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Uveitis

  • What is uveitis?

    Uveitis is inflammation of the 'uvea' of the eye. The uvea is made up of three parts. The first part is the iris, which is the colored ring of tissue you can see in the mirror. The dark hole in the middle of the iris is the pupil. The second and third parts, which you cannot see directly when looking in a mirror, are the ciliary body and the choroid. They are located behind the iris. An ophthalmologist can visualize them using special examination equipment.

    Inflammation of the iris is called iritis. Inflammation of the ciliary body is called intermediate uveitis or cyclitis. Inflammation of the choroid is called choroiditis. Inflammation of all three is called panuveitis.

    What causes uveitis?

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    There are several causes of uveitis, including autoimmune disorders (such as sarcoidosis, rheumatoid arthritis, systemic lupus erythematosus, Behcet's disease, and ankylosing spondylitis), infections (such as syphilis and toxoplasmosis), and trauma. Additionally, some are “idiopathic,” meaning the cause is unknown.

    Symptoms and signs

    - Anterior uveitis
    - Ciliary flush
    - Anterior uveitis
    - Redness of the eye
    - Blurred vision
    - Photophobia or sensitivity to light
    - Irregular pupil
    - Eye pain
    - Floaters, which are dark spots that float in the visual field
    - Headaches
    - Signs of anterior uveitis include dilated ciliary vessels, presence of cells and flare in the anterior chamber, and keratic precipitates ("KP") on the posterior surface of the cornea. In severe inflammation there may be evidence of a hypopyon. Old episodes of uveitis are identified by pigment deposits on lens, KPs, and festooned pupil on dilation of pupil.
    - Busacca nodules, inflammatory nodules located on the surface of the iris in granulomatous forms of anterior uveitis such as Fuchs heterochromic iridocyclitis (FHI).[2]

    Intermediate uveitis Most common:

    - Floaters
    - Blurred vision
    Intermediate uveitis normally only affects one eye. Less common is the presence of pain and photophobia.[3]

    Posterior uveitis

    Inflammation in the back of the eye is commonly characterized by:
    - Floaters
    - Blurred vision
    - Photopsia or seeing flashing lights

    Causes Uveitis is usually an isolated illness, but can be associated with many conditions, including diseases with major involvement of other body parts, as well as syndromes confined to the eye.

    In anterior uveitis, no associated condition or syndrome is found in approximately one-half of cases. However, anterior uveitis is often one of the syndromes associated with HLA-B27. Presence this type of HLA allele has a relative risk of evolving this disease by approximately 15%.

    [4]The most common form of uveitis is acute anterior uveitis (AAU). It is most commonly associated with HLA-B27, which has important features: HLA-B27 AAU can be associated with ocular inflammation alone or in association with systemic disease. HLA-B27 AAU has characteristic clinical features including male preponderance, unilateral alternating acute onset, a non-granulomatous appearance, and frequent recurrences whereas HLA-B27 negative AAU has an equivalent male to female onset, bilateral chronic course, and more frequent granulomatous appearance.