If you suffer from redness, pain, watering, inability to see bright light, floaters, and/ or decreased vision in your eye, you could be suffering from Uveitis.
Uvea is the middle part of the three coats of the eye. This further consists of the iris, ciliary body and the choroid. Inflammation of any of these parts is termed uveitis. Based on the part of the uvea involved, uveitis may be Anterior (involving the iris), Intermediate (involving the ciliary body), Posterior (involving the choroid) or Panuveitis (involving all the parts).
Uveitis occurs as a result of an immune reaction by our body to substances which our body treats as foreign. This reaction may occur against infectious agents such as bacteria, fungi, viruses and even parasites. It may also occur in patients with existing autoimmune diseases such as Rheumatoid arthritis, Systemic lupus erythematosus etc. In some patients, uveitis can also occur due to undeterminable causes.
Uveitic patients often require a whole series of investigations in order to identify the cause of uveitis and appropriate eyecare to treat the condition. These investigations usually include blood and urine tests and/ or X rays. At times, a sample of the fluid from the patients’ eye may have to be checked.
Steroids are an important part of Uveitis treatment. Depending on the location and the severity of the inflammation, they are used in the form of eye drops, eye ointment, injections around/ in the eye or injectable / oral medications. Anterior (and intermediate) uveitis is treated with topical steroids along with dilating eye drops which help in reducing the pain associated with inflammation. These drops are to be used until the inflammation has completely subsided. The dose, strength and duration of the drops are determined by your Ophthalmologist who decides the treatment based on the amount of inflammation.
Injection of the steroid around the eye is used in certain cases of intermediate uveitis (or in macular edema as a consequence of uveitis). This results in slow release of the drug over a period of three to four weeks.
Besides steroids, the other group of drugs used in the treatment of uveitis is immunosuppressives. These are especially used for patients who show resistance to steroids, inflammation not resolving with only steroids and patients with certain systemic conditions like rheumatoid arthritis. The commonly used immunosuppressives include Methotrexate, Azathioprine, Cyclosporine, Mycophenolate Mofetil, Cyclophosphamide and Biological agents.
Sometimes people get worried about the side effects of the drugs used in the treatment of uveitis, but both steroids and immunosuppressives have side effects that are often not serious and reversible following the discontinuation of the drugs. These drugs should always be taken as per your Ophthalmologists instructions and one should never start or stop these drugs at their own will.
Topical steroids may cause cataract or an increase in the intraocular pressure (glaucoma). Oral steroids may cause acidity, increase in weight and rarely diabetes, hypertension, osteoporosis and nervousness/ depression.
Immunosuppressives may cause bone marrow depression that is reflected as a decrease in your blood counts. Some of them also interfere with the normal functions of the liver, cause mouth ulcers, rarely sterility and secondary malignancies. Thus, periodic blood counts or liver function tests may be required.
Women in the reproductive age group are advised not to become pregnant when on treatment with immunosuppressives/ steroids. If any infection develops while on treatment one needs to take appropriate antibiotics immediately after consulting with the Ophthalmologist.
It is important to remember that Uveitis is a recurrent condition and hence requires a prolonged and regular follow up with the Ophthalmologist. Consult your ophthalmologist at the earliest signs of a recurrence, which will make the treatment easier and speedier.