Uveitis and Ocular Immunology

Uveitis is a broad group of conditions which have in common inflammation within the eye affecting part or all of the uvea, the internal pigmented tissues within the eye consisting of the:

  • iris (“colored” part of the eye)
  • ciliary body (located behind the iris and responsible for production of the internal ocular fluids or aqueous humor)
  • choroid (vascular layer underlying the retina in the back of the eye).

These conditions may be classified in several ways, including by their cause, associated conditions, or location within the eye. They may be localized to the eye or they may be associated with or the result of disease elsewhere in the body.

The following terms refer to specific subtypes of uveitis based on the location of the inflammation within the eye:

  • Iritis: inflammation of the iris
  • Iridocyclitis: Inflammation of the iris and the ciliary body
  • Choroiditis: inflammation of the choroid
  • Panuveitis: inflammation of all parts of the uvea
  • Retinochoroiditis or chorioretinitis (inflammation of both the retina and choroid)

Specific causes of Uveitis may include:

  • Infections such as, Lyme disease, Syphilis, TB, Toxoplasmosis, Herpes and other viruses and numerous fungal infections
  • Immune disorders such as Sarcoidosis, Rheumatoid Arthritis, Inflammatory Bowel diseases such as Crohns disease and Ulcerative Colitis, Reiter’s Syndrome and others
  • Primary disorders of the eye including Idiopathic (cause unknown) Iritis, Pars Planitis and multiple types of Retinitis, Vasculitis (inflammation of the blood vessels) and Choroiditis

Prior to treatment the specific cause and or association needs to be determined in order to employ the most effective treatment. The investigation of the causes of Uveitis may include:

  • A comprehensive physical exam by an Internist to rule out any systemic disease
  • A chest x ray and, depending on the presentation in the eye, other radiologic studies such as spine films or CTs and MRIs
  • Comprehensive blood tests to identify specific diseases, infections, or immunologic markers
  • Skin tests for TB
  • Biopsies, endoscopy or colonoscopy

The mainstay of treatment for Uveitis is usually anti-inflammatory drugs. These may include:

  • Topical or Systemic steroids such as Prednisone
  • Immunosuppressant drugs such as Methotrexate, Enbrel, Humera and Remicade, Cellcept or other biologic agents
  • Specific antibiotics

The comprehensive management of all forms of uveitis requires great care and attention to detail as well as years of experience. We are fortunate to have a fellowship trained expert, Dr. Jeffrey Willig, on staff at the Center for Eye Care to help us all manage the wide range of uveitis we see throughout the year.

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Monday
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