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Health Encylopedia

 
Uveitis
 
SubjectContents
Definition An inflammation of the uveal tract which includes the iris , ciliary body , and the choroid of the eye.
Alternative Names Iritis; Pars planitis; Chroiditis; Chorioretinitis; Anterior uveitis; Posterior uveitis
Causes, incidence, and risk factors Uveitis affects the uvea , the layer between the sclera and the retina , which also includes the iris , the ciliary body , and the choroid . The uvea is very vascular and provides most of the blood supply to the retina. Causes of uveitis can include autoimmunity, infection, or toxin exposure. The cause often remains unknown. The most common form of uveitis is anterior uveitis, which involves inflammation of the iris. This condition is often called "iritis." The inflammation may be associated with autoimmune diseases such as rheumatoid arthritis or ankylosing spondylitis , but most cases have no other diseases associated. The disorder may affect only one eye and is most common in young and middle-aged people. A history of an autoimmune disease is a risk factor. Pars planitis is inflammation of the pars plana, a narrow area of the choroid in between the iris and the choroid. This usually occurs in young men and is not associated with any other disease. It is usually mild in severity. Posterior uveitis affects the back portion of the uveal tract and involves primarily the choroid. It is then called "choroiditis." If the adjacent retina is also involved it is called "chorioretinitis." Posterior uveitis may follow a systemic infection or occur with an autoimmune disease. The inflammation causes spotty areas of choroid and retinal scarring that correspond to areas with vision loss . The degree of vision loss depends on the amount and location of scarring. If the central part of the retina, called the macula is involved, central vision becomes impaired. Uveitis, affecting one or both eyes, can be associated with any of the following:
  • Toxoplasmosis
  • Histoplasmosis
  • Tuberculosis
  • Sarcoidosis
  • Syphilis
  • AIDS
  • CMV retinitis
  • or other
  • cytomegalovirus infection
  • Sympathetic ophthalmia following trauma
  • Ulcerative colitis
  • Rheumatoid arthritis
  • Kawasaki disease
  • Herpes zoster infection
  • Ankylosing spondylitis
  • Behcet's disease
  • Psoriasis
  • Reiter's syndrome
  • Symptoms
  • Redness of the eye
  • Blurred vision
  • Sensitivity to light
  • Dark, floating spots in the vision
  • Eye pain
  • Note: Symptoms may develop rapidly.
  • Signs and tests A complete medical history and eye examination should be performed. If there is suspicion of an associated systemic disease, a physical examination and laboratory tests may be needed to look for underlying causes.
    Treatment Iritis is usually mild. Spasm of the pupil constriction muscle causes pain which is relieved by drops to dilate the pupil. Dark glasses may be helpful. Steroid eye drops or ointment may be needed. More severe cases require a search for an underlying cause. Pars planitis is usually mild and can be followed without medications. Choroiditis requires determination of the underlying cause, and treatment of the underlying disease. The underlying disease may be serious, and additional specialists in infectious disease or autoimmunity may be needed for such diseases as syphilis, tuberculosis, AIDS, sarcoidosis, or Behcet's syndrome. Treatment is consistent with treatment for the systemic diseases of toxoplasmosis , tuberculosis , sarcoidosis , and so forth. For infectious diseases, corticosteroids are often givens along with antimicrobial therapy. For autoimmune diseases, various forms of suppression of the immune system may be required.
    Support Groups 
    Expectations (prognosis) In anterior uveitis, most attacks last from a few days to weeks with treatment, but relapses are common. In posterior uveitis, the inflammation may last from months to years and may cause permanent vision damage, even with treatment.
    Complications
  • Glaucoma
  • Cataracts
  • Fluid within the
  • retina (cystoid macular edema)
  • Retinal detachment
  • Vision loss
  • Calling your health care provider
  • Call for an appointment with your health care provider if uveitis symptoms are present (if
  • eye pain or reduced vision are present, this condition is more urgent that if symptoms are very mild).
    Prevention Treatment of the causative disorders may help to prevent uveitis for some people with existing systemic diseases.
      

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