Uveitis ranks third among the preventable causes of blindness in the world. The uveal tissues consist of the iris, which forms the eye color, the ciliary body that secretes the intraocular fluid (aqueous humor), and the choroid (choriocapillaris), the vascular bed of the retina. Inflammation of these tissues is called uveitis.
Therefore, uveitis are intraocular inflammations. Causes of inflammation can be infectious or non-infectious. Infectious causes are bacteria, viruses, fungi or parasites. Non-infectious causes; are many inflammatory diseases such as autoimmune diseases, rheumatic diseases, connective tissue diseases, vasculitides, syndromic conditions, paroneoplastic conditions.
It is divided into anterior, middle, posterior and pan (whole eye) uveitis according to the site of inflammation.
In anterior uveitis; There are complaints of light-induced pain (photophobia), decreased vision (due to anterior corneal cells) and red eye (ciliary nejection).
Image-1: Normal eye and uveit
In the examination of the patients, anterior chamber cells, adhesions in the middle of the anterior lens capsule of the iris (synechia), atrophies in the iris, posterior subcapsular cataracts in the lens, cell masses in the cornea (keratic precipitates), rarely cystoid macular edema in the retina, secondary glaucoma, band keratopoties may develop. Treatment includes topical steroids and cycloplegic agents (medicines that paralyze the ciliary muscle).
In middle uveitis, patients may have complaints of floaters, low vision, and mild anterior uveitis. The most common cause of middle uveitis is Multiple Sclerosis (MS). Apart from this, there may be many clinical conditions such as toxoplasma, tuberculosis, leprosy, sarcoidosis, cat scratch and syphilis. Agent-oriented treatment is used in infectious origins, subtenon steroid injection or systematic steroid treatment is performed in non-infectious patients.
In posterior uveitis, the first complaint in patients is low vision. Also, floating objects are among the complaints. There is no pain or redness in the eye. Retinitis, papillitis, vasculitis, retinal granuloma, optic disc granuloma, arterial vein occlusion, bleeding, retinal axudates, all kinds of detachment can be observed. In frequently recurring posterior uveitis, retinal sensitivity disappears over time, atrophy in the optic disc, and phantom vessel appearances cause patients to lose their vision.
If the treatment is infectious, it is directed towards the agent. If it is non-infectious, systemic steroids, steroid injections behind the eyes, imminosupressive drugs, imminomodulant drugs (cyclosparin A), interferons, anti-vegef drugs can be preferred.