Description

• The term uveitis strictly means inflammation of the uveal tissue only. Clinically there is always some associated inflammation of the adjacent structures such as the retina, vitreous, sclera and cornea.
• Severe redness, pain, light sensitivity, blurred vision and dark floating spots in the field of vision are the warning signs of uveitis and can be associated with ocular inflammation alone or in association with systemic disease

CLASSIFICATION

Uveitis is often grouped by the part of the uvea it affects. There are four types of uveitis:

• Anterior uveitis
• Intermediate uveitis
• Posterior uveitis
• Panuveitis

In Anterior uveitis

• Inflammation involves the iris(iritis)
• The anterior ciliary body(cyclitis)
• Both (iridocyclitis)

Posterior uveitis

• Inflammation involving the choroid(choroiditis)
• Retina (retinitis)
• Both( chorioretinitis)
• Retinal vessels(retinal vasculitis)

Panuveitis involves all three parts of the uvea

Uveitis may extend to involve the cornea (keratouveitis) or sclera (sclerouveitis)

Types

Uveitis symptoms may occur

• Quickly in an acute form (lasts less than six weeks)
• Slowly in a chronic form (lasts longer than six weeks).

The signs and symptoms of uveitis include:

• Eye redness
• Eye pain
• Light sensitivity
• Blurred vision
• Dark, floating spots in your field of vision (floaters)
• Decreased vision
• Patients usually present with a painful red eye and decreased vision
• There may be pupillary constriction, photophobia, and tearing
• On slit-lamp examination- cells and “flare” (protein) in the anterior chamber
• The inner surface of the cornea - keratic precipitates that either fine (“granular”) or globular (“granulomatous” or “mutton fat” keratic precipitates)
• Granulomatous keratic precipitates are less common than granular precipitates and more often associated with Sarcoidosis, Syphilis, or Tuberculosis.

Investigation

• Ophthalmoscopy
• Visual acuity
• Visual field: Damage to the optic nerve may cause a loss of side vision (peripheral vision)
• Gonioscopy
• Tonometry - measures pressure in the eye
• Slit-lamp examination
• Fluorescein Angiography - Procedure provides a clear picture of the blood vessels in the retina at the back of the eye
• Optical Coherence Tomography (OCT) -This non-invasive imaging test uses light waves to take cross-section pictures of the retina
• Laboratory tests: To rule out an infection or an autoimmune disorder.

Treatments

Anterior Uveitis

• Topical corticosteroids
• Topical drop for elevated eye pressure
• Eye drops to widen pupil:

Intermediate and Posterior Uveitis

• Antibiotics, antivirals, or other medications
• Corticosteroids
• Nonsteroid anti-inflammatory drugs

Ayurvedic Treatment

Internal medicines

• Panchatikthaka Kashaya
• Guduchyadi kashaya
• Gugguluthikthaka Kashaya
• Kaisora guggulu
• Patoladi Gritha
• Tiktaka Gritha

Procedures

• Purambada - Mukkadi Gulika + milk in swelling of Eyelids & Redness
• Aschotana - Chandanadi Varthi
• Seka - Yasti+ Darvi+ Lodra Kashaya , Manjishtadi kashaya
• Bidalaka - Mukkadi
• Jaloukavacharana - forehead (repeatedly)
• Virechana - Avipathi Choorna
• Nasya - Surasa Swarasa +honey

Department

Salakya - Netra