Uveitis

Uveitis is a broad term for inflammation of one or all parts of the uvea, or the vascular area between the retina and sclera of the eye. 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.

Uveitis can be acute, recurrent, or chronic. Acute uveitis is characterized by sudden onset (over hours or days) and limited duration (≤3 months' duration). In recurrent uveitis, there are repeated episodes separated by disease inactivity ≥3 months, whether on or off treatment. Chronic uveitis is defined as persistent uveitis (>3 months' duration) characterized by relapse within 3 months of therapy termination.

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 human leukocyte antigen-B27-related disease or viral eye disease. Posterior uveitis is associated with localized infections or systemic infection, or systemic inflammatory disease. Onset and duration of the ocular symptoms offer clues to the etiology. 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 workup should be undertaken to rule out an underlying infectious cause or coexistent autoimmune disease. Rarely, uveitis can be caused by a previous eye injury or underlying neoplasm.

Even after full laboratory and diagnostic workup and treatment, etiology 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 noninfectious anterior uveitis, but intermediate and posterior uveitis usually requires injected local corticosteroids or systemic corticosteroids, 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 etiology is most commonly idiopathic.