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. We also offer leading-edge therapies that provide the best chances of achieving the goal of steroid-free remission.

What Is Uveitis (Inflammatory Eye Disease)?

Uveitis refers to a group of inflammatory diseases that affect the middle layer of the eye (the uvea). 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.

Uveitis is one of many ocular inflammatory diseases, which are eye conditions that cause swelling and damage tissue. It is the most common intraocular (inside the eye) inflammatory condition.

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 layer (white part) 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?

Most cases of uveitis are idiopathic, which means the exact cause is unknown. Some cases affect only the eye, while others are associated with a systemic disease.

In the United States, many cases of uveitis are linked to autoimmune disorders, including:

• 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

Uveitis may also be caused by infections such as:

• 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

Rarely, ocular inflammation can be caused by cancer, most commonly large B-cell lymphoma.

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 initially to reduce eye inflammation and prevent vision loss. Steroids may be prescribed in the form of:

• Eye drops
• Pills
• Intravenous (IV) medications
• Injections in or around the eye
• 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.