Uveitis

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.

Most cases get better with treatment – usually steroid medication. But sometimes uveitis can lead to further eye problems such as glaucoma and cataracts (see below).

The sooner uveitis is treated, the more successful treatment is likely to be.

Symptoms of uveitis

Symptoms of uveitis include:

• eye pain – usually a dull ache in or around your eye, which may be worse on focusing
• eye redness
• sensitivity to light (photophobia)
• blurred or cloudy vision
• small shapes moving across your field of vision (floaters)
• loss of peripheral vision (the ability to see objects at the side of your field of vision)

The symptoms can develop suddenly or gradually over a few days. One or both eyes may be affected by uveitis.

When to get medical advice

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.

Treating uveitis

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:

• eyedrops are often used for uveitis that affects the front of the eye (anterior)
• injections, tablets and capsules are usually used to treat uveitis that affects the middle and back of the eye (intermediate and posterior)

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.

What causes 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.

Types of uveitis

There are different types of uveitis, depending on which part of the eye is affected:

• uveitis at the front of the eye (anterior uveitis or iritis) – it can cause redness and pain and tends to come on quickly
• uveitis in the middle of the eye (intermediate uveitis) – it can cause floaters and blurred vision
• uveitis at the back of the eye (posterior uveitis) – it can cause vision problems

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:

• acute uveitis – uveitis that develops quickly and improves within three months
• recurrent uveitis – where there are repeated episodes of inflammation separated by gaps of several months
• chronic uveitis – where the inflammation lasts longer and returns within three months of stopping treatment

How common is uveitis?

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.

Complications of uveitis

Uveitis can sometimes lead to further problems, particularly if it isn't treated quickly and properly.

You're more likely to develop complications if:

• you're over 60
• you have long-term (chronic) uveitis
• you have less common types of uveitis that affect the middle or back of the eye (intermediate or posterior uveitis)

Some of the more common complications of uveitis include:

• glaucoma – where the optic nerve, which connects your eye to your brain, becomes damaged: it can lead to loss of vision if not detected and treated early on
• cataracts – where changes in the lens of the eye cause it to become less transparent, resulting in cloudy or misty vision
• cystoid macular oedema – swelling of the retina (the thin, light-sensitive layer of tissue at the back of the eye): it can affect some people with long-term or posterior uveitis
• detached retina – when the retina begins to pull away from the blood vessels that supply it with oxygen and nutrients
• posterior synechiae – inflammation that causes the iris to stick to the lens of the eye: it's more likely to occur if uveitis isn't treated quickly