Uveitis refers to the range of conditions that causes inflammation to the middle layer of the eye – the uvea. The condition can be painful and eyes may get red and swollen. Blindness due to uveitis sequelae is being increasingly recognized due to heightened awareness of uveitis conditions. Uveitis or inflammation can also affect other delicate tissues of the eye such as the lens, vitreous, retina and the optic nerve. Cataract and glaucoma are the common complications of uveitis and its treatment.
The Uveitis Clinic at P. D. Hinduja Hospital provides state of the art diagnostic and therapeutic services to treat the infections and inflammation of the eye. Various specialties like Rheumatology, Chest Medicine, Infectious Diseases, Paediatrics & Oncology are a few specialties that act in co-ordination to co-manage a uveitis patient.
Causes of Uveitis
Most cases of uveitis may not point towards a "specific cause" even after investigating extensively. In some others, there may be an "infective" or a "non-infective" cause that may present during the attack of uveitis or may come up sometime later.
Listed are a few causes of uveitis :
- After an eye surgery or after trauma to the eyes.
- The non-infective entities causing uveitis may have "a connection" with inflammation in other parts of the body.
- A few associated autoimmune and inflammatory disorders are as follows :
- Vogt Koyanagi Harada disease
- Ankylosing spondylitis
- Juvenile idiopathic arthritis
- Rheumatoid arthritis
- Systemic lupus erythematosus
- Behcets disease
- Inflammatory bowel disease such as Crohn's disease or ulcerative colitis
- Multiple Sclerosis
- Infections may be localised to the eyes or may be connected with an infection elsewhere in the body. It may be caused by a virus, bacteria, fungus or a parasite. A few common examples are as follows :
- Herpes zoster
- Cat-scratch disease
- Lyme's disease
Cancers and malignancies involving the body can also involve the eyes such as lymphoma or leukemia.
The aim of the treatment is to reduce inflammation & alleviate the pain. Control of inflammation thus limits further tissue damage and helps restore loss of vision. If an infective cause is found responsible for the inflammation, it has to be specifically treated with an antibiotic, antiviral, anti fungal agent or an anti-parasitic agent as and when needed in adequate dosages.
Topical steroids in the form of eye drops are often used as a first line of treatment for reducing the inflammation. Other methods include injecting steroids and other anti-inflammatory agents around the eye or inside the eye. In cases of severe inflammatory reactions, oral steroids are required to reduce the inflammation.
Intravenous steroid pulses are reserved as an emergency to bring sight-threatening inflammation under control. Biological agents, immune-suppressive therapy, disease modifying drugs & non-steroidal anti-inflammatory drugs are also utilised depending on the type of disease, severity and chronicity of the inflammation.
Dr. Samyak V. Mulkutkar
Consultant - Vitreo-Retinal Surgeon & Uveitis Specialist
M. S. Ophthalmology (PGI), Vitreo-Retina & Uveitis (PGI)