Uveitis (Eye Inflammation)

UT Southwestern ophthalmologists provide high-quality care for ocular immunologic diseases such as uveitis, or inflammation of the eye. We use the most advanced diagnostic tools to quickly diagnose the condition, prevent symptoms, and, whenever possible, restore lost vision.

What Is Uveitis (Inflammatory Eye Disease)?

Uveitis refers to a group of inflammatory diseases that affect the middle layer of the eye (the uvea). The term is also used to describe any inflammatory eye disease that causes swelling and damages tissue. Uveitis may come on suddenly and reappear later, or it can be a chronic condition. It’s the third-leading cause of blindness in the United States.

What Are the Types of Uveitis?

Uveitis is classified based on its location.

• Anterior uveitis (the most common type): Inflammation of the front of the eye
• Intermediate uveitis: Inflammation of the middle of the eye; it often affects the gel-like fluid of the eye (the vitreous)
• Posterior uveitis: Inflammation of the back of the eye
• Panuveitis: Inflammation of all three layers of the eye
• Scleritis: Inflammation of the outer layers of the eye

When the eye becomes inflamed, it may be the body’s response to an eye infection, or the immune system may be attacking healthy eye tissue (autoimmune disorder).

What Causes Uveitis?

Infectious or infection-related causes of uveitis include:

• Cytomegalovirus (CMV) retinitis, a viral infection of the retina
• Shingles (herpes zoster), a viral infection that causes a painful rash
• Syphilis, a type of sexually transmitted disease
• Toxoplasmosis, a parasitic infection that causes flu-like symptoms
• Autoimmune disorders that can cause uveitis include:
• Ankylosing spondylitis, a rare type of arthritis that causes inflammation of the spine
• Behcet’s disease, a condition that causes inflammation of the blood vessels
• Crohn’s disease, a type of inflammatory bowel disease
• Multiple sclerosis, a chronic disease that affects the central nervous system
• Rheumatoid arthritis, a disorder that causes inflammation of the lining of the joints
• Sarcoidosis, a disease that causes the growth of inflammatory cell clusters (granulomas) in one or more organs
• Vogt-Koyanagi-Harada (VKH) disease, a condition that affects the nervous system, ears, eyes, and skin
• Reactive arthritis, a type of arthritis that develops because of an infection
• Juvenile idiopathic arthritis (JIA), a type of arthritis that affects the joints in children

Sometimes, uveitis is not linked to a systemic disease. In some cases, the exact cause is unknown (idiopathic).

How Is Uveitis Diagnosed?

If a patient suspects they have uveitis, our ophthalmologists will begin each visit with a thorough evaluation, which includes a discussion of the patient’s medical history as well as their symptoms and risk factors. We’ll thoroughly check the patient’s eyes, which usually includes:

• Assessment of vision with eye charts
• Tonometry, a test that measures eye pressure
• A slit-lamp exam, which uses intense light to identify microscopic inflammatory cells in the front of the eye
• A dilated eye exam, which involves using eye drops to widen (dilate) the pupils so they can be checked thoroughly

We may order additional tests to determine if an infection or autoimmune disease is causing the uveitis.

How Is Uveitis Treated?

Our doctors create treatment plans that are tailored to each patient, taking into account the severity of the inflammatory disease, which part(s) of the eye are affected, and other existing health problems. Treatments can ease uveitis symptoms and, in some cases, reverse vision loss.

We often use steroids to reduce eye inflammation and prevent vision loss. Steroids may be prescribed in the form of:

• Eye drops
• Injections in or around the eye
• Pills
• Intravenous (IV) medications
• Eye implants that gradually release a small dose of steroid

For long-term control of uveitis, systemic medications to control the immune system may be prescribed.

If a systemic or chronic health condition has contributed to uveitis, we may use a multidisciplinary approach with coordination of care from doctors from additional specialties (such as rheumatologists, gastroenterologists, neurologists, dermatologists, pulmonologists, etc.) to control the disease process.