Ocular Inflammation and Immunology

Symptoms | Treatments

What is

Causes and Risk Factors

Diagnosis

Treatment

What is - Ocular Inflammation and Immunology

Uveitis, or ocular inflammation, is inflammation of the uvea, which is the middle layer of the eye. The eye is shaped 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 the brain. The middle layer between the sclera and retina is called the uvea. The outermost layer is the sclera, which is the external white wall of the eye.

ocular inflammation conditions & treatments

What is the importance of the uvea?
The uvea contains many blood vessels – veins and arteries that carry blood 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 - 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 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
Infective panuveitis (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)
Non-infective panuveitis	All of above	Behcets Disease Vogt-Koyanagi-Harada Disease Sympathetic Ophthalmia Sarcoidosis Masquerade syndromes (tumour related)

Diagnosis of Ocular Inflammation and Immunology

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.

Treatment for Ocular Inflammation and Immunology

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.