Uveitis

Uveitis (also known as ‘iritis’) is a condition characterised by inflammation inside the eyeball. In most cases only one eye is affected, though occasionally both can become inflamed. The symptoms of uveitis are as follows:

  • The inflamed eye is red and bloodshot
  • The eye is sensitive to bright light (photophobia)
  • The eyeball may be painful, and tender to touch
  • Vision may be blurred, and there may be ‘floaters’ in the vision

 

Uveitis is reasonably common, and it can also be a recurrent problem. The majority of cases occur in healthy people for no known reason. In some people however, the eye inflammation is related to an underlying medical problem such as those listed below:

 

  • Auto-immune diseases such as rheumatoid arthritis, lupus and Wegener’s granulomatosis
  • Sarcoidosis
  • Tuberculosis
  • ‘Reactive’ arthritis (Reiter’s syndrome)
  • Juvenile rheumatoid arthritis
  • Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
  • Genetic predisposition – approximately 10% of people in Australia have a gene called HLA-B27 that can predispose those individuals to recurrent uveitis. This same gene is also linked to a degenerative lower-back condition called ankylosing spondylitis.
  • Uveitis can also occur after an injury to the eye, or after eye surgery

 

If it is your first episode of uveitis and you have no other medical problems, then it is unlikely you will need any further investigation. On the other hand, if you have recurrent uveitis then your eye specialist may organise for you to have some other tests done to look for underlying causes as listed above.

 

The main treatment of uveitis aims at reducing the intra-ocular inflammation, with the use of corticosteroids (cortisone). Steroid eyedrops are sufficient for most people, but in severe cases higher doses of steroid must be given by direct injection behind the eye or by tablets taken orally. A complete course of treatment can last 8–12 weeks depending on the severity of the inflammation.

 

As well as treatment with corticosteroids, your specialist may treat you with other drops to dilate your pupil and keep it dilated until the inflammation starts to settle down. This is because inflammation in the eye can cause the structures inside the eye (such as the iris and lens) to stick to each other and form permanent adhesions, where tissue is joined together abnormally. Dilating the pupil will keep the iris stretched open and prevent these adhesions from forming.