Uveitis

Anterior uveitis involves inflammation of the iris and ciliary body. Intermediate uveitis involves the posterior ciliary body and pars plana. Posterior uveitis involves the posterior vitreous, retina, choroid, retinal vasculature, and optic nerve. Panuveitis involves inflammation in the anterior, intermediate, and posterior segments of the eye.

All types of uveitis are potentially blinding conditions and should be referred to and managed by an experienced ophthalmologist.

Diagnosis is clinical. Acute anterior uveitis may be idiopathic, or associated with HLA-B27-related disease or viral eye disease. Posterior uveitis is associated with localised infections or systemic infection, or systemic inflammatory disease. Diagnosis of underlying disease may require investigation. In the clinical setting of multiple recurrences or strong suspicion based on history and review of systems, a targeted work-up should be undertaken to rule out an underlying infectious cause or co-existent autoimmune disease. Rarely, uveitis can be caused by a previous eye injury or underlying neoplasm.

Even after full laboratory and diagnostic work-up and treatment, aetiology may not be determined.

Treatment for systemic disease causing uveitis must be given in conjunction with uveitis therapy.

Topical corticosteroids are usually adequate for acute non-infectious anterior uveitis, but intermediate and posterior uveitis usually requires injected local corticosteroids or systemic steroids, or other immunosuppression.

Uveitis is an inflammation of one or all parts of the uvea, or the vascular area between the retina and sclera of the eye. The anterior uvea is composed of the iris and ciliary body; an irritation of this segment, or anterior uveitis, leads to acute painful symptoms and photophobia. Inflammation of the posterior uvea, including the choroid, retina, and retinal vasculature, carries a risk of painless visual loss. Uveitis of all types affects children and adults, and the aetiology is most commonly idiopathic.