- Reference Number: HEY-118/2021
- Departments: Ophthalmology Department
- Last Updated: 16 September 2021
Introduction
This leaflet has been produced to give you general information about your condition. Most of your questions should have been answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team., but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.
What is Uveitis?
Uveitis is an inflammatory condition of one of the internal layers of eye. It may be:
- Anterior meaning ‘the front of the eye’. Another common name for this is iritis.
- This is the commonest form.
- Intermediate meaning the middle portion of the eye.
- Posterior meaning ‘the back of the eye’.
- Pan uveitis involving all of these layers.
What are the symptoms?
The symptoms can include some or all some of the following:
- Redness around the iris.
- Photophobia (sensitivity to bright light).
- Blurred or foggy vision especially when trying to read.
- Ache around the eye.
- The pupil (hole in the centre of the iris) may be a different shape in the affected eye.
The above are mainly symptoms of anterior uveitis. Intermediate or pan uveitis may cause floating objects in vision or reduced vision.
What causes Uveitis?
Some cases of uveitis are linked to other areas of inflammation in the body e.g. The joints, the skin, the bowel or the lungs. Sometimes your genes make you more likely to have uveitis. Many cases are not linked to any other cause (known as idiopathic).
If your condition recurs frequently or you have other symptoms, your doctor may organise some tests for you such as blood tests or a chest X-ray.
What is the treatment for Uveitis?
After your assessment, you may be prescribed eye drops.
1. To relieve pain and photophobia (sensitivity to light)
Dilating eye drops, such as cyclopentolate are used. These drops are used for variable lengths of time, depending on individual cases. The drops work by “paralysing” the muscles of the iris (it is the movement of these inflamed muscles that causes the pain). While you are using these drops your vision will be blurred and you will still be sensitive to bright lights. Dark glasses may be of help. The effect of these drops can last for a few days even after you have stopped taking them. As these drops cause blurring of vision, you may be advised not to drive.
These drops are also useful because they help to prevent complications, such as the iris “sticking” to the lens (posterior synechiae).
2. To treat the inflammation
Steroids are used in the form of eye drops. These drops are given very frequently (sometimes hourly) at the beginning of the treatment but are then slowly reduced over a number of weeks as your eye responds to the treatment. The bottle of drops should be shaken vigorously before putting the drops in the eye as the active ingredient can settle down to the bottom of the bottle. It is very important not to stop these drops before the doctor has advised as, although your eye may feel better, there may still be traces of inflammation left and stopping the drops too soon may cause it to suddenly get worse.
Occasionally, but not often, injections of steroids are used around the eye. These may be uncomfortable but are straightforward and are done at the Eye Outpatient Clinics or sometimes in the operating theatre.
Intermediate, Posterior, or Pan – uveitis
These conditions do not always need treatment. If these do, drops may be insufficient and an injection around the eye, an injection of a steroid drug inside the eyeball or tablet treatment may be required. Usually more investigations, in the form of blood tests, X-rays or pictures, scans, dye tests of the eye are required. Often a consultation in specialist clinic is required.
You may need a number of follow up appointments to ensure that inflammation is reducing and your drops and tablets may be altered depending on how you are doing. Eye drops and tablets must not be stopped suddenly. Your eye may feel comfortable and your vision better, but inflammation could still be present.
Always complete the course of drops or tablets prescribed.
If you have any queries regarding your eye drops or tablets please contact the eye clinic nurse advice telephone number.
What do I do it if recurs?
It is quite common for the condition to recur. If it does, treatment needs to be re-started promptly to reduce the inflammation and the risk of further complications. If your eye condition should flare up again then you will need to contact the department as soon as possible.
At your initial visit, you will be given an R.O.C (Reoccurring Ocular Condition) card. This card contains your name and hospital number, please quote these when you phone. This card also has the phone number to contact the eye clinic for advice.
Can there be any complications or risks?
- Cataract: These are more common in people with uveitis, especially those who have had long-term steroid treatment.
- Raised Eye Pressure (glaucoma): This can happen due to several different reasons in uveitis including steroid use and the inflammation itself causing blockage of the drainage system in the eye. Glaucoma is an important cause of visual loss in uveitis.
- Macular Oedema: The macula is the tiny part of the retina that is responsible for the central or detailed part of our vision. Fluid (oedema) caused by increased leakiness of the tiny blood vessels in this area as a response to the inflammation may cause problems with the central fine detail vision. This can mean difficulty recognizing faces, reading, driving and finding that straight lines appear distorted.
Useful information
A support group for those with uveitis, based in Scotland with information for all.
A website with information for uveitis sufferers, support and campaign group for best level of care for all, based in England.
Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Ophthalmology Department (01482) 816658 or (01482) 608788 (08:30am-17:00pm Monday – Friday)
General Advice and Consent
Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.
Consent to treatment
Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.
The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:
- you must be able to give your consent
- you must be given enough information to enable you to make a decision
- you must be acting under your own free will and not under the strong influence of another person
Information about you
We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.
We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.
If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.
