What uveitis is, how to treat it and why

Libra, edit, verify, review and revise

Dear Dr. Roach: For the past several months, I’ve had problems in my right eye. The eye was bloodshot and painful, and vision was blurry. I was diagnosed with uveitis, and the doctors didn’t know why it happened. I’ve had full lab work and chest X-rays. I have been treated with prednisolone and Cyclogyl (I eased off the Cyclogyl). I’d like to know more about this disease. I’m 85 years old and am afraid of losing my eyesight. — P.S.

The uvea is the middle portion of the eye. The suffix “-itis” means “inflammation.” So, uveitis is inflammation of the structures of the middle part of the eye. These include the iris (the colored portion of the eye, which constricts around the pupil), the ciliary body (which controls the shape of the lens and secretes the fluid of the middle of the eye) and the choroid (which contains the blood vessels of the globe of the eye). Uveitis can occur as a result of infection from bacteria, viruses and parasites. It also can happen as a result of systemic inflammatory conditions, such as ankylosing spondylitis or sarcoidosis, which is when I, as an internist, usually see it. Uveitis also can occur as a side effect of medication. Uveitis can occur just as a primary eye disease, and there are several subtypes, such as pars planitis and birdshot choroidopathy. Sometimes no specific cause is ever found.

Treatment depends on the underlying cause. Infections are treated with specific antimicrobials, if possible. If no clear cause is found, the inflammation is treated by antiinflammatory medicines, like prednisolone eyedrops. Cyclopentolate (Cyclogyl) relieves spasm of the ciliary muscles and may prevent complications.

Uveitis treatment requires an eye-care professional. The prognosis for most people with uveitis is very good, and vision loss is unlikely if it is treated promptly.

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