We all have heard of double edged swords. Having two sharpened edges made it easy for the warriors to cut using either of the blades. However it also added to risk of hurting themselves. Did you know that your body also wields a similar sword? It is called inflammation, the reaction of your body aimed to eliminate harmful stimuli like germs, damaged cells or irritants. This comes with the risk of severe damage to your own tissues. A catch 22 situation, isn’t it?
Uvea is the middle layer of your eye. It is made up of the iris (the coloured part of your eye), the ciliary body (a structure that produces the fluid inside your eyes) and the choroid (the layer that provides nutrition to your retina). The uvea is responsible for supplying nutrition and enhancing the contrast of the images.
Uveitis is the inflammation of the uvea and is of the following types:
• Anterior Uveitis: It refers to the involvement of the iris only or the iris and ciliary body.
• Intermediate Uveitis: There is inflammation of the ciliary body.
• Posterior Uveitis: It refers to the involvement of the choroid.
• Diffuse Uveitis: Also called pan-uveitis, it involves inflammation of all the areas of the uvea.
• Pars planitis: The narrow area between the choroid and the iris called the pars plana is affected.
Uveitis is commonly associated with:
Auto-immune disorders like sarcoidosis, multiple sclerosis, rheumatoid arthritis, or ankylosing spondylitis.
Inflammatory conditions like ulcerative colitis or Crohn’s disease
Injury to the eye
Cancers like lymphoma which can affect your eyes
Infections like herpes, tuberculosis, HIV, cat-scratch disease, toxoplasmosis or syphilis
• Redness of eyes
• Pain in your eyes
• Sensitivity to light (increase in pain when your eyes get exposed to light)
• Blurry or diminished vision
• Floaters or dark floating spots in your line of vision.
• Hypopyon or a whitish region in the lower part of your iris (coloured part of your eye)
A complete eye examination is done.
Slit Lamp Examination which shows white blood cells accumulating in the different parts of the eye.
Visual Acuity Testing
Measurement of eye pressure or Tonometry
MRI brain and spinal cord may be done to rule out multiple sclerosis
Referral to other specialists may be required to rule out the conditions that it is commonly associated with.
• Cataract or clouding of the lens of your eye
• Glaucoma or a raised pressure inside your eye.
• Problems with the retina like swelling or detachment of your retina.
• Damage to optic nerve
• Loss of vision
• Dark Glasses
• Anti-inflammatory medications: Steroids may be given via eye drops or oral medications. For posterior uveitis, a device may be implanted into your eye that slowly delivers the medication into your eyes.
• Antiviral or Antibiotic medications: If the uveitis is caused by bacterial or viral infections, these medications may be prescribed.
• Immunosuppressive medications or cell destroying medications called cytotoxins may be given if adequate response to steroids is not obtained.
• Surgery: Vitrectomy or the removal of the jelly like substance inside your eye may be needed either to remove a scar or to detect the cause of the eye inflammation.
Most attacks usually get resolved in a few days to weeks after proper treatment. Re-occurrence is also commonly seen.
Inflammation involving the back of your eye usually takes a longer time to heal than that in the front part of your eye.
Inflammation due to posterior uveitis may last for years, sometimes even causing permanent damage to vision despite treatment.