UVEA

Uvea is the middle part of the three coats of the eye. This further consists of the iris, ciliary body and the choroid. Inflammation of any of these parts is termed uveitis.Based on the part of the uvea involved, uveitis may be Anterior (involving the iris), Intermediate (involving the ciliary body), Posterior (involving the choroid) or Panuveitis (involving all the parts). Symptoms of uveitis are highly variable and may include any of the following: redness, pain, watering, inability to see bright light, floaters, and / or decreased vision. Uveitis occurs as a result of an immune reaction by our body to antigens (substances our body considers foreign). This reaction may occur against infectious agents such as bacteria, fungi, viruses and even parasites. In a small subset of patients, uveitis can occur due to undeterminable causes. Uveitic patients often require a whole battery of investigations in order that the underlying cause of uveitis be determined and hence appropriately treated. These usually include blood and urine tests and/ or X rays. At times, a sample of the fluid from the patients’ eye may have to be subjected to lab tests. Steroids are the mainstay of treatment in uveitis. Depending on the location and the severity of the inflammation, they are used in the form of eye drops, , injections around/ in the eye or injectable / oral medications. Anterior (and intermediate) uveitis is treated with topical steroids along with dilating eye drops which help in reducing the pain associated with inflammation. These drops are to be used until the inflammation has completely subsided. The dose, strength and duration of the drops are determined by your doctor who decides the treatment in accordance to the amount of inflammation. Injection of the steroid around the eye (periocular steroids) is used in certain cases of intermediate uveitis (or in macular edema as a consequence of uveitis). This results in slow release of the drug over a period of three to four weeks. Injectable/oral steroids are often indicated in posterior/panuveitis. Besides steroids, the other group of drugs used in the treatment of uveitis is immunosuppressives. These are especially reserved for patients intolerant to steroids, inflammation not resolving with only steroids and patients with certain systemic conditions like rheumatoid arthritis Both steroids and immunosuppressives have side effects that are often not serious and reversible following the discontinuation of the drugs. These drugs should always be taken as per your doctors’ instructions. Never start or stop these drugs of you own accord. It is important to remember that uveitis is a recurrent condition and hence requires a prolonged and regular follow up with your doctor. Consult your ophthalmologist at the earliest signs of a recurrence. This will make treatment easier and resolution speedier. Uveitic patients may develop cataract (opacification of the lens), glaucoma (raised intraocular pressure) and macular edema (swelling of the central part of the retina) in addition to the inflammation itself. These complications may require additional medical or surgical management.