Uveitis

ICD-9: 364.xx

Description

Uveitis is inflammation of the uveal tract, which is the principal vascular connective tissue component of the eye (iris, ciliary body, choroid). The condition is usually unilateral. The iris, ciliary body, or choroid may be affected separately or in combination. It may occur in the anterior or posterior portion of the tract.

Etiology

Uveitis may be associated with autoimmune disorders, or it may be idiopathic. Uveitis may be caused by microbial infections or debilitating diseases, such as AIDS, tuberculosis, herpes zoster infection, and histoplasmosis, or it may result from improperly healed corneal abrasions. Allergies, chemicals, trauma, or surgery may also be the cause.

Uveitis

Signs and Symptoms

Symptoms include pain; intense, unusual intolerance of light (photophobia); blurred vision; redness; and dark, floating spots in the vision. The primary care provider may note severe ciliary congestion, tearing, and a pupil that is nonreactive when exposed to light.

Diagnostic Procedures

An ophthalmic examination that includes a slitlamp examination is necessary for diagnosis. A complete medical history likely reveals any underlying medical issues that relate to the diagnosis.

Treatment

Treatment is specific to the particular type of uveitis and should be prompt and vigorous. Treatment may involve wearing dark glasses, using eyedrops to dilate the pupil and relieve pain, or using steroid eyedrops or ointment as prescribed. Atropine, an anticholinergic agent that counteracts the effects of parasympathetic stimulation, is used so that the pupil remains dilated to reduce the likelihood of adhesions. If the uveitis is caused by a bodywide infection, treatment may involve antibiotics and powerful anti-inflammatory medicines called corticosteroids. Analgesics may be prescribed, and intraocular pressure must be monitored.

Complementary Therapy

See Complementary Therapy for conjunctivitis.

Client communication

Clients should wear dark green eyeglasses both inside and outside. If uveitis recurs, encourage a good medical workup to determine the underlying cause.

Prognosis

Most uveitis subsides in a few weeks with treatment. It may persist despite treatment. Adhesions may develop that can cause glaucoma, cataracts, or even retinal detachment. Uveitis can recur.

Prevention

There is no known prevention other than prompt treatment of infections and the debilitating diseases mentioned.