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Uveitis Symptoms, Clinical Signs

Uveitis is an eye condition which is characterized by irritation and swelling of the uvea. The uvea which is also known as the uveal tract is located in the centre layer of the eye. It lies under the sclera, which is the white portion of the eye. The uvea also includes ciliary body and choroid and the iris. The ciliary body is responsible for producing a transparent fluid which helps to keep debris away from the eyeball.
The uvea comprises of ciliary muscles as well that aid changes in the shape of the lens so that the eye can focus on various objects. The choroid is made up of a sheet of blood vessels and tissues which connect the retina and sclera. It transports oxygen and vital nutrients to the inner structures of the eye. Uveitis leads to inflammation of the uvea and this can result in loss of vision. Therefore it is necessary to get an early diagnosis and to receive timely treatment. Here are some important uveitis facts. 

The clinical signs of uveitis include redness, pain and irritation in the affected eye. The individual may also experience blurry vision and sensitivity to light. Dark, floating spots in the field of vision also commonly occur due to uveitis. The onset of uveitis may be very quick and hence it is important to consult an ophthalmologist if any of these symptoms are experienced. Persistent redness and pain in the eye should be given medical attention quickly. If uveitis is not treated on time, permanent loss of vision could occur. Uveitis symptoms in children may be manifested in different ways such as frequent tripping or falling over, clumsiness, avoidance of outdoor play and swollen, tender joints especially in the knees and fingers. Children with uveitis may be unable to explain and communicate their symptoms or may also be unaware that something is wrong until vision disturbances occur. Uveitis is classified into different types based on the area of the uvea which is affected. The symptoms of each type of uveitis may also differ. Anterior uveitis affects the frontal portion of the eye, mainly the iris. It may be classified into two types, granulomatous uveitis and non-granulomatous uveitis. Anterior uveitis signs include redness, pain and sensitivity to light. The symptoms may develop rapidly and then continue for up to six weeks. Intermediate uveitis affects the ciliary body, frontal part of the retina and the vitreous body. Symptoms include blurred vision and floating spots before the eyes. This type of uveitis tends to persist for more than six weeks. Posterior uveitis is characterized by an inflamed choroid, retina and optic nerve. Posterior uveitis signs include diminished vision, dark spots in the vision and in some cases, detachment of the retina. This condition can be chronic and may last for months to years. It is also usually recurrent and tends to affect both the eyes. If uveitis is not treated, certain complications could occur such as increased pressure in the eye, optic nerve damage, clouding of the lens and accumulation of fluid in the retina.

Uveitis Causes, Side Effects and Complications

There may be many different chronic uveitis causes such as viral, bacterial, fungal or parasitic infections, inflammatory ailments and trauma or injury to the eye. The causes may also differ based on the type of uveitis. Anterior uveitis affects the iris and is also known as irisitis. Anterior uveitis causes may include autoimmune diseases such as rheumatoid arthritis. Granulomatous uveitis causes may include infections such as candidiasis, cryptococcosis and blastomycosis. Posterior uveitis causes may also include underlying immune disorders. A common cause of this type of uveitis is also infections which occur due to toxoplasmosis. Intermediate uveitis is not very common, but when it occurs it is likely to be chronic. Intermediate uveitis causes include sarcoidosis which is an inflammatory condition that affects the body. Multiple sclerosis and lyme disease may also be causes of intermediate uveitis. In some cases, the entire uvea becomes inflamed and this is referred to as panuveitis. Vision loss is more likely to occur in such cases.  Acute uveitis causes include Behcet’s disease which is a rare condition that occurs in individuals in their twenties and thirties. Uveitis causes in children include several conditions such as juvenile rheumatoid arthritis which results in stiffness and inflammation of the joints in children below the age of 16 years. Lupus which affects the kidneys, blood stream, joints and skin can also lead to uveitis. Even chicken pox which commonly occurs in childhood can lead to uveitis later on in life.

Individuals who face an increased risk of developing uveitis include those with autoimmune disorders such as crohn’s disease, infections such as tuberculosis and syphilis, eye diseases and those who take certain medications. Cat owners may also face an elevated risk because toxoplasmosis spores are present in cat litter.

Uveitis Treatment

Individuals who experience symptoms of uveitis should consult a doctor right away. The doctor will perform a physical examination and look for signs and symptoms of other ailments such as joint problems, skin rash, sores and pitting of the nails. The doctor will also check the eyes and may recommend certain laboratory tests. At this stage, the individual may also be referred to an eye specialist or ophthalmologist. In many cases, it is difficult to identify the exact cause of uveitis, but the doctors will try to evaluate if any infectious causes or other diseases are responsible for the condition.  

Since uveitis can cause permanent damage to eyesight, it is important for treatment to begin immediately. Uveitis treatment options will depend on the type of uveitis and the severity of the condition. The main focus of treatment is to alleviate the inflammation, ease pain, treat underlying causes and prevent complications that could damage vision. In some cases, uveitis subsides after using eye drops. In other cases, steroid injections may be necessary. Mydriatic eye drops are used to dilate the pupil so that healing can occur properly. Uveitis treatment duration may vary depending on the extent of the disease. The use of these eye drops as uveitis treatment may cause side effects such as light sensitivity and blurry vision. In some cases steroid eye drops may be necessary as these help to reduce iris inflammation. In eye drops do not work, steroid pills or injections may be prescribed. These are usually necessary in severe cases of uveitis. In case of long term steroid treatment, the individual must be monitored closely for side effects. Certain types of uveitis are treated through immunosuppressants. Uveitis treatment guidelines should be followed properly so that complete healing takes place and further damage to eyesight is prevented.
Since uveitis is an inflammatory condition, foods that trigger inflammation should be avoided. A diet that incorporates plenty of whole grains, fresh vegetables, fruit and fish is beneficial. Green tea has anti-inflammatory properties and so do turmeric, ginger and some other herbs. It is also a good idea to speak to a doctor regarding the intake of antioxidant vitamin and mineral supplements. Herbal remedies for uveitis include turmeric which is effective in decreasing inflammation. The herb Echinacea is also known to be beneficial as it strengthens the immune system. However since uveitis is a serious condition, one should use herbal treatments only after consultation with a doctor.

Submitted on January 16, 2014