Uveitis affects people in different ways depending on which part of the uvea and eye is affected (front, middle or back). The symptoms of uveitis may include pain, sensitivity to bright lights and poor vision. However, some symptoms can be less obvious, making uveitis more difficult to diagnose initially. Some people may not notice any symptoms and so uveitis may not be detected for several weeks or months.
Most cases of uveitis get better with treatment. Some types of uveitis are more difficult to treat because they are long-term and have sight-threatening inflammation which can also involve other tissues close by, causing more permanent changes to your sight.
This page contains a summary of our information on uveitis. To read our full information, download our factsheet:
– What are the different types of uveitis?
– What causes uveitis?
– What is anterior uveitis (iritis?)
– What is intermediate and posterior uveitis?
– What are the complications of uveitis?
Uveitis is described in different ways depending on which part of your uvea is affected:
Uveitis may also be described depending on how long it lasts:
There are several known causes for uveitis but sometimes the cause is unknown (idiopathic). Possible causes include:
Anterior uveitis, sometimes called iritis, is when the iris or ciliary body at the front of your eye is inflamed. Anterior uveitis is the most common type of uveitis.
The symptoms of anterior uveitis usually start over hours or days and often affect one eye at a time. It typically causes eye pain, eye redness and sensitivity to light (photophobia). Your eye can feel achy and the eyeball may be tender. Your vision may be slightly blurred as well.
For most people with anterior uveitis a course of eye drops is all the treatment needed to clear up the inflammation.
Corticosteroid eye drops are used to reduce the inflammation at the front of the eye.
Depending on the level of inflammation in your eye, the dose can range from using the eye drops every hour to using them just once a day. As the inflammation gets better, the dose will be reduced slowly by your ophthalmologist. It’s important not to stop using your eye drops until your ophthalmologist tells you that it is safe to do so, even if your symptoms disappear, as stopping your treatment too soon can cause the inflammation to return.
Cycloplegic or mydriatic eye drops may be given for anterior uveitis in addition to steroid medication, but this is not always the case.
Cycloplegic drops relieve your eye pain by paralysing the muscles of your iris and ciliary body as it is the movement of these inflamed muscles that cause the pain.
An episode of acute anterior uveitis which has been treated promptly doesn’t usually cause any long-term changes to your sight. This is because it responds quickly to treatment initially so only a short course of eye drops is needed, and most people recover within a few weeks.
Some people will only ever have a single episode of anterior uveitis. However, it can recur or become chronic in which case it may cause more problems over time.
Intermediate uveitis is when the area behind your ciliary body is affected, with most of the inflammation being seen in the vitreous gel, the jelly-like substance that fills your eye. Types of intermediate uveitis include vitritis – inflammation of the vitreous gel, and pars planitis – inflammation of the narrowed area (pars plana) between the iris and the choroid. Intermediate uveitis is most commonly seen in young adults.
Posterior uveitis affects the choroid (choroiditis) or retina (retinitis) or both. It can also affect the retinal blood vessels (vasculitis), or the optic nerve head, where the nerve fibres leave your eye to the brain. There are many types of posterior uveitis including birdshot chorioretinopathy and punctate inner choroidopathy (PIC). Posterior uveitis is the least common form of uveitis.
Intermediate uveitis can cause dense floaters (black dots, shapes and wispy lines that move across your vision). It usually affects both of your eyes. Your vision may gradually feel more blurry and occasionally you may be sensitive to light. Some people with intermediate uveitis may also get anterior uveitis.
Posterior uveitis causes blurry, distorted vision or patchiness or gaps in your vision. It can also cause problems with colour vision and/or seeing in the dark at night (nyctalopia).
Intermediate or posterior uveitis don’t usually cause any eye pain or redness.
Treatment for uveitis can differ from person to person quite considerably and will also take into account the cause of your uveitis.
Apart from certain types of uveitis caused by infection, steroid medication (corticosteroids) is the mainstay of treating uveitis.
Injections are used for intermediate or posterior uveitis to deliver the steroid to the parts of the eye that are inflamed. Injections can be given around the eye or into the eye. Steroids can be injected into the eye either as a liquid or as a small implant to treat non-infectious uveitis. Injections and implants are often used if only one eye requires treatment, but can be given to both eyes.
Oral (tablet) corticosteroids are another way of treating intermediate or posterior uveitis and are preferred in certain conditions or situations, such as if you have another inflammatory condition elsewhere in your body.
Immunosuppressant medication may be recommended if uveitis doesn’t respond to other treatments or to allow the dose of steroids to be reduced if they are causing you significant side effects.
If your uveitis is caused by an infection, the infection will need to be treated with antiviral or antibiotic tablets too.
In rare cases, surgery may be needed to treat uveitis. However, this is usually only used if you have repeated or severe uveitis that affects the back of your eye.
An operation called a vitrectomy to remove the vitreous (jelly that fills the eye) may be used.
Treatment with anti-TNF medication may be given to people where treatments with corticosteroids or immunosuppressants haven’t worked or if they are causing health problems, and the uveitis is causing worsening of vision.
The way in which your sight may be affected in the long term by intermediate uveitis, posterior uveitis or panuveitis may be due to the direct effects of the uveitis or its complications.
Uveitis affecting the back of your eye tends to heal more slowly so treatment may continue for a longer period of time. How your sight will be affected in the short and long term varies so much among individuals. The length of time it takes for your eye(s) to respond to treatment and how long a flare-up lasts also varies from person to person.
If you have chronic or recurrent uveitis you will usually be under the long-term care of an ophthalmologist and will have regular check-ups in the outpatient clinic.
Uveitis needs to be treated promptly to try to reduce the risk of further problems that might affect your sight. Good control of inflammation can be achieved in most people and this reduces the risk of developing complications. The treatments that are used for uveitis can have side effects (and may need monitoring) but controlling the uveitis properly with treatments will generally give a better outcome for your sight than under-treating and allowing the uveitis to continue.
Some of the complications of uveitis include:
More information about these complications can be found by downloading our full factsheet.
It’s completely natural to be upset when you have been diagnosed with uveitis and it’s normal to find yourself worrying about the future and how you will manage with a change in your vision. We’re here to support you every step of the way, and to answer any questions you may have – just get in touch with our Sight Loss Advice Service.
In whatever way the uveitis has affected your sight, there are lots of things you can do to make the most of your vision.
If uveitis has affected your sight then ask your ophthalmologist, optometrist or GP about low vision aids, like a magnifier, and ask for a referral to your local low vision service. You should also ask whether you are eligible to register as sight impaired (partially sighted) or severely sight impaired (blind). Registration can act as your passport to expert help and sometimes to financial concessions. Even if you aren’t registered a lot of this support is still available to you.
Local social services should also be able to offer you information on staying safe in your home and getting out and about safely. They should also be able to offer you some practical mobility training to give you more confidence when you are out.