Uveitis guide for primary health practitioners

Uveitis refers to inflammation of the middle layer of the eye, which is called the uvea (or uveal tract). The condition can be caused by a number of infections but is often primarily an autoimmune phenomenon. Uveitis and can sometimes result in secondary ocular complications, including cataract and glaucoma. However, most cases recover well with treatment. Early diagnosis of uveitis is very important, as the sooner the condition is treated, the more successful the outcome is likely to be.

Uveitis symptoms

A patient with uveitis can present with any of these symptoms:

• Red, painful eye (could be a dull ache around the eye)
• Cloudy vision, photophobia
• Floaters, flashes

Diagnostic considerations

• Symptoms: onset, source and laterality of the inflammation
• Medical history: previous eye problems or systemic diseases
• Medication: consider the possibility of drug-induced uveitis

The course of uveitis could be linked to some of the contributing systemic conditions. For example, endophthalmitis, posner-schlossman syndrome and toxoplasmosis are associated with an acute onset. Juvenile idiopathic arthritis, sarcoidosis, tuberculosis, and syphilis could lead to chronic uveitis. Viral and seronegative arthritis-associated anterior uveitis is usually recurrent.

Physical examination

When examining the patient, it is important to establish the primary site of inflammation which helps to classify the uveitis into:

• Anterior uveitis - the bulk of the inflammation is anterior to the lens. It’s the most common type.
• Intermediate uveitis - the bulk of the inflammation is between the lens and retina. It tends to occur in children, teenagers and young adults.
• Posterior uveitis - the bulk of inflammation is confined to the retina or choroid.
• Panuveitis - all segments of the eye are equally inflamed.

Other things to look for include presence of visible iris granulomas and keratic precipitates. Abnormal iris patterns with increased intraocular pressure are frequent in viral uveitis.

Uveitis treatment options

The treatment for uveitis depends on the type of uveitis and cause of the condition. Frequently, an underlying cause cannot be found, and the treatment of the eye disease depends on the severity and tempo of the inflammation.

The most common uveitis treatment is corticosteroid eyedrops, but severe anterior uveitis and most forms of non-infectious posterior uveitis may require treatment with systemic medication in the form of tablets or injections. In certain circumstances, an injection around or into the eye may be of benefit.

In some cases, additional treatment may be required such as eye drops to relieve any pain or dilate the pupil. In rare instances, surgery may be required, particularly if cataract or glaucoma develops.

Our experts are well versed in the treatments that exist for this condition and will be able to fully discuss the therapeutic option that is most suited to the type and severity of uveitis that your patient has.

Uveitis treatment at Moorfields Private: choosing the best for your patients

Referring your patients with suspected uveitis to Moorfields Private, you can be confident they would be treated by some of the country’s top uveitis specialists with years of experience nationally and internationally in the clinical and research spheres.

All our ophthalmic surgeons hold accredited consultant positions with the Moorfields Eye Hospital NHS Foundation Trust.

Moorfields Private’s financial surplus is invested back into Moorfields Eye Hospital NHS Trust to advance excellence in eye care.