Uveitis - Causes, Symptoms and Treatments

Posterior uveitis begins insidiously, with complaints of slightly decreased or blurred vision or floating spots. Posterior uveitis may be acute or chronic; and it may affect one or both eyes. Retinal damage, caused by lesions from toxoplasmosis, and retinal detachments may occur.

Diagnosis of Uveitis:

In anterior uveitis, a slit-lamp examination shows a flare and cell pattern, which looks like particles dancing on a sunbeam. With a special lens, slit-lamp and ophthalmoscopic examination can also identify active inflammatory fundus lesions involving the retina and choroid.

In posterior uveitis, serologic tests may be used to rule out toxoplasmosis as the cause.

Treatment of Uveitis:

Uveitis requires vigorous and prompt management, which includes treatment of any known underlying cause, application of a topical cycloplegic, such as 1 % atropine sulfate, and of topical corticosteroids. For severe uveitis, therapy includes oral systemic corticostcroids. However, long-term steroid therapy can cause a rise in intraocular pressure (lOP) or cataracts. Carefully monitor lOP during acute inflammation. If lOP rises, therapy should include an antiglaucoma medication, such as an alpha agonist, or topical carbonic anhydrase inhibitor, such as dorozolamide.

Special considerations of Uveitis:

Encourage rest during the acute phase.

Teach the patient the proper method of instilling eyedrops.

Suggest the use of dark glasses to ease the discomfort of photophobia.

Instruct the patient to watch for and report adverse effects of systemic corticosteroid therapy (for example, edema, muscle weakness).

Stress the importance of follow-up care. Tell the patient to seek treatment immediately at first signs of iritis.