Iritis or anterior uveitis

Inflammation of the front compartment of the eye, namely the iris and ciliary body. This is usually characterised by the presence of inflammatory cells in the anterior chamber of the eye. These cells are visible to the ophthalmologist examining a patient through a slit lamp (the microscope used to examine patients’ eyes)

Posterior uveitis

Inflammation in the back part of the eye, namely in the vitreous gel, the retina and/or the choroid. Depending on the exact part of the posterior part of the eye involved, other terms used may include retinitis, choroiditis, pars planitis, intermediate uveitis, retinal vasculitis.

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Pan uveitis

This is a term used to describe inflammation of both the front and the back parts of the eyes, including the optic nerve in some cases.

The medical approach to diagnosing these problems includes several levels:

1. The specialist examines the patient and defines the extent and severity of the eye problem. 2. An attempt is then made to find a cause and look for other health problems which may underlie the eye problem. 3. A decision whether treatment is required, and what treatment to use.

Typically, patients with ocular inflammation undergo a clinical assessment (describing their symptoms and answering relevant medical history questions). This is followed by examination of the eyes and, when relevant, a general medical physical examination. In many, but not all cases, further workup is required including laboratory and imaging tests. The need for such tests is determined by the specialist based on his/her clinical impression.

After conducting a medical assessment and laboratory workup, the specialist may arrive at one of the following conclusions:

1. The condition is limited to the eye and is the result of a specific, treatable problem (for instance, an infection with toxoplasma or a herpes virus) 2. The condition is limited to the eye and is the result of an immune disorder of an unknown cause (for instance, vasculitis of the retina) 3. The condition is part of a systemic problem (involving other organs than the eye), and is the result of a specific, treatable problem (for instance an infection with tuberculosis or the herpes virus) 4. The condition is part of a systemic immune disorder of unknown cause (for instance sarcoidosis, ankylosing spondylitis, Behcet’s disease). While many of these conditions have specific medical names, there is no clear understanding why they occur, and they are treated using similar general principles and similar drugs. However, given their potential effect on other organs, there is often a need for a team of doctors to be involved, most commonly an ophthalmologist and a rheumatologist.

Practically speaking, in many patients who have inflammatory eye diseases such as uveitis or scleritis no cause is found for the problem. In others, the disease is characteristic and has a medical name (for instance, sarcoidosis) and may involve other parts of the body, but there is no understanding why it occurred and what caused it.

This is a very broad question and the answer depends on the type of uveitis, and the cause, if known. Each patient has different problems and needs, and the treatment is decided on based on the individual circumstances.

Treatment may include:

* Local anti inflammatory treatment to the eye/s in the form of eye drops. * Local anti inflammatory treatment to the eye/s in the form of injections to the vicinity of the eye or to the eye. * Oral medications, including corticosteroids (cortisone type drugs) antibiotics, antiviral tablets, and/or drugs which suppress the immune system. * Local medical and surgical treatment of possible eye complications of uveitis, such as cataract, glaucoma or epiretinal membrane.

This is one of the most commonly asked questions, and the answer is far from satisfying. It would be fair to say that, for most of these conditions, there is no understanding of the reason they occur at a given time to a given person. There is therefore not a lot one can do to reduce the chance of a recurrent disease. Changing your diet, exercise patterns, environment, stress levels etc are not known to make a difference.

In the vast majority of cases, the answer is NO. Uveitis may inflict considerable damage on the eye/s and may rarely cause blindness. However, if diagnosed correctly and treated in a timely manner, many of its blinding complications can be avoided or treated and controlled. There is an ever increasing arsenal of drugs and techniques to battle complications of uveitis, such as macular oedema, cataract or glaucoma.

Like with any disease, there is a range of severity, and most patients with uveitis do not have a severe, vision threatening condition. Similarly, in a very small minority of patients, the condition is very severe and even aggressive therapy cannot prevent severe loss of vision. Luckily, most patients at this day and age manage to lead a normal lifestyle, work, study and drive, despite suffering from uveitis and similar conditions.

It certainly may, but in a very unpredictable manner. Some patients have a disease which comes and goes in short-lived episodes (“flare ups”). Others have a chronic disease which is active for many months or years. In both instances, the disease may “run its course” eventually, and become inactive, not requiring any more treatment. The challenge is to protect the eyes from the effects of uveitis and to minimise the damage caused until the disease becomes inactive.