Basics of the Uvea
The uvea is the term for all of the structures in the eye which carry blood. These include the iris (colored part of the eye), the ciliary body (the muscle that focuses the eye), and the choroid (the blood supply to the back of the eye).
In anterior uveitis, the iris and ciliary body are inflamed and have signs and symptoms of this inflammation.
The structures in the uvea provide blood supply to all of the eye, specifically all of the front of the eye which is visible.
If there are any problems with these structures or the blood flow, problems can arise both in the iris and ciliary body but also in other parts of the eye which are impacted.
Signs and Symptoms of Anterior Uveitis
Anterior uveitis will almost always present with severe symptoms including a painful, red eye, light sensitivity, and reduced vision.
Additionally, there will be many signs that are observed in an eye examination including white blood cells in the anterior chamber (called cells and flare), on the cornea (called keratic precipitates), and on the iris (called Koeppe nodules).
Associations with Anterior Uveitis
Anterior uveitis may not have a specific cause if it is a single case, but if it occurs several times, it is likely that there is an underlying condition that is playing a role.
Acute anterior uveitis is associated with a group of conditions called the HLA-B27 conditions. These all are linked by the presence of a protein found on cells called the HLA-B27 protein.
The HLA-B27 conditions include ulcerative colitis, Crohn’s Disease, reactive arthritis, ankylosing spondylitis, and psoriatic arthritis.
Chronic anterior uveitis is associated with conditions which cause prolonged inflammation throughout the body.
Conditions such as sarcoidosis, tuberculosis, and syphilis are associated with chronic anterior uveitis.
Treatment for Anterior Uveitis
The treatment for anterior uveitis includes steroid eye drops or steroid injections if the uveitis is more severe.
Additionally, a dilating drop is often used to reduce the pain that comes with many cases of uveitis.
If there has not been a complete blood work up completed, it is likely that your eye doctor will begin this process to identify if there is another condition contributing to the anterior uveitis.
Follow Up for Anterior Uveitis
Once anterior uveitis has been diagnosed, the steroid treatment will begin immediately and there will be a regular follow-up, typically at one week and then weekly until the uveitis is resolved and the steroid drops have been stopped.
Sometimes there is a need for regular monitoring if steroid medications have been used for a prolonged period of time. This follow up is usually every three months following the end of using steroids, once a baseline is established, annual eye examinations are used to continue to monitor.