The Uveitis section at the West Virginia University – Eye Institute provides comprehensive medical and surgical management for all ocular inflammatory diseases, and is the only center in the state that offers multidisciplinary care for patients with complex inflammatory diseases of the eye.
The Uveitis section is the latest addition to our wide spectrum of subspecialty eye care services.
WVU’s state-of-the-art technical capabilities provide outstanding tools in diagnosis and management of ocular inflammatory diseases.
Spectral-Domain OCT: Non-contact imaging technology that provides detailed cross-sectional images of the eye.
Spectral-domain OCT image demonstrates cystoid macular edema (CME), one of the major causes of legal blindness in patients with uveitis.
Fluorescein and Indocyanine Green (ICG) angiography, Fundus Autofluorescence (FAF): In-office diagnostic tools to assess the extent and severity of various inflammatory diseases.
Angiography demonstrates the extent and severity of the posterior segment involvement in patients with uveitis.
Ophthalmic ultrasonography: Contact imaging technology, with high-frequency sound waves that are reconstructed as an image on a monitor.
- Electroretinography (ERG) – ganzfield ERG and multifocal ERG
- Electro-oculography (EOG)
- Visual field testing (VF)
- Medical management of complex inflammatory diseases: A multidisciplinary approach is available to allow for the best possible care through collaborations with Rheumatology or Infectious Diseases in the management of complex cases.
- Intravitreal injections and intraocular steroid implants (OZURDEX, RETISERT)
- Surgical management of complex inflammatory diseases: Small-gauge pars plana vitrectomy surgery for diagnostic and therapeutic purposes, removal of uveitic cataract in complex cases.
Types of Uveitis
Based on which part of the eye is primarily involved, there are several types of uveitis:
- Anterior uveitis (if the inflammation is predominantly at the front part of the eye) – Most common type of uveitis
- Intermediate uveitis (if the inflammation is primarily in the middle part of the eye) – Includes pars planitis
- Posterior uveitis (if the inflammation is primarily in the back part of the eye)
- Panuveitis (if the inflammation involves all parts of the eye)
Causes of Uveitis
In most cases, the etiology remains unknown. However, uveitis may result from various different causes, including:
- Genetic factors
- Autoimmune diseases, such as rheumatoid arthritis (RA), ankylosing spondylitis (AS)
- Infection (Virus, fungus, parasite)
Studies have shown that smoking is a risk factor for uveitis and is associated with a dose-dependent increased rate for some of its complications.
What is Uveitis?
Uveitis is inflammation of the uvea, which consists of iris (the colored part of the eye), choroid (the vascular middle layer of the eye) and the ciliary body. Since uvea contains many blood vessels that nourish and affect important parts of the eye (including retina), inflammation of this middle layer can lead to irreversible vision loss. Early diagnosis and treatment are crucial to prevent potentially serious complications of uveitis.
What are the Symptoms of Uveitis?
Uveitis can affect one or both eyes. Symptoms can occur suddenly or develop gradually, and may include:
- Eye pain
- Blurred vision
- Floaters (dark, floating spots in the field of vision)
- Sensitivity to light.
What are Some Common Conditions Associated with Uveitis?
- Rheumatoid arthritis (RA)
- Juvenile Idiopathic Arthritis (JIA)
- Systemic lupus erythematosis (SLE)
- Anklosing spondylitis (AS)
- Inflammatory bowel disease (IBD)
- Tubulointerstitial nephritis and uveitis syndrome (TINU)
- Behcet Disease
- Herpes simplex
- Herpes zoster
- Lyme disease
How is Uveitis Diagnosed?
Uveitis is diagnosed through an eye examination. A complete medical history and a detailed eye examination should be performed for uveitis evaluation. The eye tests performed during an evaluation in the uveitis clinic may include:
- Optical Coherence Tomography (OCT)
- Fundus photography
- Fundus AutoFluorescence (FAF)
- Fluorescein Angiography (FA)
- IndoCyanine Green angiography (ICG)
- ElectroRetinoGraphy (ERG)
- Visual Field testing (VF)
The uveitis specialist may request blood tests and further imaging (such as chest X-ray). If an underlying systemic cause is suspected, you may be referred to your primary physician for further evaluation. Consultations to Rheumatology, Infectious Diseases, Gastroenterology, Neurology, and/or Internal Medicine may also be required.
The uveitis evaluation may also include taking a sample of fluid from inside the eye. And this may require a diagnostic surgical procedure in the operating room.
How is Uveitis Treated?
Based on the type and severity of uveitis, the treatment can include:
- Steroid eye drops
- Dilating eye drops
- Steroid injections (around the eye or inside the eye)
- Oral corticosteroids (to help suppress the immune system)
- Steroid implants (Ozurdex, Retisert)
- Antibiotics or antiviral medication (if uveitis is caused by an infection)
- Immunosuppressive medications
- Surgery (both for diagnostic and therapeutic purposes)
As you are preparing for your uveitis evaluation
Here are few tips to help you prepare for your evaluation:
- Please fill out the uveitis questionnaire prior to your visit and bring it with you to your appointment
- Make a list of all medications used (past and present): this includes all eye drops, pills and injections along with dosing regimen for all these medications
- Ask a family member or friend to come with you: As this will be a detailed evaluation, you will be provided with a lot of information. Having someone with you could allow for remembering more of this information later. You will also need a driver if your vision is compromised due to your eye condition.