Navigating Uveitis: Understanding, Diagnosis, and Treatment

Inflammation of the internal "uveal tissue" within the human eye is referred to as uveitis. A common complaint includes redness and pain in the eyes. Some individuals may also report the presence of "floaters" or "cobwebs" in their vision, accompanied by blurred eyesight. Frequently, patients attempt using over-the-counter eye drops or changing their eyeglasses before consulting an eye specialist. Following a comprehensive assessment, the eye doctor can diagnose uveitis.

Q) What are the potential causes of uveitis?

Uveitis can arise as an ocular manifestation of various autoimmune conditions such as rheumatoid arthritis, systemic lupus erythematosus (SLE), Behçet's disease, ankylosing spondylitis, and multiple sclerosis, among others.

Interestingly, some patients may initially present with uveitis and later receive a diagnosis of an underlying systemic disease after extensive evaluation by a rheumatologist.

Infections like tuberculosis, toxoplasmosis, herpes viruses, syphilis, various bacteria, and fungi are also recognised triggers of severe uveitis that can threaten eyesight and require specific treatments.

Past eye surgery, a history of eye trauma, or in rare cases, underlying malignancies can also manifest as uveitis. A vigilant suspicion is necessary for proper evaluation in such cases.

Q) How is uveitis diagnosed?

It is crucial not to dismiss any eye-related concerns as insignificant. Rather than conducting broad tests, the key to uveitis diagnosis lies in recognising distinctive clinical patterns and requesting targeted investigations.

There are instances where a definitive diagnosis remains elusive even after thorough evaluation. In such situations, ongoing vigilance for developing clinical indicators is essential, prompting re-evaluation and appropriate treatment adjustments.

Q) What is the approach to treating uveitis?

Corticosteroids are the primary treatment for uveitis, but their use must be carefully managed due to potential side effects. Self-treatment with steroid eye drops or oral steroids is strongly discouraged for all patients.

For those requiring prolonged treatment, alternatives to extended oral steroid use are explored. This can involve a step-by-step utilisation of conventional disease-modifying anti-rheumatic drugs or, in select cases, biologics with a steroid-sparing effect.

Treating uveitis necessitates a collaborative effort involving multiple medical specialties including rheumatology, pulmonology, infectious diseases, as well as ophthalmology.

Specialised ocular immunology clinics prove beneficial for uveitis patients, offering simultaneous evaluation by an ophthalmologist and a rheumatologist with a shared goal of comprehensive patient care.

Q) Does surgery play a role in uveitis treatment?

Surgical intervention is reserved for specific uveitis cases, primarily for diagnostic sampling and managing complications associated with uveitis.

Q) Why is timely treatment of uveitis crucial?

The delicate light-sensing structures within the human eye are extremely vulnerable. Untreated eye inflammation can lead to permanent damage of these fragile structures and result in irreversible vision loss. Hence, accurate assessment and prompt treatment are imperative to safeguard vision.

If you're seeking expert advice regarding Uveitis, contact Dr. Samyak Mulkutkar, Consultant – Vitreo-Retinal Surgeon and Uveitis, P. D. Hinduja Hospital and Medical Research Centre.

To book an appointment, please contact the hospital at the following phone numbers: 022 6766 8181 or 022 4510 8181.

*Information source: Bombay Times