Uveitis Causes and Associated Risks
Uveitis, an inflammation of the middle layer of the eye known as the uvea or uveal tract, can be caused by a variety of factors, including infections, autoimmune disorders, injuries or eye trauma, toxin exposure, and certain medications. This condition, when chronic, can lead to severe eye damage and potential vision loss if left untreated.
Chronic uveitis can affect one or both eyes and is a significant cause of visual impairment worldwide. If left untreated, it can ultimately lead to vision loss or blindness. To better understand the implications of chronic uveitis, let's explore its common complications.
1. Retinal Swelling or Scarring: This condition can affect the quality of vision and potentially lead to permanent damage.
2. Secondary Glaucoma: Caused by increased intraocular pressure due to inflammation or treatment effects, secondary glaucoma can damage the optic nerve and cause vision loss.
3. Cataracts: Particularly complicated cataracts arising from ongoing inflammation or corticosteroid treatment are common in chronic uveitis patients.
4. Cystoid Macular Edema (CME): Fluid accumulation in the macula causes blurred and distorted central vision.
5. Band-shaped Keratopathy (BSK): Characterized by calcium deposits in the cornea linked to chronic inflammation, BSK can impair vision.
6. Postoperative Infections: Patients with chronic uveitis, especially those receiving systemic corticosteroids or immunosuppressive therapy, are at a higher risk of postoperative infections such as endophthalmitis.
Effective and early treatment with anti-inflammatory medications is crucial to prevent these complications and preserve vision. A thorough drug history is essential in patients with uveitis, as drug-induced uveitis (DIU) is a significant cause of the condition.
Bacterial infections, such as Lyme disease, tuberculosis, syphilis, cat scratch disease, chlamydia trachomatis, gonorrhea, and brucellosis, can cause uveitis. Viral infections, including anterior uveitis, intermediate uveitis, acute retinal necrosis (ARN), progressive outer retinal necrosis (PORN), neuroretinitis, and infections caused by poxviruses, adenoviruses, influenza virus, mumps virus, measles virus, rubella virus, Rift Valley fever virus, and Newcastle virus, also pose a risk.
Exposure to harmful chemicals and toxins like acids used in manufacturing and pesticides can cause uveitis. Trauma to the eye can lead to traumatic iritis, a type of uveitis. Cataract surgery can result in postoperative uveitis.
It's important to note that patients with diabetes, particularly those with poor glycemic control, are almost five times more likely to experience acute uveitis. Proliferative retinopathy is also associated with an increased risk of acute uveitis in patients with diabetes.
In conclusion, chronic uveitis can have severe implications for vision health. Prompt diagnosis and sustained management of uveitis are vital to minimise ocular damage and preserve sight. Vaccination against several viral diseases remains a major focus of public health policy, despite the risk of vaccine-induced uveitis, as it helps reduce the incidence of uveitis-causing viral infections.
**Summary Table: Common Complications of Chronic Uveitis**
| Complication | Description | |-----------------------------|-----------------------------------------------------------| | Retinal swelling/scarring | Damage and scarring of retina affecting vision | | Secondary glaucoma | Increased eye pressure damaging optic nerve | | Cataracts | Lens opacification, often complicated by inflammation or steroids | | Cystoid macular edema (CME) | Fluid accumulation in macula causing vision distortion | | Band-shaped keratopathy (BSK) | Calcium deposits in cornea related to chronic inflammation | | Postoperative endophthalmitis | Infection risk elevated with corticosteroids/immunosuppression |
- The threat of vision loss or blindness from chronic uveitis underscores the importance of understanding its common complications, such as retinal swelling or scarring, which can cause permanent damage to vision quality.
- Another complication of chronic uveitis is secondary glaucoma, a condition arising from increased intraocular pressure due to inflammation or treatment effects, which can damage the optic nerve and lead to vision loss.
- Cataracts, particularly those arising from ongoing inflammation or corticosteroid treatment, are common in chronic uveitis patients, manifesting as lens opacification and often complication the condition.
- Cystoid macular edema (CME) is another complication, characterized by fluid accumulation in the macula, leading to blurred and distorted central vision.
- Band-shaped Keratopathy (BSK), which involves calcium deposits in the cornea linked to chronic inflammation, can impair vision in patients with chronic uveitis.
- Postoperative infections, particularly endophthalmitis, are a higher risk for chronic uveitis patients, especially those who are receiving systemic corticosteroids or immunosuppressive therapy.
- Effective and early treatment with anti-inflammatory medications can help prevent these complications and preserve vision, making a thorough drug history essential for patients with uveitis to identify drug-induced uveitis.
- Various factors such as bacterial infections, viral infections, exposure to harmful chemicals and toxins, trauma to the eye, and cataract surgery, can cause uveitis; diabetes, particularly in patients with poor glycemic control, increases the risk of acute uveitis.
- Public health policy focuses on vaccination against viral diseases to reduce the incidence of uveitis-causing viral infections, despite the risk of vaccine-induced uveitis.
- In conclusion, prompt diagnosis and sustained management of uveitis are vital to minimize ocular damage and preserve sight.
