Inflammatory Eye Diseases

Inflammatory Eye Diseases

This is an inflammation of the middle layer of the eyeball. The eyeball consists of iris, ciliary body and the choroid. Collectively these structures constitute the uvea and the inflammation of the middle layer is called uveitis.

Overview

One of the major conditions we treat is inflammatory eye disease. Inflammatory eye disease is eye inflammation and swelling that can destroy eye tissues. That destruction can lead to poor vision or blindness.

The word “uveitis” is used because the swelling most often affects the part of your eye called the uvea. The eye is made of layers. The uvea is the middle layer. It’s between the white part of your eye — called the sclera — and the inner layers of the eye.

The uvea consists of three important structures:

● The iris – That’s the colored circle at the front of the eye.
● The ciliary body – Its job is to help the lens focus and make the fluid that nourishes the inside of the eye.
● The choroid – This is a group of blood vessels that give the retina the nutrients it needs.

There are different types of uveitis depends on where the swelling is. Anterior uveitis is the most common. It affects the front of the eye. Intermediate uveitis affects the ciliary body. Posterior uveitis affects the back of the eye. If the entire uvea is inflamed, it’s called panuveitis.

Symptoms

Signs and symptoms of uveitis may include:

  • General vision problems, including blurred or cloudy vision.
  • Floaters, spots in the eye that look like tiny rods or chains of transparent bubbles floating around in the field of vision.
  • Eye pain and redness.
  • Photophobia, an abnormal sensitivity to light.
  • Headaches.
  • Alteration of the color of the iris.

Causes

The exact cause of uveitis is often unclear, but some factors increase the chance of it happening and these include:

  • Juvenile arthritis, psoriasis and other autoimmune disorders, such as rheumatoid arthritis.
  • Inflammatory disorders, such as Crohn's disease, ulcerative colitis.
  • AIDS/HIV and other diseases that weaken the immune system.
  • Infections that increase the risk of uveitis include HIV, brucellosis, herpes simplex, herpes zoster, leptospirosis, Lyme disease, syphilis, toxocariasis, toxoplasmosis, and tuberculosis (TB).

Uveitis may occur as a normal immune response to fight an infection inside the eye. Research suggests that there may be a link between black tattoo ink and uveitis. It is thought that skin tattooing may trigger an immune response that affects both the eyes and the skin, in some people.

Diagnosis

It is important to know whether the uveitis is caused by an infectious process or an underlying disease.

If another condition appears to underlie the uveitis, the ophthalmologist may refer the patient to a specialist to make sure that condition receives proper treatment. The ophthalmologist will look at the eye with a special slit lamp. When the light hits the inside of the eye, the doctor can determine whether that area is clear or foggy. If there is inflammation in the iris, patients may feel some pain when the pupil contracts, which is when light hits it. If uveitis is present, white blood cells and protein in the eye fluid can be seen through the microscope. The doctor may then order blood tests and x-rays.

Treatment

A patient with uveitis who receives prompt and appropriate treatment will usually recover. Without treatment, there is a risk of cataracts, glaucoma, band keratopathy, retinal edema, and permanent vision loss. Antibiotics or antiviral medication will be used if there is an infection.

Corticosteroid medications are sometimes given as well, in the form of eye drops (prednisolone acetate), tablets, or as an injection into the eye. Steroids are effective in treating inflammation. Before giving corticosteroids, it is important to rule out corneal ulcers by using a fluorescence dye test.

Medication

Mydriatic eye drops, such as atropine or cyclopentolate, dilate the pupil and help the eye to heal. It also helps with eye pain and stops the pupil from sticking to the lens. There may be blurred vision and unusual sensitivity to light, known as photophobia. Immunosuppressants might be recommended if symptoms are very severe and there is a risk of vision loss, or if the patient has not responded well to other therapies.

Few of the infusion medications used are: