadly divided into infectious and non-infectious causes:

Increased uveitis risk factors can also be related to the following health conditions:

  • An inflammatory or autoimmune condition (when the body attacks its own organs). HLA B-27 positivity is the most common association. This may also be associated with rheumatoid arthritis, ankylosing spondylitis (arthritis of the lower back), psoriasis or inflammatory bowel disease. Other systemic condition associted with uveitis include Behçet’s disease, sarcoidosis and Reiters
  • Bacterial, viral, fungal and parasitic infection such as toxoplasmosis, Herpes Simplex, Herpes Zoster(shingles), tuberculosis (TB), Lyme disease and syphilis are all causes of uveitis. Immunodeficiency in susceptible with a known underlying condition such as leukaemia, lymphoma, HIV/AIDS may make these groups of patients vulnerable to opportunistic infections in the eye e.g. cytomegalovirus retinitis
  • Juvenile Idiopathic Arthritis (JIA) is the most common identifiable cause of uveitis in children

Uveitis symptoms

The symptoms of uveitis can occur in one or both eyes and may develop suddenly or over a period of a few days.

Anterior uveitis (iritis):

Anterior uveitis affects the front of the eye (usually the iris) and is the most common type of uveitis. It can affect one or both eyes depending on the cause.

Anterior uveitis symptoms include:

  • An aching, painful, red eye. The pain can range from a mild ache to intense discomfort,
  • Blurred or cloudy vision,
  • A small pupil or a distortion of the shape of the pupil
  • An iris (the coloured part of the eye) that may have a slightly different colour,
  • Sensitivity to light (photophobia),
  • Headaches.

These symptoms may develop gradually over hours or days and may gradually increase in intensity.

Intermediate uveitis:

Intermediate uveitis is the second most common type of ocular inflammation. It predominantly affects the vitreous, a gel like structure found in the cavity just behind the ciliary body and in front of the retna in the middle part of the eye, Both eyes tend to be affected and it is usually painless. Intermediate uveitis symptoms can include:

  • Floaters (dots that move across the field of vision), and
  • Blurred vision due to cells and protein from the blood vessels leaking into the gel of the eye due to inflammation of the retinal blood vessel walls (retinal vasculitis).or deposits just behind the cilliary body (parsplanitis)
  • Mild redness (although the inflamed eye may look completely normal despite having symptoms)

Posterior uveitis:

Posterior uveitis affects the choroid, a layer of blood vessels supplying the retina (the nerve tissue responsible for vision). The choroid forms the middle layer of the wall of the eye, with the retina comprising the inner layer and the sclera the outer layer. One or both eyes may be affected and it is usually painless. However posterior uveitis is a more serious form of ocular inflammation than anterior uveitis.

Posterior uveitis usually causes decreased vision and floaters, and sometimes retinal detachment. Posterior uveitis symptoms are slower to develop and often last longer than those of anterior uveitis. It can be more damaging to the eye than other types of uveitis and can sometimes cause visual loss.

Scleritis:

Scleritis, is a form of inflammtion affecting predominantly the sclera, or outer white coat of the eye.

Scleritis may affect the front and/or back of the eye. It causes a very red eye and intense ocular pain, which can sometimes even prevent sleep.

If you experience any uveitis symptoms, you should immediately contact your GP who may refer you to an ophthalmologist for further investigation. An optometrist may also be able to detect uveitis, if very severe and recommend referral to a uveitis expert for investgation and treatment. It is recommended that urgent attention from an ophthalmologist is sought if signs of uveitis is accompanied by sudden or pronounced blurred vision, as this may represent the severe form of uveitis.

If you do receive a uveitis diagnosis, you may require further tests, such as scans of your eyes, blood tests and X-rays, which will help to determine the cause.

Uveitis treatment options

The recommended treatment for uveitis is based on the type of uveitis and cause of the condition, although determining an exact cause may not always be possible. The most common uveitis treatment is steroid medicine, known as corticosteroid, which can help to reduce the inflammation. These are usually given as eyedrops for anterior uveitis, but severe anterior uveitis and most forms of non-infectious posterior uveitis may required treqtment with systemic medication in the form of tablets or injection.

In certain specific circumstances an injection around or into the eye may be of benefit.

In some cases, additional treatment may be required. Eye drops to relieve any pain or dilate the pupil may also be prescribed. In rare instances, uveitis surgery may be required, particularly if cataract or glaucoma (a raised eye pressure that does not reach a controlled level with drops) develops.

Your ophthalmologist will be able to conduct tests to try and determine the type of uveitis you have to recommend the best course of treatment. Our experts are well verse in the may treatments that exist for this condition and will be able to fully discuss the therapeutic option that is most suited to the type and severity of uveitis that you have.

Reasons to choose Moorfields Private for your uveitis treatment

If you choose Moorfields Private for your uveitis treatment, you will benefit from access to some of the country’s top uveitis experts. Working at the top of their professions and with years of experience nationally and internationally in clinical medication and research, All our ophthalmic surgeons hold accredited consultant positions with the Moorfields Eye Hospital NHS Foundation Trust.

You will be able to choose your preferred consultant, who will oversee your entire treatment course for a service with complete continuity.

For further information

If you want to find out more about uveitis symptoms and treatment, or similar conditions, please check out our recommended blog posts below:

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If you are already a patient at Moorfields Private and have an enquiry, please contact your consultant’s practice manager.

New Patient Team: Freephone 0800 328 3421
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Uveitis consultants

A picture of Mr Peter Addison

Mr Peter Addison


Consultant Ophthalmic Surgeon

A picture of Mr Mark Westcott

Mr Mark Westcott


Consultant Ophthalmic Surgeon

A picture of Mr Bishwanath Pal

Mr Bishwanath Pal


Consultant Ophthalmic Surgeon

A picture of Miss Angela Rees

Miss Angela Rees


Consultant Ophthalmologist

A picture of Professor Adnan Tufail

Professor Adnan Tufail


Consultant Ophthalmic Surgeon

A picture of Professor Carlos Pavesio

Professor Carlos Pavesio


Consultant Ophthalmic Surgeon

A picture of Professor Narciss Okhravi

Professor Narciss Okhravi


Consultant Ophthalmic Surgeon

A picture of Mr Praveen Patel

Mr Praveen Patel


Consultant Ophthalmic Surgeon

A picture of Miss Dhanes Thomas

Miss Dhanes Thomas


Consultant Ophthalmic Surgeon

A picture of Mr Harry Petrushkin

Mr Harry Petrushkin


Consultant Ophthalmic Surgeon

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Paying for treatment

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