Patricia S. Bainter, MD
Dr. Bainter is a board-certified ophthalmologist. She received her BA from Pomona College in Claremont, CA, and her MD from the University of Colorado in Denver, CO. She completed an internal medicine internship at St. Joseph Hospital in Denver, CO, followed by an ophthalmology residency and a cornea and external disease fellowship, both at the University of Colorado. She became board certified by the American Board of Ophthalmology in 1998 and recertified in 2008. She is a fellow of the American Academy of Ophthalmology. Dr. Bainter practices general ophthalmology including cataract surgery and management of corneal and anterior segment diseases. She has volunteered in eye clinics in the Dominican Republic and Bosnia. She currently practices at One to One Eye Care in San Diego, CA.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is uveitis?
- What causes uveitis?
- What are symptoms of uveitis?
- What are the signs of uveitis?
- What are the different types of uveitis?
- What other medical conditions are associated with uveitis?
- How is uveitis diagnosed?
- What is the treatment for uveitis?
- What is the prognosis for uveitis?
- What are the complications of uveitis?
- Can uveitis be prevented?
- Find a local Eye Doctor in your town
How is uveitis diagnosed?
An ophthalmologist will ask several questions about the symptoms, both in the eye(s) and the rest of the body (for example, about painful joints, weight changes, skin rashes, etc). The doctor will also need a detailed history of any existing medical conditions and family history of medical disorders.
The vision and eye pressures will be measured, and the examination will involve careful observation of all parts of the eyes.
Though there are several types of uveitis, they all have one thing in common: invasion of white blood cells (immune cells of inflammation found in the bloodstream) from inside the blood vessels of the uvea to outside the blood vessels. These white cells permeate the uveal tissue and also leak out of the uvea into other parts of the eye. This presence of white blood cells is what an ophthalmologist looks for when making the diagnosis. Using a slit lamp, an ophthalmologist can detect white blood cells accumulating in different parts of the eye.
Iritis can present as 'subclinical' with no white blood cells visible, or as subtle microscopic white blood cells floating in the aqueous, the liquid in front of the iris. Sometimes uveitis is not so subtle with large numbers of cells visible and accumulations on the back of the cornea (the clear “dome-shaped” front cover of the eye). These clusters of cells are referred to as 'mutton fat deposits.' In extreme cases, the cells can also form a large pool in the space between the iris and the cornea. This is referred to as a 'hypopyon.'
Cyclitis (intermediate uveitis) presents as white blood cells floating in the clear material just behind the iris (the vitreous) and collections of cells on the surface of uveal tissues behind the iris. Similarly, choroiditis presents as cells in the vitreous and uveal tissue, but further posterior (towards the back of the eye). An ophthalmologist will likely need to dilate the patient's eyes and use special examination techniques to visualize this.
If an associated medical disease is suspected, additional tests or consultation with other specialists may be necessary to identify the condition. These tests might include laboratory evaluation of a small sample of aqueous or vitreous liquid from the eye, blood tests, and/or X-rays. These tests take time. Therefore, usually a treatment plan is initiated based on a clinical judgment before the cause can be definitively identified.
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