Uveitis
By Dr.Veena G.D. MBBS, DOMS
Iris is a circular, pigmented membrane that provides color to the eye e.g. blue, grayish green, common dark brown. It forms the pupil/aperture of the eye. Iris acts like a diaphragm, in dim light the aperture or pupil is large while in bright light the pupil is small. Thus eye is able to visualize inspite of variations in illumination.
Iris is composed of circular and radiating muscle fibers and a rich mesh of blood vessels. So in uveitis inflammation gives rise to congested red eyes, blurry vision with or without headache.
For treating purpose, the uveitis can be classified on causative and anatomic (location) basis –
- Traumatic – resulting from injury to the eye. Can be blunt or penetrating.
- Non Traumatic – usually seen as a symptom with other systemic diseases as in Arthritis, Rheumatic disease, psoriasis, sarcoidosis, tuberculosis, syphilis, herpes simplex and herpes zoster viruses.
- Anterior - depending on the location of inflammation on iris.
- Posterior - when part of the iris and cilliary body is involved.
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Uveitis Symptoms
The onset is sudden and generally affects only one eye depending on the severity. Following are the clinical signs and symptoms:
- Pain in the eye or eyebrow
- Severe eye pain on exposure to bright light
- Congestion or redness in exposed white portion of the eye around cornea.
- Very small pupil.
- Blurred vision.
- Moderate to severe Headache.
So it is advised to seek emergency medical attention for the above mentioned clinical presentations.
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Chronic Uveitis with Posterior Synchea
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Diagnosis
The diagnosis of uveitis or iritis is confirmed by examining the eye with a slit lamp (a special microscope designed for eye examination). Ophthalmologist can see the cells (white blood cells) and flare (particles of protein) in the aqueous humor (fluid that is produced in the eye). The tropical anesthesia applied doesn’t relieve the pain and shining bright light in the other good eye increases the pain in the affected eye because even slightest movement of the iris is painful at this juncture.
Treatment of Uveitis
Treatment generally involves use of eye drops for healing and to help in relieving the symptoms. The affected eye is dilated so that iris gets rest while it is healing. Anti-inflammatory drops for the inflammation to settle down and appropriate oral systemic pain killer is prescribed. Patient is advised to wear dark glasses for about a week or ten days till the inflammation settles down.
Certain above mentioned systemic diseases presenting with uveitis need blood investigation and appropriate systemic treatment along with uveitis treatment.