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Eye Inflammation: When Is It Serious?

 
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Red eyes, blurry vision, light sensitivity, floaters and eye pain are common, and minor, vision problems. However, sometimes they can be symptoms of uveitis, serious inflammation of the interior of the eye. The underlying cause of uveitis can be a general infection or a systemic inflammatory disease. The appropriate treatment is very different for these two possibilities.

Complications of uveitis include cataracts, glaucoma, cystoid macular edema, retinal detachment, band keratopathy and neovascularization of the retina and optic nerve. The Cleveland Clinic Journal of Medicine recommends aggressive reduction of inflammation to prevent these sight-threatening results. First, it's important to find out where the inflammation originates.

In some cases, eye inflammation is the first sign of a systemic inflammatory condition. There are many possibilities. Reactive arthritis, psoriatic arthritis, ankylosing spondylitis, and inflammatory bowel disease are called HLA-B27 associated diseases, and all have a high incidence of uveitis. Other associated conditions are sarcoidosis, Behcet disease, juvenile idiopathic arthritis, Vogt-Koyanagi-Harada syndrome, tubulointerstitial nephritis, Kawasaki disease, multiple sclerosis, relapsing polychondritis, Sjogren syndrome, Wegener granulomatosis, Lyme disease and allergic reactions to drugs or other chemicals. In these cases, the treatment options include immune modulating drugs such as steroids and TNF blockers.

If the cause is an infection, immunosuppressive drugs can be disastrous, according to The Cleveland Clinic Journal of Medicine. This is not the usual case, but patients with compromised immune systems because of organ transplants, HIV, or other illness are at significant risk. Possibilities include toxoplasmosis, cytomegalovirus, tuberculosis, syphilis, leprosy, leptospirosis, cat scratch disease, and whipple disease. If the underlying cause of uveitis is an infectious disease, then the infection should be treated first.

Corticosteroid therapy is the main treatment for eye inflammation when there is no infectious cause. Treatment includes eye drops, injections near the eye, or as oral drugs. An unfortunate side effect of steroid treatment is cataracts which can be caused either by the uveitis or by the treatment. Thus, if the inflammation does not respond readily to steroid therapy, other immunosuppressive medications may be used.

References:

Rula AH et al, “Uveitis in the internist's office: Are a patient's eye symptoms serious?”, Cleveland Clinic Journal of Medicine 2005 April; 72(4): 329-339.

Behcet's disease:
https://www.empowher.com/news/herarticle/2009/12/15/what-would-you-risk-save-your-eyesight

Reactive arthritis:
https://www.empowher.com/news/herarticle/2009/12/01/reactive-arthritis-and-reiters-syndrome

Sarcoidosis:
https://www.empowher.com/news/herarticle/2009/10/29/sarcoidosis-current-research

Inflammatory bowel disease:
https://www.empowher.com/news/herarticle/2009/10/27/inflammatory-bowel-diseases-update

Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.

Add a Comment5 Comments

EmpowHER Guest
Anonymous

Yes, that is correct, Pat, the young rheumatologist is named Rula Hajj Ali---there is another physician, an opthalmalogist, Dr. Careen Lowder, who also contributed to the same article. She was my lifesaver at the Cole Eye Center. I only lived in the Cleveland area for nine years, and in general, I hated it. BUT, I will say: when you become ill, there is no better place, IMO, than Cleveland Clinic.
And, Linda, as an individual suffering with polychondritis, a disease affecting less than 500 people in North America, I think you are ever so correct in urging people to INSIST on pursuing care beyond what is commonly offered at the corner optometrist or walk-in clinic. I might add that unilateral eye involvement is often a more telling symptom than bilateral inflammation---which was exactly my experience. Inflammatory eye disease is under-reported and marginalized; I am grateful for this forum.
SW

January 31, 2010 - 8:05am

Thanks, Pat, and thanks to our guest for acknowledging Dr. Hajj Ali. I hope everyone with eye inflammation gets appropriate treatment immediately!

January 29, 2010 - 6:25pm
Expert HERWriter Guide Blogger

Linda - I believe the guest is referring to the source listing for the article (Rula AH et al, “Uveitis in the internist's office: Are a patient's eye symptoms serious?”, Cleveland Clinic Journal of Medicine 2005 April; 72(4): 329-339.) and questioning why Rula Hajj Ali is listed as Rula AH. Does that help? Pat

January 29, 2010 - 5:35pm

What do you think the reference should be?

January 25, 2010 - 2:36pm
EmpowHER Guest
Anonymous

The author of the REFERRING article saved my eyesight and my sanity. Her name is Rula Hajj Ali, and y'all have the reference wrong. I have relapsing polychondritis, and the BEST thing anyone can do when they suffer from uveitis or scleritis (I had both) is IMMEDIATELY see a rheumatologist, and get on IMMURAN. It saved me, psychologically and physically. Inflammatory eye disease makes you want to commit suicide. DO NOT ignore it, it's ungodly painful. Love to Dr. Hajj Ali, I miss you. SW

January 25, 2010 - 1:27pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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