The eyeball is made of three
major layers. The outermost is called sclera the
white of the eye. The innermost is the retina, which
is the light sensitive layer. In between the two is
a layer call the Uvea. This has a lot of blood suply
and is primarily responsible for providing adequate
nutrition to the retina. A part of this layer can be
seen in front as the brown part of the eye. This
part of the uvea is called iris. Swelling of the
uvea is called Uveitis.
If only the front part i.e. The iris shows swelling
, it is called Anterior Uveitis (also known
as Iritis / Iridocyclitis)
If the part behind the retina (choroid) shows
swelling , it is called Posterior Uveitis
(also called Choroiditis)
If the part in between the two and the vitreous (
gel like transparent substance inside the eye in
front of retina) shows swelling, it is called
Intermediate Uveitis (also called Pars Planitis)
If all the three show swelling it is called Pan
What causes Uveitis?
The exact cause of uveitis
cannot be determined in a majority of cases. It is
just that the body itself is causing the swelling
due to yet unknown reasons. However, in some
patients it can be related to infections causes by
viruses, tuberculosis, toxoplasma, syphilis, HIV or
it can be related to other diseases such as
sarcoidosis, SLE, Ankylosing spondylitis. Trauma &
surgery can also lead to uveitis or it may be
associated with some joint disorders like Rheumatoid
Arthritis, Ankylosing Spondylitis, etc.
Who are at risk?
As the cause of the disease
cannot be determined in many cases it is difficult
to say who all are at risk. But definitely, patients
with certain infections like tuberculosis,
toxoplasma, HIV, Syphilis, herpes virus, sarcoidosis
and autoimmune disorders, i.e. disorders in which
the body reacts to itself.Also patients suffering
from arthritis & joint pains are at a higher risk.
What are the symptoms & signs?
The common symptoms of
uveitis are -
1. Redness of eye
2. Pain in the eye
3. Photophobia – difficulty in opening eyes in
4. Floaters – Seeing black spots/ lines floating in
front of the eye
5. Fall in vision
How is it diagnosed?
It can be diagnosed by an
eye specialist on a routine eye examination.
Sometimes some special tests like fluorescein
angiography are required to assess posterior uveitis.
OCT may be required to assess for swelling at the
macula ( central part of the retina) which may
develop secondary to uveitis.
What is the treatment?
The main treatment of
uveitis is administration of steroids in the form of
eye drops & / or orally or by injections.
Treatment of anterior uveitis consists of dilating
eye drops , which help to dilate the pupil by
pulling the iris. This helps to prevent
complications of uveitis. Also steroid eye drops are
given to resolve the swelling.
In cases of Intermediate / Posterior uveitis
steroids may be required in oral / injectable form.
In cases where there are frequent relapses
immunosuppressive therapy may also be needed.
In cases where a cause is found such as
tuberculosis, specific antibiotics / anti-virals
need to be added.
What are the surgical options?
Surgery may be required for
managing complications of uveitis. Important
complications are cataract and glaucoma. These may
require surgical management, which is mostly done
after the uveitis has subsided.
What are the outcomes?
Timely and proper management
can help preserve vision in most cases. The main
concern with uveitis is reoccurrence. As in most
cases we do not know the root cause of the disease
and are treating only the symptoms and preventing
complications, there are chances of reoccurrence of
the disease. However, if properly managed every time
, vision can still be preserved in many cases.
What are the complications?
The main complications of
anterior and intermediate uveitis are catarct
formation and secondary glaucoma.
Intermediate and posterior uveitis can also decrease
vision by causing selling of the macula (cystoid
Posterior uveitis may cause permanent damage to
vision if it directly affects the macula and later
Author: Dr. Rohan Chawla
Date: 27 November 2008