Generality/Definition
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Uveitis is an inflammation (swelling and irritation) of the the uvea. The uvea is the layer of the eye between the sclera and the retina. This layer includes the iris, ciliary body, and the choroid.
Source: Uveitis (nlm.nih.gov)
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Anterior uveitis (iritis, iridocyclitis):
Is an inflammation of the iris and ciliary muscle. It is an autoimmune reaction that may be either isolated or part of a systemic condition such as ankylosing spondylitis, juvenile rheumatoid arthritis, Reiter's syndrome, sarcoidosis, herpes simplex, herpes zoster, or Behçet's disease.
Source: Anterior Uveitis (kellogg.umich.edu)
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Epidemiology
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Anterior uveitis (iritis, iridocyclitis):
In the US:
Iritis is the most frequent form of uveitis encountered by ophthalmologists. In 1 community-based study, anterior uveitis accounted for more than 90% of all cases of uveitis. The annual incidence rate is approximately 8 cases per 100,000 population.
Internationally:
No particular geographic distribution for iritis has been noted.
Source: Uveitis, Anterior, Nongranulomatous (emedicine.com)
Prevention
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Anterior uveitis:
Prevention :
An evaluation for a systemic autoimmune disorder should take place if the patient has suggestive systemic symptoms or repeated attacks of uveitis.
Causes:
It is an autoimmune reaction that may be either isolated or part of a systemic condition such as ankylosing spondylitis, juvenile rheumatoid arthritis, Reiter's syndrome, sarcoidosis, herpes simplex, herpes zoster, or Behçet's disease.
Source: Anterior Uveitis (kellogg.umich.edu)
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Anterior uveitis
Causes:
- Idiopathic causes
- Diseases associated with HLA-B27
- Ankylosing spondylitis
- Reiter's syndrome
- Inflammatory bowel disease
- Psoriasis
- Sarcoidosis
- Trauma
- Infections
- Herpes zoster and/or herpes simplex
- Syphilis
- Lyme disease
- Juvenile idiopathic arthritis
- Lens-associated uveitis
- Fuchs heterochromic iridocyclitis
Source: Uveitis, Anterior, Nongranulomatous (emedicine.com)
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Symptoms
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Diagnosis
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Anterior uveitis:
- The pupil may have an irregular shape because a portion has become attached to the anterior surface of the lens or the posterior surface of the cornea.
- Slit-lamp biomicroscopy reveals turbidity and cells floating in the aqueous humor and pigment on the anterior lens surface. The edge of the iris may become adherent to the anterior lens capsule (posterior synechiae). Inflammatory cells may form clumps (keratic precipitates) on the posterior surface of the cornea.
- Intraocular pressure may be markedly elevated or depressed.
Source: Anterior Uveitis (kellogg.umich.edu)
Treatment
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Iritis is usually mild. Pain caused by spasm of the pupil constriction muscle is relieved by drops to dilate the pupil. Dark glasses may be helpful. Steroid eye drops or ointment may be needed. More severe cases require a search for an underlying cause.
Pars planitis is often treated with steroid eye drops, but may be treated with oral steroids or another type of medication to suppress the immune system.
Choroiditis requires determination of the underlying cause, and treatment of the underlying disease. The underlying disease may be serious. Additional specialists in infectious disease or autoimmunity may be needed for such diseases as syphilis, tuberculosis, AIDS, sarcoidosis, or Behcet's syndrome.
For systemic infectious diseases, corticosteroids are often used along with antibiotic therapy. For autoimmune diseases, various forms of suppression of the immune system may be required.
Source: Uveitis (nlm.nih.gov)
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Anterior uveitis:
Treatment includes topical cycloplegics and corticosteroids, agents to lower intraocular pressure, and systemic corticosteroids in refractory cases. Most cases are unassociated with systemic disease and resolve within weeks of treatment. An evaluation for a systemic autoimmune disorder should take place if the patient has suggestive systemic symptoms or repeated attacks of uveitis.
Source: Anterior Uveitis (kellogg.umich.edu)
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Illustrations
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Clinical trials for "Uveitis":
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