Uveitis

Uveitis is an inflammation of the uvea, the middle layer of the eye between the white part and the retina. Many blood vessels that nourish the eye are found in the uvea. The uvea includes the iris, and inflammation of the iris is the most common type of uveitis. Inflammation of the iris is called iritis or anterior uveitis.

Inflammation of the uvea can lead to loss of vision. Getting an early diagnosis and quick treatment can help ensure you do not have permanent vision loss. You should always get conventional medical treatment for uveitis to avoid complications.

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Signs and Symptoms

Uveitis may affect one or both eyes. Signs and symptoms include:

• Eye pain
• Red eye
• Sensitivity to light
• Blurred or decreased vision
• Tearing
• Floaters, dark spots in your vision

What Causes It?

Researchers are not sure what causes uveitis. It can happen suddenly (acute) or long-term (chronic). Uveitis affects men and women equally. It can happen at any age, but most often in the 20s.

Some possible causes of uveitis include injury to the eye, such as chemical exposure; an infection such as toxoplasmosis or herpes; or some cancers. Stuides also suggest certain drugs may contribute to uveitis.

Uveitis is also associated with autoimmune diseases, including Reiter syndrome, multiple sclerosis, juvenile rheumatoid arthritis, Crohn disease, and sarcoidosis.

Who is Most At Risk?

People with the following conditions or characteristics are at risk for uveitis:

• Having an autoimmune disease, such as rheumatoid arthritis or Crohn disease
• Having infections, such as syphilis, tuberculosis, cytomegalovirus, and Lyme disease
• Having other eye diseases
• Cat owners are at increased risk of toxoplasmosis because cat litter contains spores of the parasite. Pregnant women should not change cat litter.
• People who take certain medications, such as rifabutin (Mycobutin), a type of antibiotic

What to Expect at Your Provider's Office

If you have symptoms of uveitis, you should see your doctor right away. Your doctor will do a complete physical exam and check for signs of other diseases, such as joint problems, mouth sores, rash, and nail pitting. Your doctor will also examine your eyes and may order laboratory tests and imaging. Your doctor may refer you to an ophthalmologist, an eye specialist.

Treatment Options

Prevention

Your health care provider can screen for uveitis during a regular eye exam. If you have any underlying conditions, treating them can help prevent uveitis. Avoiding some medications, such as the antibiotic rifabutin, may also help prevent uveitis.

Treatment Plan

You need quick treatment from a doctor to prevent vision damage. Warm compresses may help relieve symptoms. Sunglasses can protect your eyes if they are sensitive to light.

Drug Therapies

Your provider may prescribe the following medications:

• Corticosteroids, to reduce swelling and pain. Your doctor may prescribe either eyedrops or pills.
• Antibiotics or antiviral medications, depending on what is causing your uveitis
• Non-steroidal anti-inflammatory drugs (NSAIDs), to reduce inflammation
• Medications to suppress the immune system, in cases where corticosteroids do not help

Surgical and Other Procedures

You may need surgery to repair any damage to the eyes. Uveitis can cause cataracts, glaucoma, or a detached retina.

Complementary and Alternative Therapies

Uveitis needs conventional medical treatment. DO NOT rely on complementary and alternative therapies (CAM) alone to treat uveitis. Depending on what is causing your uveitis, CAM therapies may help treat an underlying disease. And some herbs and supplements are good for eye health.

Tell your provider about any herbs or supplements you use or plan to use.

Nutrition and Supplements

Eating more antioxidant-rich foods is good for eye health and your overall health. Choose green, leafy vegetables and peppers, and fruits such as blueberries, tomatoes, and cherries.

These supplements may also help:

• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium. These vitamins and minerals are good for eye health and overall health. One small study suggested that vitamin C and E may help reduce symptoms of anterior uveitis. The people in the study took vitamin C (500 mg twice a day) and vitamin E (100 mg twice a day) in addition to standard medical treatment. Vitamin C supplements may interact with other medications, including chemotherapy drugs, estrogen, warfarin (Coumadin), and others. Vitamin E may interact with a number of medications, including blood thinners.
• Omega-3 fatty acids, such as fish oil, may help lower inflammation and boost the immune system. Cold-water fish, such as salmon or halibut, are good sources. Avoid taking omega-3 fatty acids before surgery for uveitis as they may increase the risk of bleeding. Tell your doctor before taking omega-3 fatty acids if you also take blood-thinning medications, such as aspirin, warfarin (Coumadin), or clopidogrel (Plavix).
• Lutein is an antioxidant that is important for eye health.

Herbs

Herbs are a way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting any treatment. If you are being treated for uveitis, tell all of your providers about any herbs you are considering taking.

Turmeric (Curcuma longa): Has antioxidant properties and may help boost the immune system. One small study suggested turmeric may help reduce symptoms of chronic uveitis, but the study was not well designed. Turmeric may increase the risk of bleeding. Ask your doctor before taking turmeric if you also take blood-thinning medication, such as aspirin, warfarin (Coumadin), or clopidogrel.

Homeopathy

Homeopathic remedies have not been studied scientifically for uveitis. An experienced homeopath could consider your individual case and may recommend treatments to help relieve your specific symptoms.

Prognosis/Possible Complications

You stand a good chance of full recovery if your uveitis is diagnosed and treated early. Depending on what is causing your uveitis, you may need short-term or long-term treatment. Possible complications include glaucoma, cataracts, vision loss, and detached retina.

Following Up

Your health care provider may examine your eyes with a slit lamp, which allows a magnified look at small sections of your cornea, iris, and lens. Your provider will also measure the pressure within your eye every 1 to 7 days while your uveitis is active.

A follow-up appointment every 1 to 6 months is generally recommended. Your provider will tell you when you should come back.

Supporting Research

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Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:18;165-166.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr. 2006;25(2):79-99.

Dawczynski J, Winnefeld K, Strobel J. Selenium and zinc in patients with acute and chronic uveitis. Biol Trace Elem Res. 2006 Nov;113(2):131-7.

Dobner BC, Max R, Becker MD, Heinz C, Veltrup I, Heiligenhaus A, Barisani-Asenbauer T, Mackensen F. A three-centre experience with adalimumab for the treatment of non-infectious uveitis. Br J Opthalmol. 2013;97(2):134-8.

Ferri: Ferri Clinical Advisor 2015, 1st ed. Uveitis. Philadelphia, PA: Elsevier Mosby; 2014.

Gaby AR. Nutritional therapies for ocular disorders: Part Three. Altern Med Rev. 2008 Sep;13(3):191-204. Review.

Galor A, Lowder CY, Kaiser PK, Perez VL, Sears JE. Surgical drainage of chronic serous retinal detachment associated with uveitis. Retina. 2008;28(2):282-8.

Gallagher MJ, Yilmaz T, Cervantes-Casteneda RA, Foster CS. The characteristic features of optical coherence tomography in posterior uveitis. Br J Ophthalmol. 2007;91(12):1680-5.

Girardin M, Waschke KA, Seidman EG. A case of acute loss of vision as the presenting symptom of Crohn's disease. Nat Clin Pract Gastroenterol Hepatol. 2007;4(12):695-8.

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Hong MC, Sheu SJ, Wu TT, Chuang CT. Ocular uveitis as the initial presentation of syphilis. J Chin Med Assoc. 2007;70(7):274-80.

Lal B, Kapoor AK, Asthana OP, et al. Efficacy of curcumin in the management of chronic anterior uveitis. Phytother Res. 1999;13:318-22.

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Maheshwari RK, Singh AK, Gaddipati J, Srimal RC. Multiple biological activities of curcumin: a short review. Life Sci. 2006;78(18):2081-7.

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van Rooij J, Schwartzenberg SG, Mulder PG, Baarsma SG. Oral vitamins C and E as additional treatment in patients with acute anterior uveitis: A randomised double masked study in 145 patients. Br J Ophthalmol. 1999 Nov;83(11):1277-82.

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Review Date: 1/5/2015  

Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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