If you wake up with a red, inflamed, and painful eye, it often requires prompt medical attention. Uveitis is an inflammation inside your eye that causes around 10% of blindness in the U.S.
In this article, we’ll go over everything you need to know about uveitis, how it’s treated, and when you should see a doctor.
What is Uveitis?
Uveitis involves an inflammation deep inside your eye's sensitive tissues. It affects the uvea, the middle layer of the eyeball.
Uveitis symptoms typically come on suddenly and worsen quickly. They include severe eye pain, redness, and blurred vision in one or both eyes.
Seeing an eye specialist at the earliest signs of uveitis is essential. Early diagnosis and treatment are necessary to prevent complications and irreversible vision loss.
What are the Symptoms of Uveitis?
Symptoms can vary widely, and in some cases, there are no symptoms. Because of this, it’s important to get a routine eye exam to catch problems early on.
Uveitis symptoms usually appear suddenly, though sometimes they can build gradually or be subtle at first. Watch closely for:
- Redness
- Sharp eye pain
- Blurry vision
- Floaters
- Light sensitivity
- Reduced vision
What Causes Uveitis?
Uveitis can stem from various causes, impacting your treatment plan significantly. The primary categories include:
- Infectious causes. Viruses such as herpes simplex or bacteria such as Mycobacterium tuberculosis can cause inflammation. Treatment involves antibiotics or antiviral medication.
- Autoimmune conditions. Diseases like ankylosing spondylitis, juvenile idiopathic arthritis, or sarcoidosis commonly lead to chronic inflammation. These cases often require long-term treatment.
- Idiopathic cases. Often, even extensive testing can’t find a clear cause. Treatment then focuses solely on controlling inflammation and symptoms.
- Genetics. Having the HLA-B27 gene can significantly increase your risk, emphasizing the importance of a thorough medical evaluation.
- Injury. Although it’s rare, you can get uveitis from eye injuries or chemical burns.
What are the Different Types of Uveitis?
There are four main types of uveitis, categorized by the location of inflammation:
- Anterior uveitis (iritis). The most common form, affecting the front of your eye. Symptoms include sharp pain, redness, and sensitivity to light.
- Intermediate uveitis. Inflammation occurs primarily in the vitreous humor (eye gel) and peripheral retina. Symptoms are often subtler, such as floaters and mildly blurred vision.
- Posterior uveitis. Affects the back part of your eye, including the choroid and retina. Symptoms include blurred vision, floaters, and vision loss.
- Panuveitis. The most severe form, involving all uveal layers. Intensive therapy is needed to protect your sight.
Your eye specialist will precisely determine your uveitis type, guiding treatment decisions and prognosis.
How is Uveitis Treated?
Your ophthalmologist’s priority is controlling inflammation quickly, preventing relapses, and safeguarding your vision. Treatment approaches depend on uveitis severity, location, and cause.
Available treatment options include:
- Steroid eye drops. Quickly reduce inflammation in anterior uveitis. Initially, you’ll use them frequently, then gradually taper under supervision to prevent recurrence.
- Cycloplegic drops. Relax your eye muscles, easing pain and preventing complications like iris adhesions (posterior synechiae).
- Systemic immunosuppressants. Drugs like methotrexate or mycophenolate mofetil help reduce inflammation throughout your body, allowing reduced steroid usage and fewer side effects, such as cataracts.
- Biologic therapies. Medications like adalimumab (Humira) effectively control severe inflammation when other treatments fail. Adalimumab is particularly beneficial for juvenile idiopathic arthritis-related uveitis and Behçet’s disease.
For persistent inflammation or severe complications, your doctor may recommend steroid implants or surgical operations like vitrectomy if uveitis causes retinal detachment.
How is Uveitis Diagnosed?
Your ophthalmologist will perform a comprehensive evaluation to pinpoint your type of uveitis and its underlying cause. Tests include:
- Slit-lamp examination. A specialized microscope that lets your doctor see detailed inflammation signs early.
- Visual acuity test. Measures how clearly you can see, revealing how much inflammation affects your vision.
- Advanced imaging (OCT and ultrasound). Optical coherence tomography (OCT) or B-scan ultrasonography helps visualize deeper eye structures and detect subtle retinal swelling.
Depending on these initial findings, your doctor might also recommend blood tests to identify underlying conditions like autoimmune diseases, infections (such as tuberculosis or syphilis), or general inflammation.
What are the Complications of Uveitis?
Untreated uveitis can cause severe, potentially irreversible damage to your eye tissue. Common complications include:
- Retinal swelling (macular edema)
- Retinal scarring
- Optic nerve damage
- Glaucoma
- Cataracts
- Retinal detachment
- Permanent vision loss
When Should You Call a Doctor?
Call your doctor as soon as possible if you experience uveitis symptoms, especially if you’re experiencing eye pain or vision problems. They may refer you to an eye specialist for proper treatment.
Be alert for other symptoms that indicate complications:
- Sudden vision loss. Requires immediate attention to avoid permanent blindness.
- Floaters or flashing lights. Could signal retinal detachment or severe inflammation.
- Severe and persistent eye pain. May indicate dangerously high eye pressure, severe inflammation, or complications such as optic nerve damage.
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