Uveitis is a relatively uncommon condition characterized by inflammation within the eye. If undiagnosed or untreated, it can lead to vision loss. Uveitis can be divided into several types based on where in the eye the inflammation occurs, including anterior uveitis (the front part of the eye) and posterior uveitis (the back part of the eye). It can occur by itself, or in association with other illnesses, including infections and autoimmune diseases. In particular, it is associated with spondyloarthritis, juvenile idiopathic arthritis, and vasculitis, among others.
Patients with uveitis may experience sudden, acute symptoms that include eye pain, redness, sensitivity to bright lights, blurred vision and "floaters" that partially obscure vision. Uveitis may also have a chronic, silent course, in which patients do not have any noticeable symptoms. Because of this, in certain autoimmune diseases it is recommended that patients undergo regular eye examinations to screen for early signs of inflammation. These examinations should be performed by a board certified ophthalmologist (or pediatric ophthalmologist for child patients) or an optometrist who regularly performs slit-lamp exams. A rheumatologist or pediatric rheumatologist can refer patients to an appropriate eye doctor, and discuss how often they should be screened.
Uveitis is typically diagnosed following a thorough history and physical exam, which must include an eye exam by a trained ophthalmologist. In certain cases, additional blood tests and imaging studies can be helpful in determining the cause.
The treatment of uveitis depends on the location of inflammation within the eye, the extent of inflammation, and the underlying cause. First line treatment often involves administration of steroid medications to help reduce inflammation, which may be given via eye drops or pills. In patients who don’t respond to steroids, numerous other immunosuppressive medications may be used. These medications may require close monitoring and frequent follow-up with a rheumatologist. Pediatric rheumatologists and ophthalmologists work together closely to determine the best course of treatment and need for follow up for patients with uveitis.