How to avoid uveitis

Uveitis mainly occurs in the 20-50 age group, and can affect one or both eyes. Most patients are in the most active period of their working life while contracting this condition. In half the patients, the age of onset is in the third or fourth decade of life. This age distribution can have a damaging socio-economic impact on patients.

Uveitis can cause devastating visual loss and is the fifth commonest cause of visual loss in the developed world, accounting for 10-15 per cent of the cases of total blindness and up to 20 per cent of legal blindness. Vision loss arises from cumulative damage to ocular tissues that result from recurrent or chronic inflammation rather than from an isolated attack of an acute inflammatory episode. Therefore, control of inflammation in non-infectious uveitis is critical to prevent vision loss.

Treatment strategies

There is no permanent cure for uveitis, and there are many different types of uveitis, with a great deal of variation between individual cases. This means that  treatment will vary, depending upon the cause, severity and location of the inflammation. Drugs used for treatment are mostly of three kinds:

- Eye drops to help dilate the pupil and temporarily paralyse the sphincter muscles to relieve pain

- Steroids to control the inflammation that can be administered as drops, injections or oral tablets.

- Immunosuppressive drugs that target the immune system more precisely than steroids.  
Complications of uveitis

Patients with uveitis can develop complications like cataract, glaucoma, raised intraocular pressure (pressure of the eye, similar to blood pressure) and macular edema (fluid accumulation in the central part of the retina). This can lead to reduced vision. Such complications can be managed medically or surgically once the inflammation is controlled.

Uveitis can lead to loss of vision if not managed properly. However, with modern diagnostic methods, better medication and surgical techniques, the prognosis for most patients is very good. It is critical that the disease is identified early and treated properly. It is also important for uveitis patients to get their eyes checked periodically.

While corticosteroids are the mainstay of therapy in an acute attack of uveitis, locally-sustained release devices and specific immunomodulatory agents are the future for better management of ocular inflammatory diseases.
 

(The author is Head — Cornea and Anterior Segment, Ocular Immunology and Uveitis Service, L V Prasad Eye Institute)