Uveitis: Types, Causes, Symptoms, Diagnosis, and Treatment

Uveitis is an eye inflammation that occurs due to an infection or an autoimmune disease. The types of uveitis are anterior uveitis, intermediate uveitis, posterior uveitis and panuveitis, which affect different regions of the eye. Symptoms of uveitis can occur suddenly and typically include redness in the eye that can either come with or without pain, severe sensitivity to light, floaters and blurry vision. Uveitis treatments may involve prescription eye drops which are typically the first line of treatment as well as steroid pills and steroid injections.

What is Uveitis?

Uveitis refers to the inflammation of the eye and can present symptoms such as redness, eye pain, severe sensitivity to light, floaters and blurry vision. The main causes of uveitis may be from autoimmune diseases and infections. However, it may be too difficult for doctors to know the direct cause of uveitis according to the National Eye Institute. Uveitis harms the region of the eye known as the uvea as well as other parts of the eye and can affect one or both eyes.

What Parts of the Eye Does Uveitis Affect?

Uveitis affects the iris, the retina, the choroid, the ciliary body, the vitreous, as well as other parts of the eye depending on the type of uveitis. Anterior uveitis affects the iris, and posterior uveitis affects the retina and choroid, causing inflammation behind the eye. Intermediate uveitis affects the ciliary body and vitreous and panuveitis affects all parts of the eye according to the National Eye Institute.

Diagram of the uvea, where uveitis occurs

What Does Uveitis Look Like?

Uveitis may look different depending on how mild or severe the condition is. However, people with uveitis can typically have swollen, red and inflamed eyes according to Cleveland Clinic. The image below demonstrates what an eye may look like when affected by uveitis.

Is Uveitis and Eye Inflammation the Same?

Yes and no, uveitis causes eye inflammation, however, eye inflammation may not always be an inherent result of uveitis. Eye inflammation can be a symptom of other eye conditions and problems such as conjunctivitis, keratitis, thyroid eye disease, hayfever, other eye infections and eye injuries.

What are the Different Types of Uveitis?

The different types of uveitis are anterior uveitis, posterior uveitis, intermediate uveitis and panuveitis, which are distinct from each other based on where the inflammation occurs. The list of the different types of uveitis and their definitions are listed below.

Anterior Uveitis: Anterior uveitis is the most common form of uveitis that develops in the iris and can be caused by various types of diseases and from injury or trauma to the eye.
Posterior Uveitis: Posterior uveitis is a rare form of uveitis that affects the retina and choroid and can cause loss of vision, floaters and flashing lights.
Intermediate Uveitis: Intermediate uveitis is a type of inflammation that develops in the vitreous and ciliary body.
Panuveitis Uveitis: Panuveitis uveitis is a type of uveitis that causes inflammation of the whole uveal tract as well as the retina and vitreous.

1. Anterior Uveitis

Anterior uveitis is the most common type of uveitis that affects the iris at the front of the eye. Anterior uveitis can be caused by viral infections and injuries and is typically categorised as mild uveitis according to the National Eye Institute. This form of uveitis may present symptoms such as redness, pain, inflammation, blurred vision and light sensitivity.

2. Posterior Uveitis

Posterior uveitis causes inflammation of the retinal vessels located at the back of the eye and is often associated with permanent vision loss. Posterior uveitis is considered to be a rare form of uveitis that can lead to declined visual acuity, floaters, sensitivity to light, loss of vision or blurred vision. It can also cause poor night vision and difficulty seeing colour according to the National Organisation for Rare Disorders. According to the Kellog Eye Centre, systemic conditions are likely the most common cause of developing posterior uveitis. Systemic conditions are conditions that affect the whole body rather than just one organ according to MedlinePlus.

3. Intermediate Uveitis

Intermediate uveitis which is also referred to as cyclitis or vitritis is the occurrence of inflammation in the vitreous and ciliary body. Intermediate uveitis, according to the Orphanet Journal of Rare Disorders, was mainly found in patients with no direct cause. Other patients with intermediate uveitis were diagnosed with multiple sclerosis, sarcoidosis, infectious diseases and an abnormal immune system-related condition. Symptoms can be minimal and include floaters and blurry vision according to the National Library of Medicine.

4. Panuveitis Uveitis

Panuveitis uveitis is when the entire uveal tract as well as the vitreous and the retina are inflamed. Panuveitis occurs in the eye’s middle layer and can lead to loss of vision or reduced vision and can also include symptoms such as pain, redness, blurred vision, sensitivity to light and floaters. According to the National Centre for Advancing Translational Sciences, on many occasions, the cause for panuveitis is often unable to be determined. However, in some circumstances, panuveitis has occurred in relation to other eye conditions or infections that implicate other parts of the body.

What Causes Eye Inflammation to Develop?

The common causes of eye inflammation can include autoimmune diseases, keratitis, conjunctivitis and eye injuries. It is important to note that eye inflammation can arise as a consequence of conditions other than uveitis. The main uveitis cause is commonly found to be from autoimmune diseases. The possible causes of eye inflammation are listed below.

Autoimmune Diseases: Autoimmune diseases such as thyroid eye disease, rheumatoid arthritis and multiple sclerosis can lead to complications in the body including eye inflammation. Autoimmune diseases can trigger several symptoms in different parts of the body which often implicate the eyes. Being positive for the HLA-B27 protein on the white blood cells increases the risks of having autoimmune diseases and also increases the likelihood of recurrent uveitis. An optometrist will likely ask patients about this as it is an important indication. However, if the patient has not previously had uveitis, a blood test with a GP will be requested.
Keratitis: Keratitis is the inflammation of the cornea, which is the clear dome-shaped tissue that covers the front of the eye. Keratitis can cause symptoms of pain, redness, watery eyes, discharge, blurry vision and difficulty opening your eyes due to the pain. Causes of keratitis can include viruses, bacteria and fungi.
Conjunctivitis: Conjunctivitis can cause eye inflammation due to the small blood vessels located in the conjunctiva becoming irritated and swelling up. Eye inflammation is typically the body’s natural response to bacterial or viral infections and allergic reactions.
Eye Injuries: Eye injuries can also prompt inflammation in the eye as part of the healing process that automatically takes place in response to injury. The first stage of inflammation often leads to redness and swelling.

How Common is Uveitis?

Uveitis may not be common in Australia. According to the Centre for Eye Research Australia, uveitis affects up to 20 people per 100,000 in Australia each year.

Who Commonly Develops Uveitis?

People who are young to middle-aged can commonly develop uveitis according to Lions Eye Institute. Other people who commonly develop uveitis are those with the HLA-B27 positive protein on their white blood cells.

Is Uveitis a Common Eye Problem?

No, uveitis is not a common problem, it is considered to be a rare eye disease according to UT Southwestern Medical Centre. While uveitis is not classed as a common eye problem, it can be successfully treated and managed with steroid medication and easily detected through a comprehensive eye exam.

What are the Symptoms of Uveitis?

The possible symptoms of uveitis can include eye floaters, blurry vision, red eyes, eye pain, loss of vision and sensitivity to light. This section will explore the different uveitis symptoms, which are also common symptoms of other eye conditions. Therefore, it is important to let your optometrist know when you experience changes to your vision. The symptoms of uveitis are listed below.

Eye Floaters: Eye floaters can occur as a result of uveitis due to inflammatory cells in the vitreous gel of the eye and typically occur in both eyes.
Blurry Vision: Blurry vision can be a symptom of uveitis and can be described as having unclear vision or vision that is not sharp.
Red Eyes: Red eyes can occur as a symptom of uveitis as a result of inflammation.
Eye Pain: Eye pain can arise during uveitis in conjunction with redness as a consequence of the inflammation.
Loss of Vision: Loss of vision can likely occur as a result of recurrent episodes of uveitis and can occur temporarily, lasting from weeks to years.
Sensitivity to Bright Light: Sensitivity to bright light can occur as the inflammation that takes place can often leave the eyes tender and extra sensitive to external stimuli. The inflammation in Uveitis can also affect and slow down the normal pupillary reactions which leads to poor regulation of the amount of light getting into the eye which causes more sensitivity to light.

1. Eye Floaters

Eye floaters are a common symptom of uveitis due to the inflammatory cells in the vitreous of the eye according to the Royal National Institute of Blind People. Eye floaters are characterised as black dots or shapes and squiggly and wispy lines that move across your vision and typically appear in both eyes. The vitreous is the gel-like fluid that fills the eye in between the eye’s retina and lens.

2. Blurry Vision

Blurry vision can be a symptom of uveitis and can be characterised as vision that is out of focus and lacks sharpness and clarity. Blurry vision can be a common symptom of other serious eye conditions. Therefore, it is important to see an optometrist if you are experiencing blurred vision especially if it occurs suddenly.

3. Red Eyes

Red eyes may occur as a symptom of uveitis as a result of the inflammation that takes place. Red eyes may develop along with pain as the middle layer of the eye becomes inflamed in response to an infection or autoimmune disease.

4. Eye Pain

Eye pain can be experienced during uveitis as when the inflammation occurs it can feel like a dull ache in and around the eye according to the National Health Service. Eye pain that is caused by uveitis may likely occur along with redness, which are also common signs of many other eye conditions. Therefore, it is recommended to see an optometrist so they can determine what is causing the pain.

5. Loss of Vision

Loss of vision can occur temporarily as a symptom of uveitis and can last from weeks to years according to the National Library of Medicine. Loss of vision from uveitis can lead to severe vision impairment, however, this likely occurs after several episodes of uveitis as opposed to just one episode according to Durrani, O M, Tehrani, N N. and Marr, J E. et al. in their 2004 study on Degree, Duration, and Causes of Visual Loss in Uveitis.

6. Sensitivity to Bright Light

Sensitivity to bright light may be induced by uveitis as the inflammation that occurs can leave the eyes tender and extra sensitive to external stimuli. Sensitivity to light may also arise due to the impact of inflammation from uveitis on pupillary reactions, which refers to the constriction of the pupils in response to light. Light sensitivity as a result of uveitis can result in pain and/or headaches when eyes are exposed to bright light.

Girl holding up hand to block sun from irritating eyes

How Do Eye Doctors Diagnose Uveitis?

Eye doctors may diagnose uveitis by carrying out a series of tests that can help assess the condition of different parts of the eye. These tests may include a tonometry test, slit-lamp examination, dilated eye exam and a visual acuity test.

What are the Eye Tests for Diagnosing Uveitis?

The eye tests for diagnosing uveitis can include a tonometry (ocular pressure) test, a visual acuity test, a dilated eye exam and a slit-lamp exam. The eye tests for diagnosing uveitis are listed below.

Tonometry (Ocular Pressure) Test: A tonometry test is an eye test used to diagnose uveitis as it can measure the pressure in your eyes.
Visual Acuity Test: Visual acuity tests can help with assessing whether you have any refractive errors which help confirm signs of uveitis.
Dilated Eye Exam: A dilated eye exam can help with detecting uveitis by letting more light into the eye to check the condition of structures further in the eye.
Slit-Lamp Exam: A slit-lamp exam involves a microscope that can help enlarge and allow more light onto the front of the eye. This helps the optometrist further examine the front and back of the eye.

1. Tonometry (Ocular Pressure Test)

A tonometry (ocular pressure test) may be used when diagnosing uveitis to measure how much pressure is in the eye. Measuring ocular pressure is important as high pressure in the eye can cause damage to the optic nerve.

2. Visual Acuity Test

Visual acuity tests can help detect uveitis by assessing the sharpness and clarity of a patient’s vision. A visual acuity test helps eye care professionals determine a patient’s ability to distinguish between different letters from a certain distance.

3. Dilated Eye Exam

Dilated eye exams help with detecting uveitis by enabling a closer examination of the eye. A dilated eye exam can evaluate the condition of the retina and optic nerve which helps to detect different forms of eye conditions.

4. Slit-Lamp Exam

Slit-Lamp exams allow the optometrist to check each eye for inflammation caused by uveitis. The slit-lamp exam will be able to identify inflammatory cells in the front of the eye according to Mayo Clinic.

How Long Does it Take to Diagnose Uveitis?

It may not take long to see the results when diagnosing uveitis as it can be detected through a comprehensive eye exam. It may take around 20 minutes to identify signs of uveitis, however, this can vary depending on the nature of each eye test and the complexity of the eye condition.

What are the Other Eye Tests Used To Diagnose Uveitis?

The other tests used to diagnose uveitis can involve colour photography, fluorescein angiography, optical coherence tomography, and analysis of aqueous and vitreous humor. The other eye tests used to diagnose uveitis are listed below.

Colour Photography: Colour photography also known as retinal imaging can help diagnose uveitis as it is intended for the detection of inflammatory diseases according to Science Direct.
Fluorescein Angiography: Fluorescein Angiography may be recommended to diagnose uveitis as it can examine the retina and choroid, which is the region in which posterior uveitis occurs.
Optical Coherence Tomography: Optical coherence tomography is another test that can be used to diagnose uveitis by identifying any ocular swelling. According to the National Library of Medicine, optical coherence tomography is a non-invasive way to detect anterior uveitis as well as its accompanying complications.
Analysis of Aqueous and Vitreous Humor: Analysis of aqueous and vitreous humor may be another non-invasive option to diagnose uveitis according to the National Library of Medicine. The aqueous humor fills the anterior and posterior chambers at the front of the lens and aids with nourishing the eye and maintaining its shape. The vitreous humor is located behind the lens, in front of the retina and also aids with maintaining the eye’s shape according to the National Institutes of Health.

Is Uveitis an Emergency?

Yes and no. Uveitis can be a serious condition that needs medical treatment if a patient is experiencing sudden eye pain and redness. However, pain may not always occur with uveitis and symptoms can also go unnoticed according to the Royal National Institute of Blind People. Therefore, some cases of uveitis can be considered mild and do not require urgent medical care. However, it is important to go to an optometrist if you do notice any changes to your vision such as blurriness or floaters. Early detection and treatment can aid in the prevention of severe symptoms or further complications.

What are the Treatments For Uveitis or Eye Inflammation?

The treatments for uveitis or eye inflammation can include eye drops, tablets, injections and treatment of underlying conditions. The possible treatments for uveitis are listed below.

Eye Drops: Eye drops, particularly steroid eye drops, may be used to treat uveitis or eye inflammation to alleviate pain as they can relax the muscles in the eye or reduce swelling.
Tablets: Tablets containing steroids may be a helpful form of treatment for uveitis as they can effectively relieve inflammation by suppressing the immune system according to the National Health Service.
Injections: Injections containing steroids may be inserted in or around the eye for direct treatment of uveitis according to the National Eye Institute.
Treatment of Underlying Conditions: Treatment of underlying conditions such as certain autoimmune diseases may assist with treating uveitis and eye inflammation. A medical professional will be able to address any possible conditions causing uveitis first before initiating other forms of treatment.

What Might Happen if Uveitis is Left Untreated?

Uveitis may lead to loss of vision and further complications in the eye if left untreated. Treating uveitis as early as possible may help prevent severe conditions such as glaucoma and cataracts which can develop due to prolonged inflammation according to the National Health Service.

Can Uveitis be Treated at Home?

No, uveitis cannot be treated at home as it requires prescribed medication from an eye care professional. You may likely be referred to an ophthalmologist for further examination and treatment of uveitis according to Better Health.

Do You Need Eye Surgery to Treat Uveitis?

No, eye surgery is rarely needed to treat uveitis unless a patient is experiencing severe or chronic uveitis. The eye surgery for uveitis is known as a vitrectomy and involves removing either a portion or all of the vitreous humor according to the National Health Service.

Can Uveitis be Treated Permanently?

No, uveitis cannot be treated permanently as it can still reoccur according to the Mayo Clinic. However, steroid medication is considered effective for uveitis treatment.

What are the Complications of Uveitis?

The complications of uveitis can include glaucoma, cataracts, posterior synechiae, epiretinal membrane, cystoid macular edema and band keratopathy. It is important to note that these different eye conditions may likely require management and treatment carried out by an ophthalmologist due to their complex nature. The possible complications of uveitis are listed below.

Glaucoma: Glaucoma may be a complication of uveitis as a result of prolonged inflammation in the eye. Glaucoma may also occur as a result of using anti-inflammatory and steroid medication for uveitis treatment according to Adam Duplechain, Christopher, D. Conrady and Bhupendra, C. Patel et al (2023). Topical anti-inflammatory and steroid treatment can cause increased eye pressure, therefore it is important for the ophthalmologist to monitor a patient’s ocular condition following uveitis treatment.
Cataracts: Cataracts can also develop as a complication of uveitis due to sustained ocular pressure as well as from the use of topical steroid medication. Cataracts can present symptoms such as blurry or cloudy vision, light sensitivity, poor night vision and halos or streaks around lights according to the Cleveland Clinic.
Posterior Synechiae: Posterior synechiae are characterised as adhesions that form between neighbouring structures in the eye and can occur due to increased inflammation in the eye. Posterior synechiae is one of the two types of ocular synechiae and refers to the occurrence of the iris sticking to the lens. Symptoms may include changes to the shape or size of the iris or pupil, eye pain, light sensitivity, redness, loss of vision and watery eyes according to the Cleveland Clinic. Early diagnosis and treatment of ocular synechiae can aid in preventing irreparable damage and loss of vision.
Epiretinal Membrane: Epiretinal membrane is a common complication of uveitis and can lead to visual acuity loss, distortion of object shapes and distortion of object sizes. Epiretinal membrane is the formation of a thin layer of tissue commonly on the macula, which causes the retina to wrinkle according to the Macular Disease Foundation. Epiretinal membrane, also known as macular pucker can present symptoms such as loss of vision, difficulty seeing or reading small details and small print and the wavy appearance of straight lines.
Cystoid Macular Edema: Cystoid Macular Edema occurs when the macula swells up with fluid, which is a condition known as edema, which can result in the edema fluid forming cyst-like patterns. Cystoid macular edema can be caused by inflammation in the eye and may not cause any symptoms. However, possible symptoms can include blurred or wavy vision around the middle section of view according to the Cleveland Clinic.
Band Keratopathy: Band keratopathy is defined as the slow development of a white opacity of the superficial cornea according to ScienceDirect. Band keratopathy can be a complication of uveitis and can lead to symptoms such as reduced visual acuity, eye irritation and discomfort. Treatment of this condition may involve a non-invasive surgical process known as superficial debridement according to ScienceDirect.

How to Prevent Uveitis?

You cannot prevent uveitis as the cause is often too difficult to determine and most patient cases of uveitis conclude without identifying a cause according to Better Health.

Can Eyeglasses Help Prevent Uveitis?

No, eyeglasses may not help prevent uveitis as this condition can either develop without a particular cause or due to autoimmune diseases. Therefore, it is strongly recommended to maintain regular eye tests at least once every two years for most young and healthy individuals. However, for older aged individuals, it is recommended to get eye tests once every one or two years.

How Does the Level of Pain in Uveitis vs Dry Eye Compare?

The level of pain in uveitis can be characterised by a dull ache in or around the eye. Eye pain from uveitis can be exacerbated when focusing your eyes. The level of pain from eye dryness is typically described as sore and gritty according to Healthdirect. Therefore, pain from uveitis may be more significant. However, it is important to note that the severity or cause of uveitis and dry eye may affect the level of pain and experiencing this symptom can differ between individuals.