Uveitis

(H20.0, H44.1) Uveitis / Intermediate Uveitis /Posterior Cyclitis / Pars Planitis

Uveitis is the inflammation to any part of the uveal tract named as Iritis (inflammation of iris), Cyclitis (inflammation of ciliary body) or Choroiditis (Inflammation of choroid). Anterior uveitis is inflammation which occurs in iris and ciliary body is also called as Iritis. Inflammation to the choroid part of the uveal tract of the eye is called posterior uveitis. The most popular occurring infection is generalized uveitis.

Chronic Posterior cyclitis is also called intermediate uveitis according to the international uveitis study group. It affects the pars plana part of the ciliary body and the peripheral part of the choroid. It is observed in children as well as adults. The disease is bilateral with women having more chances to be affected than men.

ICD-10 H20.
ICD-9 364
DiseasesDB 13676
eMedicine oph/580 emerg/284
MeSH D014605

Uveitis Symptoms

Dark floating spots, redness of eyes, blurred vision are some basic symptoms of all types of uveitis.

Anterior uveitis usually shows symptoms like blurred vision, photophobia, pain, keratic precipitates. Clusters of keratic precipitates adhere to the inner surface of the cornea and the condition is painful.
Posterior uveitis is also called as Choroiditis. Posterior cyclitis may lead to visual impairment. The disease usually originates from the uveal tract of the eye. But it may spread to other parts like cornea and sclera. White snow ball like exudates are precipitated that appears like a snow bank in the middle chamber of the eyes.

Pars planitis is the infection of pars plana region within ciliary body of posterior uveitis. Inflammation in pars plana region causes cloudy vision by production of excessive white bloods cells.  
Intermediate uveitis or posterior cyclitis is a popular cause of blindness.

Uveitis Treatment

Use of dark glasses over the eyes may be involved as a treatment for uveitis.

Uveitis treatment involves drugs to suppress the inflammation and to relieve the patient from symptoms.

Immunosuppressant drugs are administered as eye drops or injections. If the immunosuppressant drugs are not effective then surgery is recommended by the ophthalmologist.

Pars planitis or intermediate uveitis is a serious disease since it can recur again. After the treatment, monitoring of the patient is essential. Pars planitis is treated with steroids eye drops.

If other diseases are associated with uveitis, it may involve anti-inflammatory medicines and antibiotics.

Anterior uveitis reduces gradually within few days to weeks. Posterior   uveitis or Pars planitis might take months to years and can cause damage to eyes even after the treatment.

Uveitis Causes

The autoimmune diseases such as rheumatoid arthritis, ankylosing spondylitis, infection or entry of toxins in the body are some causes of uveitis.

Causes of anterior and posterior uveitis are different. The causes of the disease intermediate uveitis or Pars planitis are still unknown.

Uveitis Types

Nowadays, uveitis is classified based on the predominant site affected as

  1. Anterior Uveitis -Anterior uveitis consists of Iritis, Anterior cyclitis and Iridocyclitis
  2. Posterior Uveitis – Posterior uveitis consists of Choroiditis, Chorioretinitis, Retinochoroiditis and Neuro-uveitis.
  3. Intermediate Uveitis - Intermediate uveitis consists of Posterior cyclitis, Pars planitis, Hyalitis and Basal retinochoroiditis.

Uveitis is also classified into three categories based on its clinical course as acute, chronic and recurrent.

Pathologically it can be differentiated into two categories such as Granulomatous and non-granulomatous.

Systemic Disorders Associated with Uveitis

  • Ankylosing Spondylitis
  • Behçet's Disease
  • Chronic Granulomatous Disease
  • Enthesitis
  • Inflammatory Bowel Disease
  • Juvenile Rheumatoid Arthritis
  • Kawasaki's Disease
  • Multiple Sclerosis
  • Polyarteritis Nodosa
  • Psoriatic Arthritis
  • Reactive Arthritis
  • Sarcoidosis
  • Systemic Lupus Erythematosus
  • Vogt-Koyanagi-Harada Syndrome
  • Whipple's Disease
  • Lyme Disease

Uveitis Infectious Causes

  • Brucellosis
  • Herpes Simplex
  • Herpes Zoster
  • Leptospirosis
  • Lyme Disease
  • Presumed Ocular Histoplasmosis Syndrome
  • Syphilis
  • Toxocariasis
  • Toxoplasmosis
  • Tuberculosis

Uveitis Syndromes

  • Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE)
  • Birdshot Retinochoroidopathy
  • Fuchs Heterochromic Iridocyclitis
  • Multifocal Choroiditis and Panuveitis Syndrome
  • Multiple Evanescent White Dot Syndrome (MEWDS)
  • Punctate Inner Choroidopathy (PIC)
  • Serpiginous Choroiditis