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Ocular Inflammation and Immunology

Ocular Inflammation and Immunology - What it is

Ocular Inflammation is inflammation of the uvea, the middle layer of your eye. The eye is shaped much like a tennis ball, with three different layers of tissue surrounding a central gel-filled cavity.
The innermost layer is the retina, which senses light and helps to send images to your brain. The middle layer between the sclera and retina is called the uvea. The outermost layer is the sclera, the strong white wall of the eye.


What is the importance of the uvea?
The uvea contains many blood vessels – veins and arteries that carry blood flow to the eye. Since it nourishes many important parts of the eye (such as the retina), inflammation of the uvea can damage your sight.

Are there different types of ocular inflammation?
A simple way for classifying types of ocular inflammation is according to the affected part of the eye:

  • Episcleritis /Scleritis
  • Anterior uveitis (also known as iritis or iridocyclitis)
  • Intermediate uveitis (including pars planitis)
  • Posterior uveitis (including retinitis, choroiditis, chorioretinitis and neuroretinitis)
  • Panuveitis (when the whole eye is inflamed from anterior to posterior aspect) 

Ocular Inflammation and Immunology - Symptoms

Ocular Inflammation and Immunology - How to prevent?

Ocular Inflammation and Immunology - Causes and Risk Factors

What causes ocular inflammation?
Ocular inflammation may be the result of a wide variety of causes, including infection and inflammatory disorders. Some conditions may affect other parts of the body. In many cases however, despite thorough investigations, the cause remains unknown.

Condition

Symptoms

Possible diagnosis

Episcleritis
Scleritis

Redness, pain, watering

Idiopathic episcleritis Anterior scleritis
(diffuse or nodular, with or without necrosis)
Posterior scleritis

Anterior uveitis
Iritis
Iridocyclitis


Redness, pain,
photophobia,
watering,
elevated eye pressure, vision may or may not be
affected

Idiopathic Anterior Uveitis
HLA-B27 related uveitis
Herpetic keratouveitis
Posner Schlossman syndrome
Fuchs Heterochromic iridocyclitis
Cytomegalovirus anterior uveitis

Intermediate
uveitis
Vitritis
Pars Planitis

Floaters,
blurred vision

Idiopathic intermediate uveitis
Underlying systemic disease
(Multiple sclerosis, sarcoidosis, syphilis,
Tuberculosis, Lyme disease)

Posterior uveitis
Retinitis
Choroiditis
Chorioretinitis
Neuroretinitis

Blurred vision




Infective :
Toxoplasmosis
Viral retinitis (including acute retinal necrosis) :
Varicella zoster virus, herpes simplex virus,
cytomegalovirus, Epstein-Barr virus
Dengue-associated disease

Retinal Vasculitis






Blurred vision, floaters






Eales Disease
Behcets disease
Sarcoidosis
Systemic lupus erythematosus,
Polyarteritis nodosa
Wegeners granulomatosis
Infective:
Tuberculosis, syphilis, viral, toxoplasmosis

Panuveitis
(infective )
(Endophthalmitis)

All of above



Exogenous from open wound
e.g. trauma, post-op
Endogenous from internal source
through the blood stream e.g. hepatobiliary disease, urinary tract infection

Panuveitis
(non-infective)


All of above



Behcets Disease
Vogt-Koyanagi-Harada Disease
Sympathetic Ophthalmia
Sarcoidosis
Masquerade syndromes (tumour related)

Ocular Inflammation and Immunology - Diagnosis

A careful eye examination by an ophthalmologist is extremely important when symptoms occur. Inflammation inside the eye can permanently affect sight or even lead to blindness, if it is not treated.

Your ophthalmologist will examine the inside of your eye. He or she may order blood tests, skin tests or x-rays to help make the diagnosis. Since uveitis can be associated with disease in the rest of the body, your ophthalmologist will want to know about your overall health. He or she may want to consult with your primary care physician or other medical specialists.

Ocular Inflammation and Immunology - Treatments

Ocular inflammation is a serious eye condition that may scar the eye. You need to have it treated as soon as possible. Eye drops, especially steroids and pupil dilators, can reduce inflammation and pain. For more severe inflammation, oral medication or injections may be necessary.

Uveitis may have these complications:

  • Glaucoma (increased pressure in the eye)      

  • Cataract (clouding of the eye's natural lens)

  • Neovascularisation (growth of new, abnormal blood vessels) These complications may develop in chronic severe inflammation. Specialist care is essential to ensure your condition is appropriately managed.

Ocular Inflammation and Immunology - Preparing for surgery

Ocular Inflammation and Immunology - Post-surgery care

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