What is Uveitis? Symptoms, Causes, & Treatment

Uveitis is inflammation of the uvea, the middle layer of your eye that contains blood vessels and provides nutrients to your retina. Think of it as your eye's natural "plumbing system" becoming irritated and swollen, which can affect your vision and comfort.

This condition affects about 2 to 5 people per 10,000 each year, making it relatively uncommon but serious enough to require prompt medical attention. While the name might sound intimidating, understanding what's happening in your eye can help you recognize symptoms early and get the care you need.

What is Uveitis?

Uveitis occurs when the uvea becomes inflamed, causing redness, pain, and vision problems. The uvea has three main parts: the iris (colored part of your eye), the ciliary body (which helps your eye focus), and the choroid (which nourishes the retina).

When inflammation strikes any of these areas, it disrupts the normal flow of nutrients and can interfere with your eye's ability to function properly. Your immune system, which normally protects you, mistakenly attacks healthy eye tissue or responds to an infection or injury.

The condition can affect one or both eyes and may develop suddenly or gradually over time. Early treatment is crucial because untreated uveitis can lead to serious complications that may permanently affect your vision.

What are the Types of Uveitis?

Doctors classify uveitis based on which part of the uvea is inflamed. Understanding the type helps determine the best treatment approach for your specific situation.

Anterior uveitis affects the front part of your eye, including the iris and ciliary body. This is the most common type, accounting for about 75% of all uveitis cases. You might notice eye pain, light sensitivity, and blurred vision that develops over hours or days.

Intermediate uveitis involves the middle part of the eye, particularly the vitreous (the gel-like substance filling your eye). This type often causes floaters - those tiny specks or cobweb-like shapes that drift across your vision. The inflammation typically develops more gradually than anterior uveitis.

Posterior uveitis affects the back of your eye, including the choroid and retina. This type can be more serious because it directly impacts the retina, which is essential for clear vision. You might experience vision loss, floaters, or difficulty seeing in low light.

Panuveitis involves inflammation throughout all parts of the uvea. This comprehensive form can cause a combination of symptoms from the other types and often requires more intensive treatment to prevent vision complications.

What are the Symptoms of Uveitis?

Recognizing uveitis symptoms early can make a significant difference in protecting your vision. The signs can vary depending on which part of your eye is affected, but some symptoms are more common than others.

Eye pain is often one of the first symptoms you'll notice, especially with anterior uveitis. This isn't just mild discomfort - it can be a deep, aching pain that worsens when you move your eye or when light hits it. The pain might feel like pressure building inside your eye.

Light sensitivity, called photophobia, can make normal indoor lighting feel uncomfortably bright. You might find yourself squinting, avoiding bright spaces, or needing to wear sunglasses indoors. This happens because inflammation makes your eye more reactive to light.

Vision changes can include blurriness, reduced sharpness, or difficulty focusing. With posterior uveitis, you might notice blind spots or areas where your vision seems dimmed. These changes can develop gradually or appear suddenly.

Here are the main symptoms to watch for:

• Eye redness, particularly around the iris
• Floating spots or lines in your vision
• Decreased vision or vision loss
• Headaches, especially around the affected eye
• Tearing or excessive eye watering
• Small pupil that doesn't respond normally to light

Some people with intermediate or posterior uveitis might not experience pain at all, which is why regular eye exams are so important. The inflammation can be silently damaging your vision without obvious warning signs.

When Should You See a Doctor?

You should contact an eye doctor immediately if you experience sudden eye pain, significant vision changes, or intense light sensitivity. These symptoms can indicate serious inflammation that needs prompt treatment to prevent permanent damage.

Don't wait to see if symptoms improve on their own. Uveitis can worsen quickly, and delayed treatment increases the risk of complications. If you have a history of autoimmune conditions or previous eye problems, be especially vigilant about new eye symptoms.

Seek emergency care if you experience sudden, severe vision loss, severe eye pain that doesn't respond to over-the-counter pain medication, or if you see flashing lights or a curtain-like shadow across your vision. These could indicate serious complications requiring immediate attention.

What Causes Uveitis?

The exact cause of uveitis often remains unknown, which doctors call "idiopathic uveitis." However, several factors can trigger this inflammatory response in your eye, and understanding these can help with both treatment and prevention.

Autoimmune conditions are among the most common identifiable causes. When your immune system mistakenly attacks healthy tissue, it can target your eye's uvea just as it might attack joints in arthritis or skin in psoriasis.

Here are the main categories of causes:

• Autoimmune diseases: Rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease, multiple sclerosis, and Behçet's disease
• Infections: Toxoplasmosis, herpes simplex, cytomegalovirus, syphilis, tuberculosis, and Lyme disease
• Eye injuries: Blunt trauma, penetrating injuries, or complications from eye surgery
• Certain medications: Some antibiotics, anti-inflammatory drugs, or treatments for other conditions
• Other inflammatory conditions: Sarcoidosis, Vogt-Koyanagi-Harada disease, or sympathetic ophthalmia

Sometimes uveitis develops as part of a larger inflammatory syndrome affecting multiple body systems. Your doctor might need to investigate other symptoms or run additional tests to identify any underlying conditions that could be contributing to your eye inflammation.

In children, juvenile idiopathic arthritis is a particularly important cause to consider, as uveitis can develop silently without obvious symptoms. This is why children with certain types of arthritis need regular eye screenings.

What are the Risk Factors for Uveitis?

Certain factors can increase your likelihood of developing uveitis, though having risk factors doesn't mean you'll definitely get the condition. Understanding these can help you stay alert to symptoms and discuss screening with your doctor if needed.

Age plays a role in different types of uveitis. Anterior uveitis most commonly affects people between 20 and 50 years old, while intermediate uveitis often develops in young adults. Posterior uveitis can occur at any age but is more common in older adults.

Genetic factors can influence your risk, particularly if you carry certain genes like HLA-B27. People with this genetic marker have a higher chance of developing anterior uveitis, especially if they also have conditions like ankylosing spondylitis or inflammatory bowel disease.

Having an autoimmune condition significantly increases your risk. If you've been diagnosed with rheumatoid arthritis, lupus, multiple sclerosis, or similar conditions, your immune system is already in a heightened state that could affect your eyes.

Previous eye infections or injuries can sometimes trigger uveitis months or even years later. Your eye's immune response to the initial problem might continue longer than expected, leading to chronic inflammation.

Geographic location can influence certain infectious causes of uveitis. For example, histoplasmosis is more common in certain regions of the United States, while toxoplasmosis risk varies based on local factors and lifestyle.

What are the Possible Complications of Uveitis?

While uveitis is treatable, leaving it untreated or inadequately managed can lead to serious complications that may permanently affect your vision. Understanding these potential problems emphasizes why prompt treatment is so important.

The inflammation in uveitis can damage delicate eye structures over time, leading to various complications that range from mild to sight-threatening. Most complications develop gradually, but some can occur relatively quickly with severe inflammation.

Here are the main complications to be aware of:

• Glaucoma: Increased pressure inside your eye that can damage the optic nerve and cause vision loss
• Cataracts: Clouding of your eye's natural lens, making vision blurry or dim
• Macular edema: Swelling in the central part of your retina, affecting detailed vision
• Retinal detachment: The retina pulls away from the back of your eye, causing sudden vision loss
• Vitreous hemorrhage: Bleeding into the gel-like substance inside your eye
• Optic nerve damage: Inflammation affecting the nerve that carries visual information to your brain

Some complications, like cataracts and glaucoma, can be successfully treated if caught early. However, others like retinal detachment or severe optic nerve damage may cause permanent vision loss even with treatment.

The good news is that with proper treatment and regular monitoring, most people with uveitis can prevent serious complications. Your eye doctor will watch for early signs of these problems during follow-up visits and adjust your treatment as needed.

How is Uveitis Diagnosed?

Diagnosing uveitis requires a comprehensive eye examination by an ophthalmologist or optometrist. The process involves several steps to determine the type, severity, and possible underlying causes of your eye inflammation.

Your doctor will start with a detailed medical history, asking about your symptoms, when they started, and any other health conditions you have. They'll want to know about recent infections, injuries, medications, and family history of autoimmune diseases.

The eye examination includes several specialized tests. Your doctor will use a slit lamp microscope to examine the inside of your eye in detail, looking for signs of inflammation, cells floating in the fluid, and any damage to eye structures.

During the exam, your pupils will be dilated with eye drops so your doctor can see the back of your eye clearly. This allows them to check your retina, optic nerve, and blood vessels for signs of inflammation or complications.

Additional tests might be needed depending on your specific situation. These could include eye pressure measurements, photography of the inside of your eye, or specialized imaging tests like optical coherence tomography (OCT) to get detailed pictures of your retina.

If your doctor suspects an underlying systemic condition, they might order blood tests, chest X-rays, or other studies to look for autoimmune diseases, infections, or inflammatory conditions that could be causing your uveitis.

What is the Treatment for Uveitis?

Treatment for uveitis focuses on reducing inflammation, controlling pain, and preventing complications that could affect your vision. The specific approach depends on the type and severity of your uveitis, as well as any underlying causes.

Corticosteroid medications are usually the first line of treatment because they effectively reduce inflammation in the eye. These can be given as eye drops, injections around or into the eye, or oral medications, depending on which part of your eye is affected.

For anterior uveitis, prescription eye drops containing corticosteroids are often sufficient. You'll typically use these drops several times a day initially, then gradually reduce the frequency as inflammation improves. Your doctor will monitor your progress closely.

More severe or posterior uveitis might require stronger treatments. These could include steroid injections near the eye, implants that slowly release medication inside the eye, or oral corticosteroids for widespread inflammation.

Here are the main treatment options your doctor might recommend:

• Corticosteroid eye drops: Most common for anterior uveitis, used multiple times daily
• Dilating eye drops: Help reduce pain and prevent complications by keeping the pupil open
• Steroid injections: Delivered around or into the eye for more severe inflammation
• Oral corticosteroids: Systemic treatment for widespread or severe uveitis
• Immunosuppressive medications: For chronic cases or when steroids aren't sufficient
• Biologic medications: Newer treatments that target specific inflammatory pathways

If an underlying infection is causing your uveitis, specific antimicrobial treatments will be added to address the root cause. Similarly, if an autoimmune condition is involved, treating that condition often helps control the eye inflammation.

Some people need long-term treatment to prevent uveitis from returning. Your doctor will work with you to find the most effective treatment plan with the fewest side effects, adjusting medications as needed based on your response.

How to Manage Uveitis at Home?

While medical treatment is essential for uveitis, there are several things you can do at home to support your recovery and make yourself more comfortable during treatment. These measures work alongside, not instead of, your prescribed medications.

Protecting your eyes from bright light can significantly reduce discomfort. Wear sunglasses when outdoors, even on cloudy days, and consider using them indoors if regular lighting feels too bright. Adjusting screen brightness and using warm lighting at home can also help.

Taking your medications exactly as prescribed is crucial for controlling inflammation. Set reminders for eye drops, since the schedule can be frequent initially. Don't stop or reduce medications without talking to your doctor, even if you feel better.

Rest your eyes when they feel strained or tired. Take breaks from reading, computer work, or other close-up tasks. If you experience pain, gentle cold compresses on closed eyelids for 10-15 minutes can provide some relief.

Here are practical steps to support your treatment:

• Keep your hands clean when applying eye drops to prevent infection
• Avoid rubbing or touching your affected eye
• Stay hydrated and eat anti-inflammatory foods like leafy greens and fish
• Get adequate sleep to support your immune system's healing
• Manage stress through relaxation techniques or gentle exercise
• Keep follow-up appointments even if you feel better

Watch for signs that your condition might be worsening, such as increased pain, vision changes, or new symptoms. Contact your doctor promptly if you notice any concerning changes, as early intervention can prevent complications.

Some people find that certain activities or environments trigger their symptoms. Keep a simple log of your symptoms and activities to identify patterns you can discuss with your doctor.

How Should You Prepare for Your Doctor Appointment?

Being well-prepared for your appointment can help your doctor make an accurate diagnosis and develop the best treatment plan for your uveitis. Gathering information beforehand saves time and ensures important details aren't forgotten.

Write down all your symptoms, including when they started, how severe they are, and what makes them better or worse. Be specific about vision changes, pain levels, and how symptoms affect your daily activities.

Compile a complete list of your medications, including prescription drugs, over-the-counter medications, supplements, and eye drops. Include dosages and how long you've been taking each one, as some medications can contribute to eye problems.

Gather information about your medical history, particularly any autoimmune conditions, previous eye problems, recent infections, or injuries. Family history of eye diseases or autoimmune conditions is also important to mention.

Here's what to bring to your appointment:

• A list of all current symptoms with dates and severity
• Complete medication list with dosages
• Medical history including previous eye problems
• Insurance cards and identification
• Previous eye exam records if available
• List of questions you want to ask

Prepare questions about your condition, treatment options, and what to expect. Ask about potential side effects of treatments, how long treatment might take, and what symptoms should prompt you to call the office.

Plan to have your pupils dilated during the exam, which means your vision will be blurry for several hours afterward. Arrange for someone to drive you home, or plan to use public transportation or rideshare services.

Can Uveitis be Prevented?

While you can't prevent all cases of uveitis, especially those related to autoimmune conditions or genetic factors, there are steps you can take to reduce your risk and prevent recurrences if you've had uveitis before.

Protecting your eyes from injury is one of the most important preventive measures. Wear appropriate safety glasses during sports, home improvement projects, or work activities that could result in eye trauma. Even minor injuries can sometimes trigger inflammatory responses.

If you have an autoimmune condition, working closely with your healthcare team to keep it well-controlled may help reduce your risk of developing uveitis. This includes taking prescribed medications consistently and attending regular check-ups.

Prompt treatment of eye infections can prevent some cases of infectious uveitis. Don't ignore symptoms like persistent redness, discharge, or pain, and avoid sharing eye makeup or contact lenses with others.

For people who've had uveitis before, recognizing early warning signs and seeking prompt treatment can prevent severe flares. Some people notice subtle changes in vision or mild discomfort before a full recurrence develops.

Regular eye exams are particularly important if you have risk factors for uveitis. Children with juvenile arthritis need routine eye screenings even without symptoms, as uveitis can develop silently in this population.

While stress doesn't directly cause uveitis, managing stress through healthy lifestyle choices may help support your overall immune system function and potentially reduce inflammation throughout your body.

What's the Key Takeaway About Uveitis?

Uveitis is a serious but treatable condition that requires prompt medical attention to protect your vision. While the inflammation can be concerning, understanding what's happening in your eye and following your treatment plan can lead to excellent outcomes for most people.

The most important thing to remember is that early treatment makes a significant difference. If you experience eye pain, vision changes, or light sensitivity, don't wait to see if symptoms improve on their own. Quick action can prevent complications and preserve your sight.

Many people with uveitis go on to maintain good vision with proper treatment and follow-up care. Even if you need long-term management, newer treatments and monitoring techniques have made it much easier to control inflammation and prevent vision loss.

Working closely with your eye care team, taking medications as prescribed, and attending regular follow-up appointments are your best strategies for managing uveitis successfully. With proper care, most people can expect to maintain their quality of life and visual function.