Uveitis is inflammation inside the eye. The name refers to the uvea — the pigmented middle layer comprising the iris, ciliary body and choroid — though inflammation frequently involves the retina, the vitreous and the optic nerve as well.

It is uncommon relative to other eye conditions but accounts for a meaningful share of preventable vision loss, largely because it can be persistent, can recur, and can cause damage between episodes if it is not managed closely.

Wendy Huang, MD provides uveitis care at Retina Macula Institute of Arizona, having completed fellowship training in uveitis and cornea in addition to her earlier training in pediatric ophthalmology.

Symptoms vary with which part of the eye is inflamed, and this variation is why uveitis is sometimes mistaken for other conditions.

• Eye pain and marked sensitivity to light, more typical of inflammation at the front of the eye
• Redness, often concentrated in a ring around the cornea
• Blurred vision or a general haze
• Floaters, sometimes numerous, more typical of inflammation toward the back
• Reduced vision without redness or pain, which is common in posterior uveitis

Inflammation at the back of the eye can be entirely painless and produce a quiet, white eye, so the absence of redness or discomfort does not exclude uveitis. Some forms — notably those associated with juvenile arthritis in children — may cause no symptoms at all and are found only on screening examination.

Uveitis has many causes, and identifying which applies is central to treating it correctly.

• Autoimmune and inflammatory conditions — including ankylosing spondylitis, sarcoidosis, inflammatory bowel disease, juvenile idiopathic arthritis, multiple sclerosis and Behçet disease.
• Infection — including herpes viruses, toxoplasmosis, tuberculosis, syphilis and Lyme disease.
• Trauma or prior eye surgery.
• Idiopathic uveitis — in a substantial proportion of patients no underlying cause is identified despite thorough investigation, and this does not prevent effective treatment.

The distinction between inflammatory and infectious causes is critical, because the corticosteroid treatment that helps autoimmune uveitis can worsen an untreated infection considerably. This is the principal reason uveitis is investigated before it is treated aggressively.

Assessment begins with a detailed history and a careful examination that classifies where the inflammation sits — anterior, intermediate, posterior or diffuse — and grades its activity. That classification directs everything that follows.

Imaging typically includes optical coherence tomography to detect macular swelling, which is the most common way uveitis reduces vision, and fluorescein angiography to identify vascular leakage and inflammation of retinal vessels.

Targeted laboratory testing and sometimes chest imaging are ordered based on the pattern of inflammation and the history. Testing is directed rather than broad; indiscriminate panels tend to produce misleading results. Coordination with rheumatology, infectious disease or your primary care physician is common where a systemic condition is identified.

Treatment aims to suppress inflammation, relieve symptoms and prevent the structural damage that repeated or persistent inflammation causes.

• Corticosteroid eye drops for anterior uveitis, often frequently at first and then tapered gradually.
• Dilating drops to relieve the spasm that causes pain and to prevent the iris from adhering to the lens.
• Corticosteroid injections or implants around or inside the eye for inflammation at the back, where drops do not penetrate adequately.
• Oral corticosteroids for more severe or bilateral disease.
• Steroid-sparing immunomodulatory therapy — including methotrexate, mycophenolate and biologic agents — for chronic uveitis, to control inflammation while limiting long-term steroid exposure. These are usually co-managed with a rheumatologist.
• Antimicrobial treatment where an infectious cause is identified, sometimes alongside careful steroid use.

Tapering is done gradually and under supervision, because stopping treatment abruptly is a common cause of relapse.

Many patients experience uveitis as a chronic or relapsing condition rather than a single episode. Practical management matters as much as medication:

• Keep to follow-up appointments even when the eye feels normal — inflammation and raised eye pressure can be present without symptoms.
• Report a recurrence of pain, light sensitivity, redness or blurring promptly; early treatment of a flare is more straightforward than treating an established one.
• Attend monitoring for the side effects of treatment, including eye pressure checks and cataract assessment during steroid use, and any blood tests required for immunomodulatory therapy.
• Tell other treating physicians about the diagnosis, particularly before steroids are prescribed for another condition.

Complications including glaucoma, cataract and macular swelling are largely manageable when detected early, which is what regular review is for.

Uveitis care in Scottsdale

Wendy Huang, MD is accepting new patients for uveitis and ocular inflammatory disease at our Scottsdale location. Call (602) 613-5473 or contact our office to arrange an evaluation.