What is Uveitis?
A three layered coat covers the gel – like substance placed at the center of the eye ball. The outer white coat is called Sclera and the inner coat, which enables us to see, is called retina. The uvea is the layer placed at the middle of this 3 layered coat. The inflammation of the uvea is called uveitis. Uvea contains the veins that feed the eye. The inflammation of this part affects all tissues of an eye. Thus, this situation causes issues that seriously threat the vision.
Uveitis is held as a seperate field of practice among the eye diseases. Uveitis is a disease that can only be cured if the patient accepts and understands the disease and if the disease is treated and followed up regularly without any delay.
Manifastation and Reasons
The most important indications are the sensitivity to light, pain, lubor in the eye and the reduction of the visual strenght. Even if there are no motives that cause the disease in most of the cases, viruses, fungi and parasites may cause the uveitis in certain cases. Additionally some diseases (like arthritis, Behcet Syndrome) that occur in other parts of the body may cause the uveitis.
What are the Reasons of Uveitis?
No reasons for uveitis can be diagnosed in 30 – 40 % of the patients. Uveitis can result from factors like viruses, fungi and parasites and as well as it may develop as an indication of another disease in the body. For this reason in uveitis cases, different possible diseases shall be examined and various analyzes shall be conducted. Additionally, the uveitis may be concurrent with systemic diseases. Behcet Syndrome can be given as an example of this type. Yet, each uveitis case does not result from Behcet syndrome.
The other disease that may cause uveitis can be stated as: Infections (bacteria, virus, parasite or fungi) can spread from other parts to the eye (tuberculosis, syphilis, herpes, toxoplazmosis, etc), eye trauma, immune system disease, rheumatismal diseases and ulcerative colitis.
Behcet Syndrome is a disease which was firstly identified by Ord. Prof Dr. Hulusi Behcet in 1937 and which has three main manifestations as cankers in the mouth, uveitis in the eye and scars in the genital organs.
The uveitis is basically a vasculitis which may develop in addition to the eye, in skin, joints, digestive and nervous systems and larger veins. This disease had been resulting in complete blindness in 2 – 3 years when it was not treated in the past. Novadays a success rate of 80 % can be achieved because the disease is understood better now and immunosupressive treatment options (suppressing the immuno system) are variated.
The eye, brain – nervous system and vein involvements in Behcet Syndrome are accepted as vital organ involvement since they affect the life quality of the individual. Especially the Behcet Syndrome in our country poses high significance with regards to its frequency.
How is uveitis diagnosed?
You should visit a ophtalmologist when indications start. Inflammation can cause permenant visual loss. Along with the eye examination, a survey on a systemic disease may be needed in various cases. In such situations, rheumatologists would conduct studies with internal disease specialists.
How is Uveitis Treated?
Especially drops containing steroits and pupil enlarging medicines are frequently used. In inflammations located deeper in the eye, the use of systemic medicines may be required. Various complications like glaucoma, cataract, neovascularizations (generations of new vessels) may occur.
How is Uveitis Diagnosed?
Regardless to its acuteness, veitis is an emergency disease and must be diagnosed without delay. The disease will advance if delayed and may cause permenant disorders like malformation of pupil, cataract and increasing eye pressure.
The diagnosis of certain diseases can be made instantly because of typical appearence. Even in such a situation, if the case is the involvement of the back side of the eye, advanced techniques like angiography, ultrasonography and ERG may be required to understand in what degree the vision is threated and to monitor the effectiveness of the treatment. You should immediately visit an ophtalmologist for examination as soon as the indications start. After the tratment started joint studies of internal diseases department and rheumatology unit may be needed.
What are the inications of Uveitis attack?
When the uveitis is localized at the front side of the eye ball, produces indications like rubor in the eye, blurred vision or reduction in visual strenght, pain at the eye, sensitivity against the light and fuzziness in the inflammation periods. If the inflammation or activation takes place in back side of the eye ball, indications like blurred vision or reduction in the visual strength will occur. In cases where the inflammation takes place in the central area the indication will then be suddent reduction of visual strenght and permenant visual losses occur due to damage of tissues. The inflammations and damages that occur out of the central area cause blurred vision and regardless the fact that they end by leaving sequela lesions, no visual loss occur unless the macula is directly affected.
Uveitis is a curable disease. Even after the completion of the treatment, the patient shall be periodically followed up. Since the disease can relapse the controls shall not be postphoned and examinations on different indications relevant to other organs shall continue. Cankers in the mouth, maculas on the skin can be given as examples of such indications.
The vision can be protected or re -acquired if the uveitis is diagnosed and the treatment is started immediately. The eye can be saved by early diagnosis, correct treatment, frequent and good monitoring and doctor – patient harmony.