When you visit an eye specialist (ophthalmologist), he or she will likely conduct a complete eye exam and gather a thorough health history. The eye examination usually involves the following:
- Assessment of vision (with your glasses if you normally wear them) and the response of your pupils to light.
- Tonometry. A tonometry exam measures the pressure inside your eye (intraocular pressure). Numbing eyedrops may be used for this test.
- A slit-lamp examination. A slit lamp is a microscope that magnifies and illuminates the front of your eye with an intense line of light. This evaluation is necessary to identify microscopic inflammatory cells in the front of the eye.
- Ophthalmoscopy. Also known as funduscopy, this exam involves widening (dilating) the pupil with eyedrops and shining a bright light into the eye to examine the back of the eye.
Your doctor may also recommend:
- Color photography of the inside of the eye (retina).
- Optical coherence tomography (OCT) imaging. This test measures the thickness of the retina and choroid to reveal inflammation in these layers.
- Fluorescein angiography or indocyanine green angiography. These tests require placement of an intravenous (IV) catheter in a vein in your arm in order to administer a dye. This dye will reach the blood vessels in the eyes and allow photographs of blood vessel inflammation inside the eyes.
- Analysis of aqueous or vitreous fluid from the eye.
- Blood tests.
- Imaging tests, radiography, CT or MRI scans.
If the ophthalmologist thinks an underlying condition may be the cause of your uveitis, you may be referred to another doctor for a general medical examination and laboratory tests.
Sometimes, it's difficult to find a specific cause for uveitis. Even if a specific cause is not identified, uveitis can still be treated successfully. In the majority of cases, identifying a cause for the uveitis does not lead to a cure. It is still necessary to use some form of treatment to control the inflammation.
If uveitis is caused by an underlying condition, treatment may focus on that specific condition. Usually the treatment for uveitis is the same regardless of the associated cause, as long as it is not infectious. The goal of treatment is to reduce the inflammation in your eye, as well as in other parts of the body, if present. In some cases, treatment may be necessary for months to years. Several treatment options are available.
- Drugs that reduce inflammation. Your doctor may first prescribe eyedrops with an anti-inflammatory medication, such as a corticosteroid. Eyedrops are usually not enough to treat inflammation beyond the front of the eye, so a corticosteroid injection in or around the eye or corticosteroid tablets (taken by mouth) may be necessary.
- Drugs that control spasms. Eyedrops that widen (dilate) the pupil may be prescribed to control spasms in the iris and ciliary body, which can help relieve eye pain.
- Drugs that fight bacteria or viruses. If uveitis is caused by an infection, your doctor may prescribe antibiotics, antiviral medications or other medicines, with or without corticosteroids, to bring the infection under control.
- Drugs that affect the immune system or destroy cells. You may need immunosuppressive drugs if your uveitis affects both eyes, doesn't respond well to corticosteroids or becomes severe enough to threaten your vision.
Some of these medications can have serious eye-related side effects, such as glaucoma and cataracts. Medications by mouth or injection can have side effects in other parts of the body outside the eyes. You may need to visit your doctor for follow-up examinations and blood tests every one to three months.
Surgical or other procedures
- Vitrectomy. Surgery to remove some of the vitreous in your eye is rarely used to diagnose or manage the condition.
A medication-releasing implant. For people with difficult-to-treat posterior uveitis, a device that's implanted in the eye may be an option. This device slowly releases corticosteroid into the eye for two to three years.
Cataracts usually develop in people who have not yet had cataract surgery. Up to 30% of patients will also require treatment for elevated eye pressure to prevent the development of glaucoma.
The speed of your recovery depends in part on the type of uveitis you have and the severity of your symptoms. Uveitis that affects the back of your eye (posterior uveitis or panuveitis, including retinitis or choroiditis) tends to heal more slowly than uveitis in the front of the eye (anterior uveitis or iritis). Severe inflammation takes longer to clear up than mild inflammation does.
Uveitis can come back. Make an appointment with your doctor if any of your symptoms reappear or worsen.
Preparing for your appointment
Your symptoms may prompt you to make an appointment with your primary doctor. You may be referred to a doctor who specializes in disorders of the eyes (ophthalmologist).
Here's some information to help you get ready for your appointment and know what to expect from your doctor.
What you can do
- List your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
- List key personal information, including any major illnesses, traumas or recent life changes.
- Bring a list of all medications, vitamins or supplements that you're taking.
- Ask a family member or friend to come with you. Sometimes it can be difficult to remember all of the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot. Additionally, someone who comes with you can drive you to your appointment, especially if your symptoms make it difficult to see properly.
- List questions to ask your doctor.
Preparing a list of questions can help cover all of the points that are important to you. For uveitis, some basic questions to ask include:
- What's the most likely cause of my eye problems?
- What else might be causing my symptoms?
- What kinds of tests do I need? Do these tests require any special preparation?
- Is uveitis temporary or long lasting?
- Will I lose my sight?
- What treatments are available, and which do you recommend?
- What types of side effects can I expect from treatment?
- Is there anything I can do to prevent this from happening again?
- I have other health conditions. How can I best manage these conditions together?
- Do you have any brochures or material I can take home with me?
- What websites do you recommend?
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms? Have they gotten worse?
- Does anything seem to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Have you ever had uveitis before?
- Do you have any other medical problems?
- Do you have arthritis?
- Do you have back problems?
- Have you had any recent skin rashes?
- Have you had any ulcerated sores in your mouth or on your genitalia?
- Have you had a recent upper respiratory infection or cold symptoms?