Uveitis: a disease of young people with good prognosis if treated by an expert

Uveitis is an inflammation of the uvea, the vascular layer below the sclera, which consists of the iris (what gives color to our eyes), the ciliary body (which produces the aqueous humor, the fluid that maintains eye pressure) and the choroid (which nourishes our retina). Therefore, we can have anterior uveitis when the iris is inflamed, intermediate uveitis or posterior uveitis.

At what age does it usually appear?

Uveitis is a rare disease, affecting 0.1% of the population, which occurs mainly in relatively young patients. It frequently appears in patients between 20-50 years of age, around the age of forty. As it is often a chronic process over time, it has a great impact on the working life of patients because they have to visit the doctor frequently to follow up their disease.

It is a disease of complex management, which without adequate treatment results in a significant loss of vision and can lead to blindness. The most important thing is a correct diagnostic orientation by a specialized ophthalmologist, in order to avoid unnecessary examinations and inappropriate treatments. In this sense, uveitis with a good control and follow-up by an ophthalmology specialist has a good prognosis.

What are the main causes?

There are three main causes of uveitis: infections, autoimmune and neoplastic (abnormal tissue growth). Determining the exact cause requires a highly complex individualized study, but is key to correct treatment.

How is it treated?

At the moment there are multiple drugs available for the treatment of the disease. With a good follow-up, a good control of the disease is achieved (the aim is to make the inflammation disappear) and a decrease in the risk of sequelae such as glaucoma, cataract, macular edema, retinal lesions or corneal alterations, which lead to a significant loss of vision.

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The treatment of uveitis requires the use of powerful systemic medication (anti-inflammatory drugs, steroids, immunomodulators and antimetabolites) that are difficult to manage, so it is advisable for the ophthalmologist to be an expert in this pathology. As the basis of most uveitis is autoimmunity, immune modulating drugs are used, starting with corticosteroids (in drops or systemic), non-steroidal anti-inflammatory drugs, immunomodulators and in some cases antineoplastic drugs.

Uveitis tends to recur, so we should consider it a chronic disease with intervals of time in which symptoms do not appear. It is essential that the patient is aware of the importance of a good follow-up both at the level of consultations and treatment.