Iritis, Uveitis, and Eye Inflammation

Uveitis is a common ocular condition that involves inflammation of the middle layer of the eye, otherwise known as the uveal tract. The inflammation may be focused in one part of the uvea (at the front, middle, or back of the eye) or all of them at once. This inflammation can be acute (only one episode), chronic (lasting a long time), or recurrent (recurring every once in a while). Depending on which specific portions of the uvea are inflamed and how often, the treatment and effect on the eyes can vary.

Unfortunately, it is common that the cause is unknown but autoimmune conditions are often the culprit, meaning that the body is attacking itself. Other causes include infection or trauma. In recurrent, chronic, or severe cases of uveitis, our optometrists may order further testing in order to investigate underlying conditions.

Anterior Uveitis

This is the most common type of uveitis and refers to inflammation of the iris (the coloured part of the eye) and ciliary body (muscles that control the near focusing power of the eye). It is due to an immune reaction of the body inside these tissues and a subsequent leakage of white blood cells, causing swelling and pain.

The treatment for anterior uveitis includes steroid eye drops, often used every hour to start, in order to quickly decrease the amount and severity of inflammation. Then, after the inflammation in the eye has stabilized a bit, the patient is to instill the eye drops less often. This involves a less frequent use of the steroids in the following days and weeks as sudden discontinuation of the drops has been associated with the inflammation flaring up again. It is key to follow the instructions provided by our eye doctor during these steps. In addition to the steroid drops, eye drops that make your pupils bigger may be prescribed, which will stop the iris from moving in response to light stimuli. This will help with decreasing pain, improving healing, and preventing the inflammation from damaging other parts of the eyes. In cases where there is a clear cause of the uveitis (i.e. an infection in the eye), the underlying cause will be treated or referred as necessary to the appropriate medical provider.

Intermediate Uveitis

Intermediate uveitis is the least common form of uveitis and refers to inflammation of the middle portion of the uvea, mostly the gel-like fluid that holds the structure of the eye, called the vitreous. Unfortunately, it is common in some cases for the cause of intermediate uveitis to be unknown. However some identified causes include sarcoidosis, lyme, tuberculosis, multiple sclerosis etc. Treatment includes regional steroid injection, systemic oral NSAIDs, and often a referral to a specialist.

Posterior Uveitis

This is the second most common type of uveitis and involves inflammation of the back of the eye, which includes the choroid (the layer holding the blood vessels) and retina (the nerve fiber layer that detects light). Some causes include syphilis, tuberculosis, toxoplasmosis, herpes, sarcoidosis, etc. Management for this condition will include treating the underlying infection if detectable, systemic steroids, or anti-inflammatory therapy. Panuveitis refers to an inflammation of the entire uveal tract, which includes all or various levels of the above signs and symptoms.