Anterior Uveitis

  • Reference Number: HEY-118/2018
  • Departments: Ophthalmology Department

Introduction

This leaflet has been produced to give you general information about your condition.  Most of your questions should have been answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is Anterior Uveitis?

Uveitis is inflammation of the coloured part of the eye (the iris) and sometimes the structures associated with it.

What are the symptoms?

The symptoms can include some or all some of the following:

  • Redness around the iris.
  • Photophobia (sensitivity to bright light).
  • Blurred/foggy vision especially when trying to read.
  • Ache around the eye.
  • The pupil (hole in the centre of the iris) may be a different shape in the affected eye.

In most cases the symptoms will affect only one eye, although both can be affected at the same time.

What causes Uveitis?

In most people the cause is unknown. In a few cases it can be linked to inflammatory diseases that affect the whole body, for example ankylosing spondylitis, inflammatory bowel disease such as Crohn’s disease and ulcerative colitis. Occasionally it can be linked to infections or to a genetic predisposition but in about 50% of cases no definite cause is identified. If you have had more than one episode of anterior uveitis or disease affecting both eyes and there is no known cause your doctor may organise special blood tests or X-rays, but in normal circumstances no further investigations are needed.

What treatment will I be given?

1. To relieve pain and photophobia (sensitivity to light)

Dilating eye drops, such as atropine long acting eye drop or cyclopentolate short acting eye drop are used. These drops are used for variable lengths of time, depending on individual cases. The drops work by “paralysing” the muscles of the iris (it is the movement of these inflamed muscles that causes the pain). While you are using these drops your vision will be blurred and you will still be sensitive to bright lights. Dark glasses may be of help. The effect of these drops can last for a few days even after you have stopped taking them. As these drops cause blurring of vision, you may be advised not to drive.

These drops are also useful because they help to prevent complications, such as the iris “sticking” to the lens (posterior synechiae).

2. To treat the inflammation

Steroids are used in the form of eye drops, usually prednisolone (Predforte) 1% or dexamethasone (Maxidex). These drops are given very frequently (sometimes hourly) at the beginning of the treatment but are then slowly reduced over a number of weeks as your eye responds to the treatment. The bottle of drops should be shaken vigorously before putting the drops in the eye as the active ingredient can settle down to the bottom of the bottle. It is very important not to stop these drops before the doctor has advised as, although your eye may feel better, there may still be traces of inflammation left and stopping the drops too soon may cause it to suddenly get worse.

Occasionally, but not often, injections of steroids are used around the eye. These may be uncomfortable but are straightforward and are done at the Eye Outpatient Clinics.

How often will I need to be seen?

This depends upon the amount of inflammation and how your eye responds to the treatment.

Will it come back?

It is difficult to say, as everyone is different. A few people will just experience one attack during their lifetime. However, many people have more than one attack. This may be close in time to the original one or years apart. It may affect either eye.

What do I do if the symptoms come back?

If you experience similar symptoms in either eye, such as redness and/or sensitivity to light, you should contact the Eye Clinic or the Eye Hospital immediately for further advice. You will be given a yellow Recurring Ocular Condition (ROC) card which has a contact name and telephone numbers on it for you to use. It is very important that you do not start drops at home as this can cause other problems with the eye.

Can there be any complications or risks?

  • Cataracts. These are more common in people with uveitis, especially those who have had long term steroid treatment.
  • Raised Eye Pressure and Synechiae. In anterior uveitis the pressure can be raised due to the inflamed iris “sticking” to the lens preventing the fluid from passing through the pupil. The drops that dilate your pupil help prevent this. It can also be due to the inflammation of the area where the fluid drains out of the eye. The other possible cause of a raised pressure is as a side-effect of the steroids used in the treatment.
  • Macular Oedema. The Macula is the tiny part of the retina that is responsible for the central or detailed part of our vision. Fluid (oedema) in this area may cause problems with central vision. This can mean difficulty recognising people’s faces, reading, driving and finding that straight lines appear distorted.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Ophthalmology Department on tel no: (01482) 608788.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

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We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

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