14414 Uveitis

Overview

Uveitis is inflammation (swelling and irritation) inside the middle layer of your eye, called the uvea. The uvea is made up of the colored part of your eye, the tissue behind it, and a layer that lines the inside wall of your eye. When it becomes inflamed, it can cause redness, pain, and blurred vision.

Uveitis is not as common as eye allergies or dry eyes, but it's not rare either. It affects around 1 in 4,500 people each year in the UK. It can happen at any age, and many cases are treatable.

Uveitis can affect anyone, but it most commonly appears in adults between 20 and 60 years old. Some types, like anterior uveitis, often affect younger adults, while other forms may be more common in older adults or children with certain health conditions.

Symptoms

Common symptoms

• Eye redness, especially without discharge
• Eye pain or aching
• Light sensitivity (finding light uncomfortable)
• Blurred or cloudy vision
• Floating spots or threads in your vision
• Reduced or changed vision

Symptoms in children

• May not complain about vision – watch for squeezing or squinting
• Redness or swelling in the eye
• A pupil that is smaller or looks odd
• Rubbing the eye more than usual
• Avoiding bright light or bright rooms

Symptoms in older adults

• Sometimes less pain than younger people, but vision changes are more noticeable
• Blurred vision that may come and go
• Eye redness that may be mild but persistent
• Overall eye fatigue or a heavy feeling in the eye

Causes

Main causes

• An infection in the eye or elsewhere in the body (for example, shingles, herpes, or toxoplasmosis)
• An overactive or misguided immune system (autoimmune conditions like arthritis, sarcoidosis, or Crohn's disease)
• An injury or surgery to the eye
• Sometimes no cause is found – this is called 'idiopathic' uveitis

Risk factors

• Smoking – this can increase the risk and make uveitis worse
• Having an autoimmune or inflammatory condition
• A recent infection, especially viral or parasitic
• Certain inherited gene types linked to immune responses
• Past eye trauma or eye surgery

When to see a doctor

See a doctor urgently if:

• See a doctor or eye specialist the same day if you have eye pain, eye redness, light sensitivity, or new floaters.
• If you already have a diagnosis of uveitis and your symptoms change, call your eye clinic without delay.

Book a routine appointment if:

• Make a routine appointment if you have a health condition like arthritis or Crohn's disease and are due a regular eye check.
• If you've had uveitis before, keep follow-up appointments with your specialist, even if you feel fine.

Diagnosis

A doctor or eye specialist will examine your eyes with a special microscope called a slit lamp, which shines a thin beam of light into the eye to see the inside clearly. They will also ask about your symptoms, medical history, and any other health conditions.

Tests that may be done

• Eye pressure test (tonometry) to check for glaucoma
• Visual acuity test to check how sharp your vision is
• Pupil dilation to look at the back of the eye
• Blood tests to look for inflammation or infection
• Sometimes a chest X-ray or imaging scan if your doctor suspects a full-body condition

What to expect at your appointment

The exam itself is not painful, but light may be uncomfortable. Drops are used to widen your pupils, which can make your vision blurry for a few hours, so you may need someone to drive you home. Your doctor will explain what they find and talk through next steps, including whether you need to see a specialist called an ophthalmologist.

Treatment

Treatment aims to calm the inflammation, relieve symptoms, and protect your eyesight. It depends on the type and severity of uveitis and whether there's an underlying cause. Most people need treatment for a limited time, though some need longer-term care to keep the condition under control.

Self-care at home

• Wear sunglasses indoors or outdoors to reduce light discomfort.
• Avoid wearing contact lenses until your eyes are better – ask your eye doctor when it's safe.
• Rest your eyes when they feel tired; try taking breaks from screens.
• Apply a cool, damp cloth over closed eyes if it feels soothing – but do not press on them.
• Take pain relief for mild aches like you would for a headache, but follow the directions on the packet or ask your pharmacist.

Medical treatments

Uveitis is typically treated with anti-inflammatory medicines, which may be given as eye drops, pills, injections, or a slow-release device. These medicines help reduce inflammation and prevent damage. If an infection is causing the uveitis, you'll receive treatment for that infection. For more severe or repeated uveitis, doctors may use medicines that calm the immune system, but only under specialist supervision. Never stop or change your medicine without talking to your doctor first.

When is surgery considered?

Most uveitis is treated with medicines alone. Surgery is rarely the first step, but it may be needed if complications like cataracts, glaucoma, or a detached retina develop. Sometimes, a small surgical implant is used to release anti-inflammatory medicine into the eye over time.

Living with this condition

Living with uveitis means paying attention to your eyes. Keep a note of your symptoms, take your medicines as directed, and go to all follow-up appointments. If you feel a flare coming on – pain, redness, or blurred vision – let your eye care team know early, rather than waiting.

Lifestyle tips

• If you smoke, getting support to quit can lower your risk of flares and eye damage.
• Protect your eyes from sunlight with quality sunglasses that block UV light.
• Try to manage stress, as stress may sometimes make inflammation worse.
• Keep other health conditions, like diabetes or high blood pressure, well managed.

Diet and exercise

There's no special diet that cures uveitis, but eating a balanced, colourful diet rich in vegetables, fruits, and healthy fats supports your overall eye health. Low-impact exercise like walking, swimming, or yoga is usually fine, but if you have intense symptoms, let your body rest.

Mental health and emotional wellbeing

Dealing with a vision condition can be frustrating and worrying. It's normal to feel anxious, especially if uveitis keeps coming back. Talk to your doctor about how you're feeling. If you feel low for more than a couple of weeks, consider speaking to a counsellor or your GP.

Prevention

Uveitis itself is not always preventable, because often the cause is unknown or linked to your immune system. But you can reduce the risk of complications by seeing a doctor early when symptoms appear, taking all medicines as prescribed, and avoiding known triggers like smoking or certain infections.

Vaccines

Keeping your vaccinations up to date is a good idea because some infections – like shingles or the flu – can sometimes trigger uveitis. There is no vaccine that specifically prevents uveitis, but staying current with routine jabs can help lower your risk of related infections.

Screening programmes

If you have a condition like ankylosing spondylitis, Crohn's disease, or sarcoidosis, regular eye exams from an optometrist or ophthalmologist can help catch uveitis early. Ask your doctor or eye clinic how often you should be checked.

Complications

If left untreated

• Permanent vision loss or blindness
• Glaucoma – increased pressure inside the eye that can damage the optic nerve
• Cataracts – clouding of the eye's lens
• Swelling inside the retina (macular edema)
• Retinal tears or detachment – where the layer at the back separates

Long-term outlook

With proper treatment, most people with uveitis recover well and keep good vision. The condition can sometimes come back, which is why follow-up care is so important. Newer treatments are very effective, and eye specialists can usually control inflammation before it causes lasting harm. Be patient with your recovery and stay in touch with your eye team – the outlook is hopeful for most people.

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