Uveitis is a diverse group of diseases that all involve inflammation in the eye.   Inflammation can occur for many reasons, but is most often due to an overactive immune system or an infection in the eye.  Occasionally, uveitis is related to an underlying systemic disease, like rheumatoid arthritis or juvenile idiopathic arthritis.  While inflammation that occurs elsewhere in the body is sometimes no more than annoyance, in the eye inflammation can be blinding.  Long-standing inflammation in the eye can cause scarring, cataract, glaucoma, and macular edema (retinal nerve swelling), all of which are harmful to vision.  Thankfully, permanent vision loss often can be avoided with proper and timely treatment.

Diagnosis

Finding the reason for your inflammation can help target your treatment plan.  If your inflammation is part of a larger systemic problem, finding this problem can save you disability, an in some cases, even years of life.  A typical office consultation involves an extensive dilated eye examination, imaging studies, and laboratory tests to diagnose the problem and individualize treatment.  Your diagnostic studies will be completed and/or ordered at your first visit.  Please allow about 2 hours for your initial consultation and expect to be blurry for four hours after your appointment.

Treatment

At Achieve Eye and Laser Specialists, Dr. Nakamoto uses both medical and surgical therapies to treat uveitis.  Treatment for uveitis is achieved in a three step process: 1) immediate control of inflammation  2) long term control of inflammation (maintenance), and 3) visual rehabilitation.  Immediate control involves extinguishing the current inflammation episode in your eye.  This is usually achieved with corticosteroids, delivered by drops, orally, or by (painless) injection.  Long-term control, if indicated, usually involves immunomodulatory medication or a low dose steroid regimen.  These medications are managed very precisely and will be chosen for your specific situation.  Patients with recurring episodes of uveitis, very severe flares, or systemic disease need long term inflammatory control or risk cumulative visual decline and systemic morbidity.

Visual rehabilitation occurs after long term inflammatory control is maintained.  Many of the procedures offered by Dr Nakamoto are the same ones as for patients without uveitis, except that the perioperative care is specially tailored to reduce the chances of a uveitis flare after surgery.  Surgical care includes cataract extraction; removal of scar tissue; glaucoma tubes, valves, and shunts (to relieve high pressure in the eye); and vitrectomy (removal of the cloudy jelly in the eye).