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Uveitis is inflammation of the middle layer of the eye, called the uvea or uveal tract. It can cause eye pain and changes to your vision.
The sooner uveitis is treated, the more successful treatment is likely to be.
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Symptoms of uveitis include:
The symptoms can develop suddenly or gradually over a few days. One or both eyes may be affected by uveitis.
Contact your GP as soon as possible if you have persistent eye pain or an unusual change in your vision, particularly if you've had previous episodes of uveitis.
The sooner uveitis is treated, the more successful treatment is likely to be.
Your GP may refer you to an ophthalmologist (eye specialist). The ophthalmologist will examine your eye in more detail.
They may suggest further tests if uveitis is diagnosed, including eye scans, X-rays and blood tests. It's important to establish the cause of uveitis because it will help determine the specific treatment needed.
Steroid medication (corticosteroids) is the main treatment for uveitis. It can help reduce inflammation inside your eye.
Different types of steroid medication are recommended depending on the type of uveitis. For example:
Additional treatment may also be needed. This might be eyedrops to relieve pain, a type of medicine known as an immunosuppressant or, in some cases, surgery.
Read more about treating uveitis.
Many cases of uveitis are linked to a problem with the immune system (the body's defence against illness and infection). For unknown reasons, the immune system can become overactive in the eye.
Less often, uveitis can be caused by an infection or an eye injury, and it can also occur after eye surgery.
In some cases a cause can't be identified.
Read more about the causes of uveitis.
There are different types of uveitis, depending on which part of the eye is affected:
Uveitis can sometimes affect both the front and the back of the eye. This is known as panuveitis.
Uveitis at the front of the eye is the most common type of uveitis, accounting for about three out of four cases.
Uveitis can also be described according to how long it lasts. For example:
Uveitis is rare, affecting around two to five people in every 10,000 in the UK each year. It's most common in people aged 20 to 59, but it can also sometimes affect children.
Uveitis can sometimes lead to further problems, particularly if it isn't treated quickly and properly.
You're more likely to develop complications if:
Some of the more common complications of uveitis include:
Uveitis occurs when the eye becomes inflamed (red and swollen).
Inflammation is the body's response to illness or infection.
Most cases of uveitis are linked to a problem with the immune system (the body's defence against infection and illness).
Rarely, uveitis may occur without the eye becoming red or swollen.
Uveitis often occurs in people who have an underlying autoimmune condition (where the immune system mistakenly attacks healthy tissue).
Autoimmune conditions known to cause uveitis include:
Uveitis can also be caused by an infection, such as:
Uveitis can also be caused by:
Sometimes, a specific cause of uveitis can't be identified.
Treatment for uveitis depends on what's causing it and which area of the eye is affected.
Medication is the main treatment, but in rare cases, surgery may be recommended to treat particularly severe uveitis.
Most cases of uveitis can be treated with steroid medication (corticosteroids). A medicine called prednisolone is usually used.
Corticosteroids work by disrupting the normal function of the immune system so it no longer releases the chemicals that cause inflammation.
Corticosteroids are available in a number of forms, and the type used will often depend on the areas of your eye affected by uveitis.
Corticosteroid eyedrops are usually the first treatment used for uveitis that affects the front of the eye (anterior uveitis) and isn't caused by an infection.
Depending on your symptoms, the recommended dose can range from having to use eyedrops every hour to once every two days.
You may have temporary blurred vision after using the drops. Don't drive or operate machinery until your vision returns to normal.
In some people, steroid eyedrops can increase pressure in the eye. The ophthalmologist will check for this and advise you if this happens.
Don't stop using your eyedrops until your GP or ophthalmologist tells you it's safe to do so, even if your symptoms disappear. Stopping treatment too soon could lead to your symptoms returning. The frequency of drops will usually be slowly reduced over a number of weeks.
If the middle or back of your eye is affected (intermediate or posterior uveitis), or corticosteroid eyedrops haven't worked, you may need corticosteroid injections.
Local anaesthetic eyedrops are used to numb your eye so you won't feel any pain or discomfort.
You'll usually only require one injection while your symptoms are at their worst.
Corticosteroid injections rarely cause significant side effects, but in some people they can make the pressure in the eye increase. The ophthalmologist will check for this and advise you if this happens.
Corticosteroids tablets or capsules (oral corticosteroids) are the strongest form of corticosteroids. They're usually used if steroid eyedrops and injections haven't worked or are unsuitable, or for uveitis affecting the back of the eye.
Corticosteroids tablets can cause a wide range of side effects, so will only be recommended if it's thought there's a risk of permanent damage to your vision (see complications of uveitis for more information).
How long you'll have to take oral corticosteroids for depends on how well you respond to treatment and whether you have an underlying autoimmune condition.
Some people only need a three- to six-week course, while others need to have a course lasting months or possibly years.
Short-term side effects of corticosteroids tablets or capsules can include weight gain, increased appetite, insomnia and mood changes – such as feeling irritable or anxious.
In the long term they can cause osteoporosis, thinning of the skin, and an increased risk of infection.
To minimise any side effects, you'll be prescribed the lowest possible dose to control your symptoms.
Read more about the side effects of corticosteroids.
Don't stop taking corticosteroids until your doctor says it's safe to do so. Suddenly stopping your medication can cause unpleasant withdrawal effects.
When your GP or ophthalmologist thinks you can stop the treatment, they'll advise you about how to gradually reduce the amount of corticosteroids you're taking.
If you have uveitis that affects the front of your eye (anterior uveitis), you may be given mydriatic (or dilating) eyedrops in addition to steroid medication.
These drops enlarge (dilate) your pupils and relieve pain by relaxing the muscles in your eye. They can also reduce your risk of developing glaucoma, which affects vision.
However, mydriatic eyedrops can cause some temporary blurring of your vision and problems focusing your eyes.
If an underlying infection is causing your uveitis, the infection may also need to be treated.
Immunosuppressant may be recommended if you're among the few people who don't respond to the treatments described above.
Immunosuppressants work by controlling the immune system and disrupting the process of inflammation.
If steroid treatment is causing significant side effects, immunosuppressants can also be used to allow your dose of steroids to be reduced.
Possible side effects of immunosuppressants include:
Taking immunosuppressants will make you more vulnerable to infection, so you should try to avoid close contact with anyone who has a known infection.
Report any symptoms of a potential infection, such as a high temperature, cough, or inflammation in other parts of your body, to your GP. You should also have the annual flu jab.
Immunosuppressants can also affect the functioning of some organs and systems, such as the lungs, liver, kidneys and bone marrow. Blood tests are needed at regular intervals to check these systems remain healthy.
A small number of people with uveitis can benefit from treatment with immunosuppressants known as biologics.
Rarely, an operation called a vitrectomy may be needed to treat uveitis. It's usually only recommended if you have repeated or severe uveitis, or if the condition is caused by certain infections.
A vitrectomy involves gently sucking out the vitreous humour (the jelly-like substance that fills the inside of the eye). It can be carried out using either general anaesthetic or local anaesthetic.
During the operation, the fluid inside your eye will be temporarily replaced with either a bubble of air or gas (or a mixture of the two), or a liquid substitute. Eventually, the vitreous humour will naturally replace itself.
Like all operations, a vitrectomy carries a risk of complications. These include needing further surgery and an increased risk of developing cataracts.