Uveitis

Comprehensive Care for Chronic Eye Inflammation

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Overview

Uveitis is a rare, complex condition that may result in eye pain, eye redness, blurred vision, light sensitivity, or floaters. The type of uveitis you have depends on which part of the eye is affected -- the front, middle, or the back. If not properly treated by an experienced ophthalmologist, uveitis may lead to glaucoma, cataracts, retinal swelling, or permanent vision impairment. Some common causes of the condition include infections, trauma, and autoimmune or inflammatory diseases.

Duke's team of uveitis specialists work to accurately diagnose your condition and provide comprehensive care to reduce inflammation and preserve your vision. At the same time, we help you manage the complications that are sometimes associated with uveitis treatments.

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Uveitic Glaucoma

Content

In some people, uveitis or the steroids used to treat it can cause increased eye pressure, which can lead to uveitic glaucoma. This form of glaucoma can affect adults and children and can progress rapidly. Our uveitis specialists frequently assess your eyes for signs of glaucoma so any necessary treatment can be started as soon as possible. We work closely with Duke ocular immunologists to adjust medications and to provide other treatments to protect your vision, including surgery if needed.

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Treatments for Uveitis

Steroids

Description

Steroids in the form of eyedrops, eye injections, and oral or intravenous medications are often the first line of treatment for non-infectious uveitis. Sustained doses of steroids may also be delivered directly to the eye through a tiny, biodegradable implant that is injected into the gel of the eye. This provides longer-term control of inflammation. Because long-term use of steroids taken by mouth can have serious side effects, other types of medication may be recommended, depending on the degree of inflammation.

Immunosuppressive Medications

Description

Drugs that suppress an overactive immune system may be recommended if long-term treatment is required to control chronic eye inflammation. Although they do not have the same side effects as steroids, these medications may require frequent monitoring of blood work for potential side effects.

Immunosuppressive medications include biologics, which control inflammation by blocking specific proteins in the body. Adalimumab is the first approved biologic for the treatment of uveitis. It can be administered at home via an injection under the skin, typically every two weeks.

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Tests for Uveitis

Tests Overview

To make an accurate diagnosis and to identify or exclude possible causes of uveitis, our specialists may perform several tests. In roughly 50% of cases, no associated systemic or infectious cause is detected.

Blood Tests

Description

Blood tests look for various inflammatory, autoimmune, and infectious conditions that may be causing uveitis.

X-Ray

Description

A chest X-ray can help identify signs of tuberculosis or sarcoidosis (a disease that affects the lungs and lymph glands).

Fluid Samples

Description

Fluid samples from the eye can sometimes help identify the cause of uveitis. An aqueous fluid sample may be obtained from the front of the eye during a clinic visit. If needed, a vitreous sample may be taken from the back of the eye during vitrectomy surgery, which is performed in the operating room.

Retinal Imaging

Description

Various types of retinal imaging, often combined with a dye injection (angiography), can help to confirm a diagnosis of uveitis and determine the extent of lesions and scarring. During follow-up, retinal imaging is performed to monitor the progression of uveitis and response to treatment.

Best Eye Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our ophthalmology program is ranked sixth in the nation and is the highest ranked program in North Carolina, according to U.S. News & World Report for 2022–2023.

Why Choose Duke

Content

Advanced Training and Experience
The Duke uveitis clinic is staffed by ophthalmologists with advanced training and experience in managing uveitis, as well as experts in glaucoma, cataracts, and retinal disease. Our uveitis specialists work with rheumatologists to provide a comprehensive plan for managing medications and monitoring for complications. Joint uveitis-rheumatology appointments allow patients to receive a complete eye exam with monitoring of immunosuppressive medications at a single visit.

Specialized Treatment
Infectious uveitis often requires specific treatment tailored to the infection. Duke’s uveitis specialists use specially compounded medications that are not readily available to treat different types of eye infections.

Learning to Manage Your Condition
Your care includes education about your condition and access to our low vision rehabilitation program, which offers tools for living with impaired vision. Our dedicated social worker is also available to help you and your loved ones manage your care and maximize your quality of life.

Over 30 Years of Innovative Research
Duke’s uveitis specialists have been studying effective treatments for more than 30 years. We were instrumental in the development of a new steroid delivery system and were involved in the clinical trials that led to the 2016 FDA approval of the non-steroidal biologic drug Humira (adalimumab) to treat uveitis. We continue to actively participate in clinical trials and research to broaden our understanding of uveitis and effective treatments, and you may be a candidate to participate in these clinical trials.

This page was medically reviewed on 02/02/2023 by

Katy L. Liu, MD, PhD | Glaucoma Specialist