Uveitis

What exactly is the uvea?

The uvea is a vascularized fibrous layer that protects the eye and is extremely important for nutrition. It consists of three parts: the iris, the ciliary body and the choroid. It contains many blood vessels, arteries, veins and capillaries that carry blood to and from the eye. This way, many vital eye centers are maintained.

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Uveitis and causes

What is uveitis?

With the general term of uveitis (uveitis), we describe an inflammation (swelling of the ocular structures) of the medium segment of the eye (uvea). Inflammation of the uvea is able to cause a lot of vision problems.

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Main causes:

  • a virus (e.g. herpes)
  • a fungus (e.g. histoplasmosis)
  • a parasite (e.g. toxoplasmosis)
  • a systemic disease (eg arthritis, collagen diseases, sarcoidosis, etc.)
  • a trauma
  • an infection

However, it is possible, in some cases the causes of uveitis remain unclear.

Symptoms and diagnosis

The main symptoms are:

  • redness
  • pain
  • blurred vision
  • sensitivity to light (photophobia)
  • floaters (floaters)
  • black spots in parts of the visual field

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Diagnosis:

The diagnosis of uveitis is the detailed examination of the eye using a slit lamp and an ophthalmoscope. Moreover visual acuity and intraocular pressure measurements are performed. In some cases even blood tests are necessary. As uveitis is often associated with other systemic diseases your ophthalmologist may want to consult your general practitioner or another specialist. Early diagnosis and treatment are important to prevent the complications of uveitis.

Uveitis types

Basic forms of uveitis:

In fact many different diseases are able to induce uveitis. One way of categorization is based on the anatomic region of inflammation (3 points of the uvea):

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  • anterior uveitis: Inflammation of the anterior uvea (iritis, iridocyclitis). Accompanying swelling of the macular edema and edema of the optic nerve may occur
  • intermediate uveitis: when the central part of the uvea is affected. A special form of intermediate uveitis is pars planitis. One can show accompanying retinal periphlebitis, vasculitis, macular edema and papilloedema
  • posterior uveitis: Inflammatory cells in the posterior section (retina, choroid)

When the generalized uveitis (inflammation of all three parts) then called panuveitis.

Treatment

The most common therapeutic approaches for uveitis are:

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  • use of medicinal eye drops: in combination with anti-inflammatory drugs. Note that because a collyrium may not penetrate the posterior segment of the eye, this type of treatment has no effects on posterior uveitis
  • periocular steroid injections: extremely effective technique in acute uveitis
  • systemic or oral administration of steroids, other immunosuppressants and antimetabolites: the dose required for the penetration and treatment of uveitis is often associated with adverse reactions in the rest of the body (including Cushing's syndrome and lesions in the kidneys, liver and bone marrow)