Intermediate Uveitis

Summary about Disease


Intermediate uveitis is a type of uveitis, which is inflammation of the middle layer of the eye (uvea). Specifically, intermediate uveitis primarily affects the vitreous humor (the gel-like substance filling the eye) and often the peripheral retina. It is characterized by inflammatory cells accumulating in the vitreous and sometimes "snowbanking" (inflammatory debris) on the pars plana (part of the ciliary body).

Symptoms


Common symptoms of intermediate uveitis include:

Blurred vision

Floaters (spots or strings that drift in the field of vision)

Eye pain (usually mild)

Light sensitivity (photophobia)

Decreased vision

Causes


The exact cause of intermediate uveitis is often unknown (idiopathic). However, it can be associated with:

Infections (e.g., Lyme disease, tuberculosis, syphilis, herpesviruses)

Autoimmune diseases (e.g., multiple sclerosis, sarcoidosis)

Inflammatory conditions

In some cases, no underlying cause can be identified

Medicine Used


Treatment for intermediate uveitis typically involves:

Corticosteroids: Eye drops, injections, or oral medications to reduce inflammation.

Immunosuppressants: Medications to suppress the immune system, especially in chronic or severe cases. Examples include methotrexate, azathioprine, and mycophenolate mofetil.

Biologic agents: TNF inhibitors (e.g., adalimumab, infliximab) may be used in cases resistant to other treatments.

Cycloplegic eye drops: To dilate the pupil and relieve pain.

Is Communicable


Intermediate uveitis is not communicable. It is not contagious and cannot be spread from person to person.

Precautions


There are no specific precautions to prevent intermediate uveitis, as the cause is often unknown. However, if associated with an underlying condition:

Managing associated autoimmune diseases may help.

Prompt treatment of infections is essential.

Regular eye exams are crucial for early detection and management.

How long does an outbreak last?


The duration of an intermediate uveitis outbreak can vary significantly. It can be:

Acute: Lasting for a few weeks to months.

Chronic: Persisting for longer than three months.

Recurrent: Episodes that come and go over time. Treatment can help to control inflammation and shorten the duration of outbreaks.

How is it diagnosed?


Diagnosis of intermediate uveitis involves:

Eye examination: A thorough examination by an ophthalmologist to assess the structures of the eye and look for signs of inflammation.

Slit-lamp examination: To visualize the anterior chamber and vitreous for inflammatory cells.

Fundoscopy: To examine the retina and optic nerve.

Optical Coherence Tomography (OCT): An imaging technique to assess the retina and look for macular edema or other abnormalities.

Fluorescein angiography: To evaluate blood vessel leakage in the retina.

Blood tests: To look for underlying infections or autoimmune diseases.

Timeline of Symptoms


The onset of symptoms can be gradual or more sudden, depending on the severity of the inflammation.

Early: Floaters, mild blurred vision, and slight light sensitivity may be the first symptoms noticed.

Progression: Vision may worsen, and eye pain may increase if left untreated.

Chronic: Symptoms may persist for months or years, with periods of exacerbation and remission.

Important Considerations


Early diagnosis and treatment are crucial to prevent vision loss.

Regular follow-up appointments with an ophthalmologist are necessary to monitor the condition and adjust treatment as needed.

Compliance with prescribed medications is essential for managing inflammation.

Underlying conditions should be identified and treated appropriately.

Long-term immunosuppression may have side effects that need to be monitored.

Patient education about the disease and its management is important for successful outcomes.