Uveitis is a serious eye disease that people are afraid of, a kind of inflammation. For the disease to be cured, it is very important to make the diagnosis and treatment correctly.
What is uveitis?
Uveitis is called inflammation of some or all of the uvea layer in the eye. It is an inflammatory disease. Inflammation of the uvea affects all tissues in the eye.
The Uvea layer, on the other hand, is a continuous and fibrous layer consisting of the iris, choroid, and ciliary body in the eye. The iris layer is the layer that gives color to the eye. The choroid layer is the layer that nourishes the eye, is covered with fine blood vessels, and surrounds the eye. The ciliary body, on the other hand, is the layer that is in direct relation with the iris and the choroidal layer and is responsible for controlling the shape of the lens.
Usually, uveitis that starts suddenly can also cause permanent blindness. For this reason, it is said to be a serious illness. It is known as the 3rd most common cause of vision loss in developed countries around the world.
In some cases, this disease can improve by responding positively to treatment, and sometimes it can become chronic or even recur even though it heals. Like many diseases, early diagnosis and correct treatment are very important for uveitis. Otherwise, the possibility of the disease responding positively to treatment decreases.
The sudden exacerbation of the symptoms in uveitis is called uveitis attack. That disease is divided into 3 according to the area of inflammation in the eye. If the inflammation is located near the iris or ciliary body, ie in the front of the eye, it is called anterior uveitis. Anterior uveitis is also called iridocyclitis. Anterior uveitis is easier to treat and more likely to get a positive response. But if the inflammation occurs in the part close to the choroid layer; This is called posterior uveitis and is more difficult to treat and can cause permanent blindness if left untreated. Intermediate uveitis occurs when inflammation affects the ciliary body and retinal periphery. If inflammation is seen in every layer in the uvea layer in this disease, it is called panuveitis.
What are the causes of uveitis?
The causative factors of uveitis cannot be detected in 30-40% of patients and they are called idiopathic.
- Some uveitis diseases can occur as a result of viruses, fungi, or different parasites, while others occur as a result of the disease in any part of the body affecting the eye. Examples of diseases that cause uveitis in the eye are syphilis, tuberculosis, brucellosis, herpes, and AIDS. At the same time, some diseases originating from autoimmune or collagen tissue may also cause uveitis. These diseases include diseases such as Behçet’s disease, sarcoidosis, ankylosing spondylitis, and rheumatoid arthritis.
- Some diseases related to the digestive system, such as Crohn’s disease or ulcerative colitis, can also be said to be the cause of uveitis.
- Eye injuries, eye trauma, eye surgeries are also counted as causes of uveitis.
- Some types of cancer (such as lymphoma) also metastasize to the body, affecting the eye and causing uveitis.
Since uveitis usually indicates other disorders in the body, it is absolutely necessary to perform medical tests at the hospital and also to take a detailed and accurate medical history of the patient. In this way, if there is an underlying disease, it can be diagnosed.
What are the signs and symptoms of uveitis?
- Blurred vision,
- Redness in the eyes,
- Eye pain,
- Eye tearing frequently,
- Sensitivity to light,
- Seeing black dots floating in front of the eyes,
- It can be said as a decrease in vision.
Both the severity and symptoms of the disease vary depending on the area of the inflammation in the eye. For example, in the case of posterior uveitis, symptoms such as blurred vision and decreased vision are usually observed. If this disease affects the nerves in the eye or a central area, there may be a sudden decrease in vision and treatment should never be delayed in such a situation. If delayed, the sudden decrease in vision may cause blindness over time and may progress to permanent blindness.
While these symptoms sometimes appear suddenly in uveitis, they sometimes become noticeable very slowly. Symptoms can also worsen rapidly in the sudden onset of uveitis. The disease can also begin in both eyes at the same time, or it can be seen in both eyes at different times.
What are the risk factors that cause uveitis in people?
- Genetic Susceptibility: As a result of the predisposition to this disease in the genes passed on to the person from previous generations, the possibility of uveitis increases in people.
- Infection: Some disorders are seen in different parts of the body also affect the eye, causing uveitis.
- History of Autoimmune or Inflammatory Disease in the Person: The presence of diseases such as Behçet’s disease, ankylosing spondylitis, sarcoidosis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis increases the risk of uveitis.
- History of Eye Trauma of the Person: Occurrence of conditions such as eye injury may cause uveitis and sometimes even uveitis may develop after the injury in the eye heals.
How is uveitis diagnosed?
The severity of the uveitis disease may vary from person to person, depending on the underlying cause and the area of inflammation in the eye, but regardless of the severity of this disease, it should be diagnosed urgently and properly treated. It should be noted that it is a disease that is urgent for patients.
Deformities in the pupil if treatment or diagnosis is delayed; Permanent side effects such as cataracts, increased eye pressure (glaucoma) may occur, which seriously affect the quality of life of the person.
The person who notices the symptoms of uveitis himself should first go to an ophthalmologist who specializes in uveitis. In this examination, the specialist doctor should obtain detailed information about the patient’s eye and other disease conditions and should also perform a detailed eye examination. He should never neglect this. He should not use medication or wait for the symptoms to go away on their own. Being late for the first examination may cause the above-mentioned permanent damage.
There are several types of uveitis, and among these types, some can be diagnosed very easily, while others may be difficult to diagnose. Even if the disease is easily diagnosed, some techniques such as eye angiography (FFA) and ultrasonography should be used to determine the extent to which the vision is affected, to understand whether the treatment is effective, and to monitor the effectiveness of the treatment, if there is inflammation in the back of the eye.
Sometimes special eye examinations may be required in the diagnosis of uveitis. Fluorescein angiography, optical coherence tomography (OCT) can be given as examples of these examinations.
According to the characteristics and symptoms of the diagnosed uveitis disease, the physician may also request special examinations (PCR), blood tests, and imaging tests from the patient’s eye fluid. In this disease, it is also very important to consult with doctors in other specialties during the diagnosis phase.
How is uveitis treated?
- Primarily, if uveitis is caused by a disease, that disease should be treated.
- In people with this disease, it is generally recommended to use sunglasses to prevent sensitivity to the sun or the sun from adversely affecting the disease.
- In this disease, there is usually no restriction in the patient’s activity. However, it is beneficial to avoid work that requires attention, as some eye drops used by the patient for treatment enlarge the pupil and cause great difficulties in vision.
- A salt-free diet is applied in patients who are deemed suitable for cortisone treatment.
- Eye drops, cortisone tablets, and needles are usually therapeutic agents used in the treatment of this disease.
- During the treatment phase, patients should be monitored regularly, because some important findings are encountered thanks to this monitoring. These important findings guide the person’s treatment. According to the findings, sometimes even a completely different treatment method can be applied to the person.
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