Tuesday , May 18 2021

[건강칼럼] Uveitis which causes vision loss and blindness

Most eye diseases that cause blindness are usually associated with aging, but there are diseases that can cause blindness even in young and healthy patients. What is uveitis that can cause sudden onset and cause serious symptoms?

What is uveitis?

Lee, who had been in normal health without special medical problems and had never visited a hospital, had suffered a decrease in visual acuity after the onset of redness and pain in his right eye. I felt tired at first, but the symptoms became very severe. At the time of reception, my vision reached a level of security (I could not see the vision plate and could count the number of fingers before 30cm). Through eye examinations and blood tests, the cause of uveitis is related to ankylosing spondylitis.

Uveitis is an inflammation that literally occurs in the uvea. Uvea is an iris that forms the middle layer of the eyeball (brown tissue at the front of the eye), ciliary body, and choroid, rich in blood vessels and prone to inflammation, and inflammation that occurs here is called uveitis. Uveitis is divided into anterior uveitis, middle uveitis and uveitis depend on its location, and all forms of uveitis are referred to as total uveitis. Some causes such as germs, viruses, parasites, trauma, and inflammatory system diseases are known, but idiopathic uveitis can occur without specific causes.

Symptoms and Diagnosis of Uveitis

Uveitis can have various symptoms depending on the location and level of inflammation. Anterior uveitis is usually acute. Congestion, pain, and bright light can cause symptoms such as tearing the eyes, and inflammation of the eyes can be caused by severe inflammation. In middle uveitis and uveitis, the main symptom is decreased vision and insomnia, in cases of uveitis, glare and varicose veins can appear.

Symptoms caused by uveitis can also occur in other inflammatory diseases such as conjunctivitis, keratitis, or scleritis, so you should visit an ophthalmologist to make an accurate diagnosis. For diagnosis, it is necessary to confirm inflammation in the anterior part of the anterior eye through a light-lamp microscope, and an intraocular pressure test is needed because it can be accompanied by hypotension or ocular hypertension. In some cases, fundal examinations are performed to confirm inflammation in the back of the eye, and fluorescent angiography or tomography of optical coherence is done to distinguish more accurately between ocular disease and other retinal complications.

In addition to ophthalmological examinations for diagnosis, it is necessary to identify systemic diseases accompanied by uveitis, blood tests including genetic tests and radiological examinations needed for this. If the patient has an inflammatory systemic disease or an autoimmune disease, care must be taken only if the internal medicine works together and is managed, therefore, it is important to examine this systemic disease. Despite various tests, there are cases where no obvious cause can be found.

Complications due to uveitis

Chronic recurrent uveitis itself can also reduce visual acuity. Secondary vision loss can also occur if the optic nerve is involved or macular papules develop. Other complications of uveitis include iris adhesion, iris atrophy, cataracts, glaucoma, retinal detachment, retinal detachment, retinal atrophy, uveitic atrophy, optic atrophy, guidance on angiogenesis, vitreous bleeding, loss and eyeball conditions can occur. The eyeball is a condition in which the overall function of the eye is so bad that it causes black opacity, decreased intraocular pressure, decreased eye size, and loss of vision.

In the treatment of uveitis, various drugs such as steroids are used. In the case of long-term medication treatment, various problems such as cataracts, glaucoma, ptosis, gastric ulcers, diabetes and hypertension can occur due to medication, it is necessary.

Uveitis treatment

If the cause is found, the right treatment for the cause of this disease is done. In cases of infectious causes, antibiotics and antivirals are suitable for the causative bacteria or viruses that cause infection. If not infected, topical drugs to control inflammation, such as eye drops or oral medications (steroids), are needed. Pain relief and eye irritation (paralytic agent) that shakes the pupil for the purpose of preventing adhesion of the posterior iris to the surrounding tissue treated with eye drops. If necessary, eye or intraocular steroid injections can be performed in addition to eye / oral steroids. Inflammation does not diminish or recur, and in this case, chronic inflammation recurs, immunosuppressants are sometimes needed, and in this case it is necessary to periodically carry out blood tests for possible adverse drug reactions. This is related to inflammation and can cause various intraocular complications such as macular edema, exudative retinal release, and glaucoma. In addition, these complications can leave side effects even if the inflammation subsides, and visual disturbances caused by these complications can be abandoned, so continuous observation and proper treatment are important. Therefore, it is recommended to visit an ophthalmologic clinic without delay if the same symptoms reappear after treatment, to minimize eye damage with diagnosis and treatment, and to receive regular ophthalmologic examinations without recurrence.

Although uveitis is a serious eye disease that can cause blindness and blindness, it is still a popular public awareness of this disease. I think it's usually & # 39; tired & # 39; and & # 39; temporary & # 39; Experience. It is important to monitor health care to avoid unfavorable situations when you miss the right period of treatment and after the disease has developed significantly.

Q & A about uveitis

Q. How are the symptoms of uveitis different from conjunctivitis?

A. Uveitis is often confused with conjunctivitis, and general pneumococcal conjunctivitis usually causes eye rashes, itching, glare, pain, and redness. Uveitis can also cause pain, redness, and glare, but there is a slight feeling of foreign objects and itching. Congestion symptoms also occur in pre-whites of conjunctivitis, but in uveitis it is more common around blackheads (corneas).

Q. Should uveitis be treated quickly?

A. Depending on the severity of the disease, if inflammation is very severe, if you do not receive proper treatment in a few days, you may end up with structural damage to the eye and not recovering. Therefore, it is good to receive eye care as soon as possible.

Q. How should I give steroid eye drops?

A. Steroid eye drops are not transparent, need to shake the eyewash bottle thoroughly before mixing eye drops, mix the medicine evenly, and then stop. Also, after the inflammation has been controlled, it must be cut off gradually. If you don't take steroid eye drops for a long time without limits, complications such as cataracts, glaucoma, and keratitis can occur.

Q. Is my body swollen after eating steroid medicine, is it okay?

A. When taking steroid pills, swelling can occur gradually. In short-term use, the drug can be restored after the drug is stopped, but must be used after consulting a doctor.

Q. I did not receive treatment on the date promised for steroid eye drops. Can I continue to use eye drops and get medical treatment in a month?

A. Steroid eye drops must be examined by an ophthalmologist and adjusted for use and time. If you use it for a long time, you may get cataracts, glaucoma, keratitis, and so on.


Gyeongbuk Branch (Northern Daegu Medical Center) 053-350-9000, http://www.kahpgb.co.kr

Daegu Branch (Daegu East Checkup Center) 053-757-0500, http://daegu.kahp.or.kr

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