Uveitis affects the middle layer or uvea. At the front of the eye, this refers to the iris and the ciliary body. In the center and back, it refers to the choroid, the tunic of blood vessels under the sclera that nourish the retina.

Overview

Uveitis (you-vee-I-tis) is an infection or inflammation of the uvea, the pigmented middle layer of the eye that contains the iris, the ciliary body and the choroid, which is composed of blood vessels that supply the retina. It is most common in people between ages 20 and 50.

There are four main categories of uveitis, characterized by the portion of the uvea that is affected:

• Anterior uveitis is the most common type and affects the iris, the front portion of the uvea. This is also called “iritis.”
• Intermediate uveitis affects middle portion containing the ciliary body, vitreous and retina. This form is also known as “cyclitis.”
• Posterior uveitis affects the choroid and optic nerve in the back portion and is also known as “choroiditis.”
• Diffuse uveitis refers to inflammation of all portions of the uvea.

The are some 100 known causes of uveitis — so many that in at least half the cases (and by some estimates, as many as 90 percent), the exact cause is never known. Most commonly, though, it results from trauma to the eye, such as an accident, or from a bacteria or viral infection that has spread from other parts of the body. Uveitis may also develop from autoimmune diseases such as juvenile rheumatoid arthritis or sarcoidosis, or from AIDS or other sexually transmitted diseases such as herpes or syphilis. Some forms are caused by genetics.

Symptoms

Blurred vision and pain are the most obvious signs of uveitis, but each category has its own symptoms:

• Anterior uveitis is often marked by redness around the iris, and an aching or intense pain. Along with blurred vision, there may also be tearing, light sensitivity and the pupil may appear smaller than usual.
• Intermediate uveitis is often characterized by the sudden presence of floaters; however, occasional floaters are extremely common and do not necessarily indicate uveitis, any unusual incidence warrants an examination by an eye doctor. There may or may not be pain, and can affect both eyes.
• Posterior uveitis typically involves only pain and blurred vision.
• Diffuse uveitis may have any combination of symptoms.

Prevention

Shielding eyes from trauma with protective eyewear and quickly controlling infections such sexually transmitted diseases can prevent some cases. But most cases cannot be prevented.

Treatment

Uveitis usually does not pose a serious threat to vision, but it can and needs to be evaluated by your eyecare provider. When identified and treated early, the prognosis for recovery is good. Topical eye drops and oral medications are typically used for treatment, but since intraocular pressure may increase, additional medications to lower IOP may be necessary.

Uveitis is diagnosed with a thorough examination of the eye with a slit lamp microscope, which has an attached light that allows the doctor to examine your eye under high magnification, and with an ophthalmoscope to examine the retina and vitreous. In some cases, your doctor may recommend blood tests to determine the presence of infection.

A stye is typically harmless, resulting from a bacterial infection and forming at the base of an eyelash, or on or inside the eyelid.

Overview

A stye, medically known as a hordeolum, is a small lump that appears on, inside or under the eyelid or on eyelashes. Styes typically result from a staphylococcal bacteria infection or from a clogging of the oil glands around the eyelashes or inside the eyelid, but can be triggered during times of stress. They are usually harmless, despite their appearance – causing redness, tenderness, pain and sometimes light-sensitivity and eye-watering.

Styes are often confused with chalazion, which are cysts that forms on or inside the eyelids as a result of a blockage of one or more of meibomian glands. However, a chalazion is not an infection and is usually painless, but may attract bacteria and lead to an infection. Styes that appear on the eyelid are usually deeper, more painful and last longer than those appearing on the eyelash.

Symptoms

Redness, tenderness and pain are usually the first symptoms of a stye (though eyelash styes are less painful and heal with less effort than eyelid styes). These are followed by:

• Swelling in a small area or the entire eyelid
• The affected eye may water, feel irritated or be sensitive to light
• Discomfort when blinking
• A small yellowish spot (pointing) in the center of a sty, which occurs when pus collects and expands. Pain is usually is relieved when the sty ruptures, draining the pus.

Prevention

Wash your hands regularly and avoid touching your eyes to the spread of bacteria. Avoid sharing eye makeup, especially if you’re prone to recurring styes.

Treatment

While an eyelash stye will usually drain on its own in approximately 2 days, a warm compress can speeding healing. Apply a washcloth on the affected eye for 10 minutes, four times per day, to release the fluids that have built up inside the stye. Do not squeeze the stye. Antibiotic ointment, or an antibiotic-steroid combination, can be used until symptoms have cleared.

If the eyelash stye lasts more than 3 days or the infection appears to be spreading, consult your eye doctor. You may have a chalazion or another condition that may require further examination.

Eyelid styes are more stubborn and usually require treatment by a physician. They may need to be lanced under sterile conditions. Oral antibiotics may be prescribed if the stye is very large, abscessed or not responding to other treatment.

Contact lenses should not be worn during infection or drainage of a stye. Your eyecare provider may recommend replacing your contact lenses after the stye has healed to prevent recurrence or spread of the infection.

Overview

Low vision is a term used to describe having impaired but some useful vision that that cannot be fully corrected by conventional eyewear, surgery or medical treatments. More than 13 million Americans have some degree of low vision — often a loss in visual sharpness or acuity. However, low vision may also include a loss in the general field of vision, increased light sensitivity, distorted vision, a loss in contrast or other impairments that affect the quality of life and the ability to do everyday activities.

People with low vision are not blind, although many are classified as being “legally blind” — a term used to describe visual acuity no better than 20/200 in the better eye with visual correction such as eyeglasses or contact lenses. This means that they must be 20 feet away to clearly see an object that a person with 20/20 eyesight can see clearly from 200 feet away. “Partially sighted” is the other general classification associated with low vision and refers to a visual acuity between 20/70 and 20/200 in the better eye with the best-corrected lens in place.

Low vision often occurs from complications of eye diseases such as diabetic retinopathy, macular degeneration, retinitis pigmentosa inoperable cataracts, retinal lesions or glaucoma. It can also result from stroke, eye or head injuries, brain tumors, birth defects or even the natural aging process. Although low vision cannot be cured, there are various devices and adaptive products to help you live a more productive and safe life. Many of these devices — along along with counseling and other rehabilitative therapies — are specifically prescribed on a case-by-case basis by an eyecare provider.

Symptoms

Any difficulties in seeing — whether it’s recognizing a familiar face, trouble reading or seeing objects such as furniture or walls — could be symptoms of low vision. Other symptoms include:

• Blurred or distorted vision
• Central or multiple field loss, in which a dark hole, patches or hazy area appears in the center or around objects
• The loss of peripheral vision, in which objects in the center of vision appear clear but those on the sides are blurry
• Light sensitivity or glare
• A loss in contrast, in which objects blend in with their surroundings

Prevention

Since low vision often results from eye and other diseases, prevention may occur by quick management of those conditions.

Treatment

A thorough eye exam by your eyecare providers that includes a comprehensive health history is necessary to determine the possible cause of your low vision, and help determine which specific optical and non-optical devices may be most useful to you.

Optical devices include but are not limited to:

• Magnifiers that can be held or mounted onto eyeglasses or on a special headband that help for reading, writing, sewing, and other “close” activities.
• Spectacle-mounted telescopes that are useful for seeing longer distances, such as across the room to watch television.
• Closed-circuit television (also called CCTVs) that enlarge reading material on a video screen. Some are portable, while some can be connected to a computer. The user can adjust the image brightness, size, contrast and background illumination.

Non-optical devices include products such as large-print reading material, check-writing guides, enlarged telephone dials, high contrast watch faces, self-threading needles, “talking” computers, clocks and other products, and special lighting to reduce glare.

In addition to products, your eyecare provider may recommend resources that provide social services to those with low vision, counseling to deal with emotional effects, or occupational therapists that come to your home to help you make it safer and more efficient.