uveitis

What is Uveitis?

Uveitis is a form of eye inflammation that affects the middle layer of the eyeball, known as the uvea. This condition can cause pain, redness, and blurry vision in one or both eyes.

• Causes: Uveitis has many possible causes, including infections, autoimmune disorders, and injuries to the eye.
• Symptoms: The main symptoms of uveitis include:
  • Eye redness
  • Aching eye pain
  • Swelling
  • Blurry vision
• Treatment: Prompt treatment is essential to prevent damage to the eye tissue. Treatments typically include steroid eye drops, oral steroids, and/or antibiotics.

Key Facts

• Uveitis can affect anyone, but it's more common in people with certain medical conditions.
• The condition can be caused by a variety of factors, including infections, trauma, and autoimmune disorders.
• Prompt treatment is crucial to prevent long-term damage to the eye.

Sources:

[1] - Uveitis is inflammation of the middle layer of the eyeball called the uvea. The uvea has many blood vessels that nourish the eye.[3] [2] - Uveitis is a condition where you have inflammation of one of the inside layers of your eye. It has many possible causes but is usually treatable.[2] [4] - Uveitis is defined as inflammation of the uveal tract—the iris, ciliary body, and choroid.[6] [7] - Uveitis is a swelling of the middle layer of the eye, called the uvea. Treatments typically include steroid eye drops, oral steroids, and/or antibiotics.[9]

Common Signs and Symptoms of Uveitis

Uveitis, an inflammatory condition affecting the middle layer of the eye (uvea), can manifest in various ways. The symptoms often come on suddenly and worsen quickly if left untreated.

• Eye Redness: A red or pinkish hue to the eye is a common symptom of uveitis [1].
• Pain: Eye pain, which may feel worse when reading or performing other activities that require focus, is another frequent sign [3].
• Reduced or Blurred Vision: Uveitis can cause blurry vision, making it difficult to see objects clearly [2][4].
• Sensitivity to Light: Many people with uveitis experience sensitivity to light, which may be exacerbated by bright lights or sunlight [3][6].
• Floaters: Seeing "floaters" (specks or moving spots) in the field of vision is another symptom that can occur [4][7].
• Pupil Changes: In some cases, uveitis can cause changes to the pupil's size or shape [7].

It's essential to seek medical attention if you experience any of these symptoms, as prompt treatment can help prevent long-term damage and complications.

References: [1] - Context result 1 [2] - Context result 2 [3] - Context result 3 [4] - Context result 4 [6] - Context result 6 [7] - Context result 7

Diagnostic Tests for Uveitis

Uveitis, an inflammatory condition affecting the uvea in the eye, requires a comprehensive diagnostic approach to determine its cause and extent. The following tests are commonly used to diagnose and manage uveitis:

• Visual Acuity Test: A simple test that measures the sharpness of vision, which can be affected by uveitis [6].
• Slit Lamp Exam: A crucial test for diagnosing uveitis, where a slit lamp microscope is used to examine the eye's anterior segment and detect signs of inflammation [8].
• Tonometry: Measures the pressure inside the eye, which can be elevated in cases of uveitis [6].
• Complete Blood Count (CBC): A blood test that measures various components, including red and white blood cells, platelets, and hemoglobin, to assess overall health and detect any underlying conditions [4].
• Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP): Blood tests that measure inflammation levels in the body [4].
• Imaging Tests: In some cases, imaging tests like MRI, CT scan, X-ray, or skin tests may be ordered to identify the underlying cause of uveitis [9].

Additional Tests

Depending on the suspected cause and severity of uveitis, additional tests may be recommended, such as:

• HLA-B27 test: To rule out reactive arthritis or other autoimmune conditions [2].
• Syphilis testing: To detect syphilis infection, which can cause uveitis [2].
• Chest radiography and serum ACE and lysozyme tests: To assess lung involvement and detect sarcoidosis or other systemic diseases [2].

References

[1] Fluorescein angiography or indocyanine green angiography may be used to visualize the blood vessels in the eye.

[2] Tests like HLA-B27, syphilis IgG or FTA-ABS (if not available then VDRL), chest radiography, serum ACE and lysozyme, and Quantiferon are recommended for minimal first-line testing for all types of uveitis.

[3] The ophthalmologist may perform a variety of successive tests to diagnose uveitis, including optometric chart and visual acuity.

[4] Complete blood count (CBC), erythrocyte sedimentation rate (ESR), c-reactive protein (CRP) are minimal first-line tests for all types of uveitis.

[5] Serological tests like micro-agglutination test, slide agglutination test, ELISA may be used to diagnose leptospirosis.

[6] Testing for uveitis itself starts with an eye exam, especially parts like the visual acuity test and slit lamp exam.

[7] If the history, physical examination, and basic laboratory tests do not suggest a specific diagnosis, serologic studies for syphilis and chest radiography may be ordered.

[8] Uveitis is diagnosed by a slit lamp exam.

[9] In some cases, your doctor may order tests like an MRI, CT scan, X-ray, or even a skin test to find the cause of your uveitis.

Treatment Options for Uveitis

Uveitis, an inflammatory condition affecting the uvea in the eye, can be treated with various medications to reduce pain and inflammation. The primary goal is to manage symptoms and prevent complications.

• Corticosteroids: These are the mainstay of therapy for uveitis (1). For anterior uveitis, higher-potency drops, specifically prednisolone acetate 1%, should be used (8).
• Immunosuppressive agents: Medications like methotrexate, mycophenolate mofetil, azathioprine, and cyclosporine can help reduce inflammation by suppressing the immune system (2, 11). These medications are often used in combination with corticosteroids.
• Targeted therapies: Adalimumab (Humira), daclizumab (Zinbryta), infliximab (Remicade), and rituximab (Rituxan) are targeted therapies that can be effective in treating uveitis, particularly in cases resistant to other treatments (9).
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like NSAIDs can help reduce pain and inflammation from uveitis (6).

Medications Used to Treat Uveitis

Some common medications used to treat uveitis include:

• Methotrexate
• Mycophenolate mofetil
• Azathioprine
• Cyclosporine
• Adalimumab (Humira)
• Daclizumab (Zinbryta)
• Infliximab (Remicade)
• Rituximab (Rituxan)

Monitoring Medication Effectiveness

It is essential to closely monitor the effect of these medications, as they can have significant side effects and interact with other medications (11).

References:

1. [2] - Methotrexate and mycophenolate mofetil are commonly used medications that work by suppressing the immune system.
2. [8] - Corticosteroids are the mainstay of therapy for uveitis, particularly prednisolone acetate 1% drops for anterior uveitis.
3. [6] - Medications like steroids and NSAIDs can help reduce pain and inflammation from uveitis.
4. [11] - Medication options include methotrexate, mycophenolate, azathioprine, and cyclosporine; monitoring their effect is crucial.
5. [9] - Targeted therapies such as adalimumab (Humira), daclizumab (Zinbryta), infliximab (Remicade), and rituximab (Rituxan) can be effective in treating uveitis.

Note: The numbers in square brackets refer to the corresponding search result number.

Differential Diagnosis of Uveitis

Uveitis, an inflammatory condition affecting the uveal tract of the eye, can be caused by various factors and has a wide range of differential diagnoses. Here are some possible causes:

• Infectious agents: Bacterial (e.g., endophthalmitis), viral (e.g., herpes simplex), fungal (e.g., histoplasmosis), and parasitic (e.g., toxoplasmosis) infections can cause uveitis.
• Autoimmune disorders: Conditions like rheumatoid arthritis, ankylosing spondylitis, and sarcoidosis can lead to uveitis.
• Inflammatory conditions: Behçet disease, multiple sclerosis, and systemic lupus erythematosus are examples of inflammatory conditions that can cause uveitis.
• Tumors: Malignant tumors (e.g., melanoma) or benign growths (e.g., hemangiomas) in the eye can lead to uveitis.
• Other causes: Trauma, surgery, and certain medications (e.g., sulfonamides) can also cause uveitis.

Key factors for differential diagnosis

To determine the underlying cause of uveitis, clinicians should consider the following:

• Clinical presentation: The symptoms and signs presented by the patient, such as eye pain, redness, or vision loss.
• Medical history: Any pre-existing medical conditions that may be contributing to the uveitis.
• Laboratory tests: Results from blood tests, imaging studies (e.g., MRI), and other diagnostic procedures can help identify underlying causes.

References

1. [3] The definition of uveitis and its subsets; causes of uveitis and differential diagnosis of underlying conditions; clinical manifestations...
2. [8] Indeed, many uveitis entities can be diagnosed based on patients' histories and results from clinical exams.
3. [10] Uveitis is an isolated condition in 50% of the cases; however, a detailed interview, thorough physical examination and general laboratory tests with an...

Note: The numbers in square brackets refer to the search result numbers provided in the context.