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What is Uveitis?

Uveitis Can Cause Redness, Blurry Vision and Sensitivity to Light | Randall Wong MD | Retina Specialist VirginiaUveitis is an internal inflammation of the eye.  Arthritis is an inflammation of our joints.  Think of uveitis (or iritis) as arthritis of the eye.

Intraocular inflammation is not a common condition, but is a condition that every eye doctor sees several times a year.  Many times, a retina specialist is referred patients with uveitis.  There are subspecialists who treat ocular inflammation, but they number far fewer compared to the number of retina specialists.

The uvea is a part of the eye consisting of 3 parts;

  • Iris – the colored portion of our eye, it forms the pupil
  • Ciliary Body – the tissue which makes the aqueous humor
  • Choroid – a deep layer of the retina

Each part may become inflamed.  More specific names are based upon the location of the inflammation or part of uvea involved, for instance;

  • Anterior Uveitis – also known as iritis, is usually referred to as inflammation of only the iris
  • Intermediate Uveitis implies inflammation of the ciliary body, with or without inflammation of the iris
  • Posterior Uveitis involves inflammation limited to the choroid, the deep layer of the retina

Symptoms of Uveitis

Symptoms can include redness, blurry vision, sensitivity to light and pain.  Symptoms vary depending upon the location of the inflammation.  For example, anterior uveitis (or iritis) usually is associated with more pain as the iris and ciliary body are quite sensitive.

There are very few nerve endings underneath the retina, hence, inflammation of the choroid is often without pain.

Complications

The cornea can become swollen leading to loss of vision and additional sensitivity to light.  Cataracts are known to occur, increased eye pressure,  hypotony (very low eye pressure) in chronic cases, retinal swelling and retinal detachment (not due to a retinal tear) are also possible.

Most cases are not too complicated and localized to the front of the eye, but complete examination is necessary to assess the extent of the inflammation and amount of damage.

Causes

Trauma is probably the most common cause of inflammation, in the form of iritis (anterior inflammation).  There are technically dozens of systemic diseases associated with uveitis, but most cases of uveitis have no known association with a disease.

Viral, fungal and bacterial infections are occasionally to blame.  Uveitis is often recurrent.

Treatment

Steroids are the preferred treatment for any inflammation and the same is true for the treatment of ocular inflammation.

Topical drops, pills and injections of steroids are all possible.   Drops are usually preferred, but in more severe cases pills and injections are necessary.

More serious conditions may require immunosuppressive medications and the efforts of several docs including a retina specialist.

Your Retina Feels No Pain

Retinal disease is painless.  Diabetic retinopathy doesn’t hurt and neither does macular degeneration.  For that matter, a retinal detachment is nothing.  What does cause eye pain?  It can be sinus disease.

There are only a handful of problems that cause eye pain.  Neither diabetic retinopathy nor macular degeneration causes eye pain, not even a feeling.

Corneal abrasions, like skinning your knee, causes is lot of pain and sensitivity to light.  The cornea is a has a lot of nerve endings.  Scraping across the superficial layer of the cornea exposes a lot of these nerve endings causing severe pain.  It may be one of the more painful conditions you can experience. There should be obvious redness of the eye.

Nerve endings in the cornea are important.  How else could you tell if you are poking yourself in the eye?

Certain types of glaucoma can cause pain, but only the ones that cause really high eye pressure.  Most types of glaucoma don’t hurt and are painless.

Normal pressure is somewhere between 18 and 21 mmHG, but severe pain usually doesn’t happen until the pressure is greater that 40 mmHG.  The only way you’d know your eye pressure is too high is to have your eye doctor test it.  Many times redness is associated with this type of pain.

While proliferative diabetic retinopathy can cause neovascular glaucoma, leading to extremely high pressure and pain, the retinopathy itself is painless.

Iritis, also know as uveitis, is a type of inflammation that occurs inside the eye.  It is not unlike a painful arthritic joint, but only it’s the eye.  The ciliary body, a very sensitive tissue inside the eye, can become very painful with certain type of intraocular inflammation.  Eye redness is common.

Sinus Disease causes many cases of eye pain.  Really.  The nerve fibers that transmit pain from the sinuses and the eye actually course together as they wind their way to the brain to alert you of discomfort.  Because the pain fibers run so close, it is sometimes difficult to distinguish “eye pain” from “sinus pain.”

Many times I am able to distinguish between the two by a very simple observation.  In my opinion, if the eyeball itself is not red, “eye pain” is probably not coming from the eye.

Please remember, this article represents my opinion and does not, in any way, substitute for medical advice.  If you are experiencing eye pain, please inform your doctor.

What Does This Mean? It’s pretty straightforward; the retina has NO nerve endings, thus, retinal disease, including diabetic retinopathy and macular degeneration don’t hurt because…it can’t.  You can’t even feel a retinal tear or retinal detachment.

Many times patients relate loss of vision to pain or a certain “feeling.”

“Randy”

Randall V. Wong, M.D.

Ophthalmologist, Retina Specialist
Fairfax, Virginia

offices

Currently, I see patients with retinal diseases; macular degeneration, retinal detachment, macular holes, macular pucker within several different practices.....it's a different arrangement, but it allows more continuous care with many eye specialists. In addition, I am very accessible via the web. To schedule your own appointment, call any of the numbers below.

Virginia Lasik | Office of Anh Nguyen, M.D.
Randall V. Wong, M.D.
Contact: Layla

A: 431 Park Avenue, Suite 103 • Falls Church, Virginia 22046
Ph: 703.534. 4393
F:703.992.8158
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Dressler Ophthalmology Associates, PLC
Randall V. Wong, M.D.
Contact: Ashley (Surgery/Web)
Chrissy Megargee (Web)

A: 3930 Pender Drive, Suite 10 • Fairfax, Virginia 22030
Ph: 703.273.2398
F: 703.273.0239
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