What are the causes of mild uveitis

Uveitis - the eye disease is hardly known, although it affects almost half a million people in Germany and 10,000 new cases are added every year. The inflammation of the vascular skin and iris can be noticed as an acute event by a red eye with a feeling of pressure. More insidious are the slow-moving inflammations, which often lead to a slow deterioration in eyesight without any acute warning signs. Then the uveitis is occasionally discovered by the ophthalmologist by chance. If uveitis goes undetected and untreated, there is a possibility that complications could lead to severe changes in vision. For example, increased eye pressure, commonly known as glaucoma or glaucoma, as well as clouding of the lens can result. Numerous diseases can lead to uveitis in the eye, with rheumatic diseases in particular in children, in later life the tick-borne borreliosis, tuberculosis or herpes viruses are the focus. "Serious consequential damage caused by uveitis can only be prevented with timely treatment by an ophthalmologist. A holistic diagnosis is particularly necessary because of the many causes," advises Professor Manfred Zierhut, senior physician at the University of Tübingen's eye clinic for the professional association of ophthalmologists.

Blood vessels - life stream

The middle layer of the eye encloses the blood vessels, which is why it is also called the vascular skin. In the anterior segment of the eye, the vascular skin merges into the iris. Both layers can become inflamed individually or together, causing uveitis. If the iris becomes inflamed on its own (iritis), patients often go to the ophthalmologist too late because the eye is reddened like conjunctivitis. With 10,000 new cases annually, uveitis is a widespread disease. While particularly aggressive forms of rheumatism are triggered in children, so-called medium uveitis (intermediate uveitis) tends to occur in adolescence, often without additional disease. Other possible diseases that lead to uveitis are pulmonary tuberculosis or sarcoidosis, herpes viruses, borreliosis, which can be transmitted by tick bites, and infections with the parasite Toxoplasma gondii, which is often transmitted by cats. Severe inflammation can occur in immunocompromised patients, e.g. triggered by AIDS viruses or the Candida skin fungus.

The bomb is ticking

While the sudden onset of uveitis usually occurs as a so-called iris inflammation and usually takes the patient to the ophthalmologist quickly, the chronic form is very treacherous. Veils or flakes in front of the eyes often lead those affected to the ophthalmologist late because these signs are not taken seriously. Prof. Manfred Zierhut, who has been dealing with the disease for years, advises anyone with altered visual acuity and moving flakes to consult an ophthalmologist immediately: because "the consequences of such an inflammation can have major effects".

Lengthy treatment

The treatment of uveitis is often complicated and depends on the cause - if it is known. Therefore, a qualified ophthalmologist will diagnose and treat uveitis holistically, but cooperation with other doctors is often necessary. To avoid the risk of the lens and iris sticking together, the pupil is dilated with special eye drops, which in the acute form usually leads to the pain disappearing. The focus of the treatment is the fight against inflammation. While in the initial stage, especially with iris inflammation, the anterior form of uveitis, therapy with drops containing cortisone is successful, administration of cortisone tablets or even immunosuppressants may be necessary in later stages. In severe forms of uveitis, the vitreous must be surgically removed.

Therapy of the underlying disease

If an infection is based on uveitis (e.g. borreliosis or tuberculosis or herpes viruses), the disease can be treated with antibiotics or antivirals. If no underlying infectious disease can be determined, the uveitis is often based on a so-called autoimmune process. With these diseases, the body's own defense system can no longer differentiate between its own and foreign structures. As a consequence, the wrongly informed body's own defense system contributes to the inflammation of the vascular skin and iris. In addition to cortisone tablets, immunosuppressants in particular, moderately dosed, are of great help. "The particularly severe forms of the disease, which are characterized by the presence of numerous complications and frequent relapses, place high demands on ophthalmologists today. These patients are often treated in specialized hospitals," says the author of several specialist books on uveitis, Professor Manfred Zierhut.

The sick advise the sick

In order to promote education about this widespread disease, the German Uveitis Working Group (DUAG) has been set up by patients (Volker Becker, Forsthausstr. 6, 34792 Löhnberg; email: [email protected]). The aim of DUAG is to provide information to the people concerned, but also to the ophthalmologist, through brochures and magazines. Those affected have the opportunity to exchange ideas with fellow sufferers via the DUAG. "Many people are not clear about the special demands of our everyday work and our free time on the eyesight these days. In Germany there are 25 million workstations at computer screens, almost every German participates in road traffic. Therefore, no one should experience a slow deterioration in visual acuity or pain in the eye take something lightly". Professor Manfred Zierhut advises patients who suffer from diseases such as multiple sclerosis, sarcoid, borreliosis and similar systemic diseases, especially arthritis in children, to be closely monitored by an ophthalmologist.