Diagnosis of Uveitis
The diagnosis of uveitis is based on the patient's medical history and examination findings. Accordingly, a targeted laboratory investigation is performed, which usually includes blood tests, chest X-rays, and a protein derivative skin test (PPD), which assists in diagnosing tuberculosis and sarcoidosis.
Complications of Uveitis
Many cases of uveitis resolve without complications. However, a significant portion of patients may develop chronic disease that can cause structural damage in the eye, leading to severe vision loss. The main reasons for visual impairment in uveitis are glaucoma (increased intraocular pressure), cataracts, and macular edema (swelling of the central part of the retina).
In children with chronic uveitis, a condition called band keratopathy often occurs, which results from the deposition of calcium salts on the cornea.
It is important to note that with the advancements in diagnostic tools and treatments for uveitis, maintaining good vision is achievable in many cases.
Treatment of Uveitis
Appropriate treatment for uveitis depends on the severity and type of the disease, as untreated uveitis can lead to irreversible vision damage. The mainstay of treatment usually involves using steroid eye drops to reduce inflammation. This treatment is generally effective for anterior uveitis, but long-term use may come with side effects. Side effects of prolonged steroid eye drop use may include increased intraocular pressure, glaucoma, cataracts, and secondary infections. Therefore, the treatment with steroid eye drops should be monitored by an eye specialist and administered according to their instructions.
In some cases, eye drops for dilating the pupil may be added to prevent adhesions of the iris and alleviate pain. These drops cause transient blurring of vision, especially for near vision.
For more severe or internal forms of uveitis, steroid injections may be necessary, either around the eye or through oral administration (prednisone). Oral steroid treatment is generally effective but comes with potential side effects. Side effects of oral steroid treatment depend on the dosage and duration of the treatment and can include various systemic effects. For any oral steroid treatment lasting more than a week, it is crucial to consult the family doctor.
In more challenging or refractory cases of uveitis that do not respond well to steroid treatment or when the goal is to minimize the side effects associated with prolonged high-dose oral steroids, non-steroidal anti-inflammatory drugs (NSAIDs) may be added to the treatment. One group of these drugs is the immunomodulatory agents, which are used at much lower doses than traditional steroids. These drugs have been used for many years, and they are highly effective and relatively safe. Regular blood tests should be conducted during the use of these agents, as directed by the treating eye specialist.
Another group of drugs belonging to the biological agents includes rituximab and Humira. Even with these treatments, it is important to keep the family doctor informed about the treatment.
Uveitis Clinic
The Uveitis Clinic deals with inflammatory eye diseases (uveitis) and diagnoses the disease through tailored tests, including comprehensive blood tests, X-rays, specific tests, and eye imaging. In cases requiring it, biopsies from the eye or other body tissues may be taken. After the diagnosis of the disease and its cause, the most appropriate treatment is determined, with collaboration between different departments in the hospital, as needed.
Treatment is tailored to the type of uveitis and may include various eye drops, periocular injections (around the eye), intraocular injections (into the vitreous), and oral treatments. Treatment may cause ocular and/or systemic side effects, so regular eye examinations before and during treatment are essential, along with long-term follow-up. Surgical treatments may include cataract removal, glaucoma surgeries, and retinal surgeries when necessary.