OHSU

Casey Eye Institute at OHSU, Portland, Oregon

Where Healing, Teaching and Discovery Come Together


Uveitis and Inflammatory Disease

Uveitis is a descriptive term that refers to inflammation within the eye. The uvea includes the iris at the front of the eye, the ciliary body and the choroid toward the back of the eye. The uvea is very important because its many veins and arteries transport blood to the parts of the eye that are critical for vision. Because uveitis is serious, treatment needs to begin right away. For uveitis not caused by an infection, your ophthalmologist may prescribe eye drops containing steroids to reduce swelling and drugs to relieve pain. Antibiotics are used in patients with infectious uveitis. Dark glasses will help if your eyes are sensitive to light.

Complications of uveitis may include glaucoma, cataracts, abnormal growth of blood vessels in the eyes that interfere with vision, fluid within the retina and vision loss. Early diagnosis and treatment by your ophthalmologist is critical.

At the Uveitis Clinic at the Casey Eye Institute, we use the following guiding principles in providing advice to patients:
  • Everyone is different. This means that treatment is individually tailored to each patient's needs. Designing the best-tolerated and most effective therapy may require some trial and error, because each patient is unique.

  • Treating inflammation is like dousing a fire. Often, relatively high doses of medication are prescribed at first as we try to reduce inflammation. However, many types of inflammation resist--the flames aren’t out completely. When treatment appears to reduce or eliminate the inflammation completely, medication is usually stopped gradually to make sure the flames are indeed out.

  • The least amount of medication is the best amount of medication. All medications have potential toxicity. The optimal dosage of medication is the lowest amount that controls the inflammatory process.

  • Various medications have different degrees of potential risk. In general, the degree of risk that is appropriate depends on how severe the inflammation is and how much it impairs the patient's daily living.

  • Choosing the right treatment is like choosing what to eat from a restaurant menu. Your doctor's responsibility is to describe the options, their advantages and their risks. The best choice of therapy is very much a matter of personal preference, based on understanding the advantages and disadvantages of each approach.

  • It is not always possible to determine how successful therapy is. When you take a medication and visual acuity doesn’t improve, it’s possible that vision may have worsened significantly if the medication had not been taken. On the other hand, if you take a medication and your vision improves, it’s conceivable that the improvement occurred on its own, without the use of the medication.

  • Medications that suppress the immune system don’t work immediately. In general, medications such as methotrexate, imuran, cyclosporine and cytoxan take several weeks before you see improvement. Corticosteroid medications tend to work much faster in reducing the inflammatory response.

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