Uveitis: how it manifests itself, diagnosis and therapies

It is a rare eye disease that needs early diagnosis because, if prolonged, it can lead to blindness.

Uveitis are ocular pathologies due to an inflammatory process that affects the uvea, that is a thin membrane located between the retina and the sclera.

There are many ways of classifying uveitis: depending on the affected area, anterior, intermediate, posterior uveitis and pan uveitis are distinguished; Depending on the clinical course, we speak of acute or chronic uveitis.

Uveitis can be caused by external agents (and in this case they are called exogenous uveitis) or already present in our body (endogenous uveitis); They can also be due to viruses, bacteria, fungi and parasites (infectious uveitis).

Symptoms

The symptomatology depends on which part of the uvea is affected by inflammation: acute anterior uveitis presents with intolerance to light, eye pain, visual clouding and tearing, while chronic anterior ones may present with slight redness and vision of “flying flies” or may be asymptomatic.

Intermediate uveitis can present with vision of moving bodies or become symptomatic until the appearance of complications such as macular edema (fluid that forms between the layers of the center of the retina). Posterior uveitis can occur as intermediate ones, but can also cause a rapid decline in vision if the inflammatory process affects the fòvea (central area of the macula responsible for distinct vision).

Complications

Anterior uveitis can be complicated by the formation of adhesions between the iris and the anterior surface of the lens. When they form around the pupil, you may have the so-called pupillary seclusion, which can lead to an increase in eye pressure. Other complications of anterior uveitis are cataracts and corneal suffering.

Intermediate uveitis, on the other hand, has cystoid macular edema and retinal detachment as complications.

In posterior uveitis, complications concern macular edema, phenomena of occlusion of the vessels of the retina, formation of new vessels in the choroid and inflammation of the optic nerve.

Diagnosis and treatment

Uveitis must be diagnosed and treated promptly, because there are forms that, in the worst cases, can lead to blindness. Diagnosis begins with a comprehensive eye examination that includes:

• Examination of visual acuity
• Evaluation of the anterior segment
• Eye pressure measurement
• examination of the fundus oculi with pupil dilation.

The type of therapy depends on the form of uveitis: infectious therapies require topical therapy (i.e. drugs for the ocular surface such as eye drops, gels or ointments) and systemic therapy (antibiotic, in general) to combat the pathogen.

Cortisone drugs can also be used either by mouth or in the form of eye drops, but always under the supervision of an ophthalmologist. Some forms of uveitis may also require additional treatment options such as immunosuppressants or biologics.

To prevent it, in addition to periodic eye checks, a certain hygiene is also necessary, especially on the part of contact lens wearers.