Summary about Disease
Recurrent uveitis is a form of uveitis, an inflammation of the uvea (the middle layer of the eye). "Recurrent" means the inflammation reappears after a period of remission. Uveitis can affect different parts of the uvea (iris, ciliary body, choroid) or all of them. Recurrent episodes can lead to progressive eye damage and vision loss if not properly managed.
Symptoms
Symptoms of recurrent uveitis can vary depending on the location and severity of the inflammation, but commonly include:
Eye pain (can be mild to severe)
Redness of the eye
Blurred vision
Sensitivity to light (photophobia)
Floaters (dark spots or strands that drift in your field of vision)
Decreased vision
Small pupils.
Causes
The exact cause of recurrent uveitis is not always known. In many cases, it is associated with:
Autoimmune diseases: Such as ankylosing spondylitis, rheumatoid arthritis, inflammatory bowel disease (Crohn's disease, ulcerative colitis), and psoriatic arthritis.
Infections: Such as herpes simplex virus (HSV), herpes zoster virus (shingles), syphilis, toxoplasmosis, tuberculosis, and histoplasmosis.
Injury to the eye: Trauma can sometimes trigger uveitis.
Genetic factors: Some people may be genetically predisposed to developing uveitis.
Idiopathic: In many cases, no specific cause can be identified (idiopathic uveitis).
Certain medications: Rarely, some medications can induce uveitis.
Medicine Used
Treatment for recurrent uveitis aims to reduce inflammation and prevent further damage to the eye. Common medications include:
Corticosteroid eye drops: Prednisolone acetate is a common example for anterior uveitis.
Corticosteroid injections: Periocular or intravitreal injections may be used for more severe or posterior uveitis.
Oral corticosteroids: Prednisone is often prescribed for systemic control.
Immunosuppressants: Medications like methotrexate, azathioprine, mycophenolate mofetil, and cyclosporine may be used to suppress the immune system, especially in recurrent or severe cases.
Biologic therapies: TNF-alpha inhibitors (e.g., adalimumab, infliximab) are sometimes used for uveitis associated with autoimmune diseases.
Mydriatic eye drops: Atropine or cyclopentolate can help dilate the pupil, relieve pain, and prevent the iris from sticking to the lens.
Antibiotics/Antivirals/Antifungals: Used to treat uveitis caused by specific infections.
Is Communicable
Uveitis itself is generally not communicable. However, if the uveitis is caused by an infection (like herpes or syphilis), the underlying infection may be communicable.
Precautions
Adhere to treatment plan: Follow your doctor's instructions carefully regarding medication and follow-up appointments.
Protect your eyes from light: Wear sunglasses to reduce light sensitivity.
Manage underlying conditions: If your uveitis is related to an autoimmune disease or infection, manage that condition effectively.
Regular eye exams: Get regular eye exams to monitor for complications such as glaucoma, cataracts, or vision loss.
Avoid triggers: If you know of any triggers that seem to exacerbate your uveitis, try to avoid them.
How long does an outbreak last?
The duration of a uveitis outbreak can vary significantly. It can last from a few weeks to several months. Recurrent uveitis means the inflammation returns after a period of remission. The length of remission periods varies greatly between individuals and depends on the underlying cause and effectiveness of treatment.
How is it diagnosed?
Uveitis is diagnosed through a comprehensive eye exam, which may include:
Visual acuity test: To assess your vision.
Slit-lamp examination: A special microscope is used to examine the structures of the eye.
Fundoscopy: Examination of the back of the eye (retina and optic nerve).
Intraocular pressure measurement: To check for glaucoma.
Optical coherence tomography (OCT): To visualize the retinal layers.
Fluorescein angiography: To visualize blood vessels in the retina.
Blood tests: To look for underlying infections, autoimmune diseases, or inflammatory markers.
Chest X-ray or other imaging studies: May be needed to rule out systemic conditions.
Timeline of Symptoms
The onset of uveitis symptoms can be gradual or sudden.
Early symptoms: Redness, mild pain, light sensitivity, slightly blurred vision, and increased floaters might appear over days or weeks.
Progressive symptoms: If untreated, pain can increase, vision can worsen, and floaters can become more prominent.
Recurrent episodes: Symptoms reappear after a period of remission, often with similar characteristics to the initial episode. The severity of symptoms can vary with each recurrence.
Important Considerations
Prompt diagnosis and treatment are crucial to prevent vision loss and complications.
Uveitis can be a symptom of a systemic disease, so it's important to rule out underlying causes.
Long-term management is often necessary for recurrent uveitis, even during remission periods.
Complications such as glaucoma, cataracts, and macular edema can occur, requiring additional treatment.
Consult with an ophthalmologist specializing in uveitis for optimal care.