Uveitis, Iritis & Intraocular Inflammation
Inflammation of the middle vascular tunic of the eye (iris, ciliary body, and choroid), frequently linked to systemic autoimmune or infectious diseases.
Article Table of Contents
1. Comprehensive Overview
Uveitis is intraocular inflammation of the uveal tract (iris, ciliary body, and choroid), a major cause of preventable visual impairment.
Standardized Anatomical Classification (SUN Criteria): 1. Anterior Uveitis (Iritis / Iridocyclitis): The most prevalent form (~75%). Involves the iris and anterior ciliary body. Characterized by circumcorneal ciliary flush, anterior chamber inflammatory cells and flare, keratic precipitates (KPs) on the endothelium, and pupillary miosis. Highly correlated with HLA-B27 spondyloarthropathies. 2. Intermediate Uveitis (Pars Planitis / Vitritis): Primary inflammation of the vitreous humor and pars plana; presents with dense vitreous floaters, 'snowballs' and 'snowbanks', and secondary cystoid macular edema (CME). 3. Posterior Uveitis (Choroiditis / Retinitis): Focal, multifocal, or diffuse inflammation of the choroid and retina, frequently infectious (Toxoplasmosis, CMV, TB, Syphilis) or autoimmune (Behçet's disease, VKH). 4. Panuveitis: Generalized inflammation involving anterior chamber, vitreous, and retina/choroid simultaneously.
2. Symptoms & Warning Signs
If you observe any of the following symptoms repeatedly, an eye exam is strongly recommended:
- Deep, throbbing, dull ocular ache exacerbated by accommodation and light
- Marked circumcorneal ciliary injection (perilimbal flush)
- Severe photophobia and painful consensual light sensitivity
- Decreased visual acuity and optical blurring
- Sudden emergence of dense vitreous floaters and haze
- Irregular, non-reactive pupil contour caused by inflammatory posterior synechiae adhering the iris to the crystalline lens
3. Causes & Risk Factors
- 1HLA-B27 associated autoimmune spondyloarthropathies (Ankylosing Spondylitis, Reactive Arthritis, Psoriatic Arthritis, IBD)
- 2Systemic vasculitis and granulomatous disorders (Behçet's disease, Sarcoidosis, VKH)
- 3Infectious pathogens (Toxoplasma gondii, Tuberculosis, Syphilis, HSV, VZV, Cytomegalovirus)
- 4Ocular trauma, surgical entry, or lens-induced uveitis
- 5Sympathetic Ophthalmia following penetrating trauma to the contralateral fellow eye
4. Treatments & Medical Management
5. Prevention & Daily Eye Care Advice
- Collaborative systemic management with a rheumatologist to maintain autoimmune remission
- Strict, gradual tapering of topical or systemic corticosteroids to prevent rebound uveitic flare-ups
- Immediate emergency ophthalmology visit at the earliest sensation of ocular redness or photophobia in patients with Behçet's or HLA-B27 conditions
6. When to Seek Emergency Eye Care
Visit an immediate eye emergency center if you experience any of the following critical indicators:
- ⚠Sudden severe ocular ache accompanied by redness and extreme photophobia
- ⚠Irregular, distorted, or constricted pupil shape
- ⚠Abrupt visual blurring, cloudy vision, or sudden showers of dark floaters
- ⚠Recurrent red eyes in a patient with inflammatory back pain, arthritis, or aphthous oral ulcers
7. Frequently Asked Questions
Q:Why do ophthalmologists prescribe dilating drops for iritis?
Cycloplegic drops accomplish two critical goals: they relax the inflamed ciliary muscle, providing immediate pain relief, and dilate the pupil away from the crystalline lens, preventing irreversible posterior synechiae formation.