Eyes Uveitis

Overview

Uveitis (say: you-vee-EYE-tis) is inflammation inside the eye. It affects the uvea, the middle layer of the eye. The most common type affects the front of the eye and is sometimes called iritis. Uveitis is not the same as common pink eye. It needs care from an eye doctor because untreated inflammation can damage vision.

Uveitis is uncommon, but it is an important cause of eye problems. The front-of-the-eye type is the most common form.

It can affect people of any age. It is most often seen in working-age adults. Children with juvenile arthritis may need regular eye screening because they can have uveitis without obvious symptoms.

Symptoms

Common symptoms

• Eye pain, often a dull ache
• Redness, especially around the colored part of the eye
• Being sensitive to light (photophobia)
• Blurred or cloudy vision
• Small moving specks called floaters
• Watery eyes
• A feeling that the eye is tender or irritated

Symptoms in children

• Children may not complain of pain or blurry vision.
• Uveitis may be found only during an eye check, especially in children with juvenile arthritis.
• Watch for red eyes, squinting, rubbing the eyes, holding things close, or changes in schoolwork or behavior.

Symptoms in older adults

• Symptoms may be less obvious or mistaken for other eye problems.
• New floaters, blurring, eye pain, or redness should be checked, especially with an immune condition or recent infection.
• Regular eye checks are important if you take medicines that affect the immune system.

Causes

Main causes

• Often the immune system mistakenly attacks the eye for reasons that are not fully clear.
• Infections caused by viruses, bacteria, fungi, or parasites.
• An eye injury or surgery.
• Other inflammatory conditions in the body.
• Sometimes no cause is found.

Risk factors

• Having an autoimmune or inflammatory disease, such as ankylosing spondylitis, sarcoidosis, inflammatory bowel disease, psoriasis, or juvenile arthritis
• Certain gene types, such as HLA-B27, and family history
• Smoking
• Recent infection
• Eye injury
• Taking medicines that affect the immune system

When to see a doctor

See a doctor urgently if:

• You have new eye pain, redness, or light sensitivity.
• Your vision becomes blurred or cloudy.
• You see many new floaters or flashes.
• You have eye symptoms and a known immune condition.
• You wear contact lenses and have eye pain or redness.

Book a routine appointment if:

• You have had uveitis before and notice mild changes.
• You need a follow-up eye check.
• You have an immune condition and are due for eye screening.
• You have questions about your eye drops or treatment plan.

Diagnosis

An eye doctor can often spot uveitis by looking inside your eye with a special microscope and light. They will ask about your health, medicines, and recent infections. Because uveitis can be linked to other conditions, they may arrange tests or refer you to another specialist.

Tests that may be done

• Slit-lamp eye exam, using a special microscope and light
• Eye pressure check
• Dilated eye exam, using drops to widen your pupil
• Blood tests to look for infection or immune conditions
• Imaging scans of the eye
• Sometimes a chest X-ray or other tests

What to expect at your appointment

The eye exam is quick but the light can feel bright. Drops used to widen your pupil may blur your vision and make light uncomfortable for a few hours. You may need someone to drive you home. Not everyone needs every test.

Treatment

The goal is to calm inflammation, relieve pain, and prevent damage. Treatment depends on which part of the eye is affected and whether an infection or another condition is involved. Most people are treated by an eye specialist, sometimes with help from other doctors.

Self-care at home

• Use your eye drops exactly as prescribed and wash your hands first.
• Do not rub your eyes.
• Wear sunglasses in bright light if your eyes feel sensitive.
• Avoid contact lenses until your eye doctor says it is safe.
• Keep all follow-up appointments, even when your eye feels better.
• Do not stop steroid eye drops suddenly unless your care team tells you to.
• Notice and write down any new symptoms or side effects.

Medical treatments

Steroid medicines are often used to reduce inflammation. For uveitis at the front of the eye, this is usually in the form of eye drops. For uveitis deeper in the eye, treatment may include steroid injections, steroid implants, or steroid tablets. If the immune system is causing the problem, medicines that calm the immune system may be used. If an infection is found, it is treated. Your care team will tailor treatment and monitor you for side effects.

When is surgery considered?

Surgery is not usually used to treat uveitis itself. If uveitis causes complications such as cataracts, glaucoma, or scar tissue, surgery may be considered once inflammation is controlled. Your eye specialist will discuss the risks and benefits with you.

Living with this condition

Uveitis can be a one-off problem or can come back. Keep all follow-up appointments, even when your eye feels better. Tell your care team about new symptoms or side effects. Do not stop steroid drops suddenly unless you are told to.

Lifestyle tips

• Avoid smoking and secondhand smoke.
• Wear sunglasses in bright light.
• Use eye protection for DIY, sports, or work.
• Get enough sleep and manage stress where you can.
• Wash your hands before putting in eye drops.
• Ask your eye doctor before swimming or using contact lenses.

Diet and exercise

No special diet treats uveitis. Eat a balanced diet and stay active for general health. If your vision is blurry, choose safe activities and ask your doctor about exercise.

Mental health and emotional wellbeing

Long-term or repeated eye problems can cause worry, low mood, or frustration. This is common. Talk to your eye team or GP. Counseling and support groups can help. If you ever have thoughts of harming yourself, contact your local emergency number or crisis support right away.

Prevention

Not all uveitis can be prevented. You can lower some risks by protecting your eyes from injury, not smoking, and managing health conditions with your care team. If you have an infection that can trigger eye inflammation, get it treated.

Vaccines

There is no vaccine that prevents uveitis itself. Routine vaccines can prevent some infections that may trigger eye inflammation, so follow local vaccine advice.

Screening programmes

If you have an immune condition linked to uveitis, or take medicines that affect the immune system, ask your care team about regular eye checks. Children with juvenile arthritis need eye screening even if their eyes look fine.

Complications

If left untreated

• Long-term inflammation can damage the eye.
• Glaucoma, which is high pressure inside the eye
• Cataract, which is clouding of the lens
• Macular edema, which is swelling at the back of the eye
• Scar tissue that can pull the iris or retina
• Vision loss or blindness

Long-term outlook

With early treatment, most people with uveitis keep useful vision. Some need long-term care and repeated treatment, but modern treatment can control inflammation and reduce complications. Keep regular appointments and seek help early if symptoms return.

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