Posterior Uveitis
Inflammation at the back of the eye's middle layer
Quick Facts
- Type: Inflammatory eye condition
- Area affected: Choroid and often the retina
- Common causes: Infection, autoimmune disease
- Risk: Vision loss if untreated
Overview
The uvea is the middle layer of the eye and includes the iris at the front and the choroid at the back. Posterior uveitis is inflammation that affects the back portion of the uvea, mainly the choroid, and frequently spreads to involve the retina, the light-sensing layer at the back of the eye.
Because it affects structures essential for clear central vision, posterior uveitis can be sight-threatening and needs prompt evaluation by an eye specialist. With the right treatment, inflammation can often be controlled and vision protected, though the condition sometimes recurs or becomes long-lasting.
Symptoms
Posterior uveitis often causes fewer signs on the surface of the eye than inflammation at the front, so symptoms can be subtle at first:
- Blurred or decreased vision
- Floaters, which look like spots or strands drifting across vision
- Reduced ability to see fine detail or colors
- Blind spots or areas of missing vision
- Usually little or no eye pain or redness, unlike front-of-eye inflammation
Symptoms may affect one or both eyes and can develop gradually.
Causes
Posterior uveitis can be caused by infections, immune system conditions, or sometimes no identifiable cause:
- Infections: Such as toxoplasmosis, tuberculosis, syphilis, certain viruses, and other organisms.
- Autoimmune and inflammatory diseases: Conditions in which the immune system attacks the body's own tissues, such as sarcoidosis and others.
- Idiopathic: In many cases a specific cause cannot be found.
Risk Factors
- Autoimmune or inflammatory disorders
- Certain infections, including those affecting the whole body
- A weakened immune system
- A previous episode of uveitis
Diagnosis
An eye specialist (ophthalmologist) diagnoses posterior uveitis through a detailed eye examination, often after dilating the pupils to view the back of the eye. Additional tests may include:
- Imaging of the retina, such as optical coherence tomography or specialized photography.
- Blood tests to look for infections and autoimmune conditions.
- General medical evaluation, since the cause may involve the whole body.
Treatment
Treatment aims to reduce inflammation, treat any underlying cause, and protect vision:
- Corticosteroids: Given as pills, injections around or into the eye, or sometimes implants to control inflammation.
- Treating infection: Specific antibiotics, antiviral, or antiparasitic medicines when an infection is responsible.
- Immune-modulating medicines: For autoimmune causes or severe, recurrent disease.
- Close follow-up: Monitoring for complications such as swelling of the retina, glaucoma, or cataract.
Prompt and consistent treatment offers the best chance of preserving vision.
Prevention
- Manage any underlying autoimmune or infectious disease as advised
- Attend regular eye checkups, especially after a previous episode
- Report new floaters, blurred vision, or blind spots promptly
- Take prescribed medicines exactly as directed and do not stop early
When to See a Doctor
See an eye doctor promptly if you notice new or increasing floaters, blurred vision, blind spots, or a sudden change in your sight. Posterior uveitis can quietly damage vision, so any unexplained vision change deserves urgent evaluation, particularly if you have an autoimmune condition or a history of eye inflammation.
Frequently Asked Questions
Is posterior uveitis serious?
It can be serious because it affects the retina and choroid, which are essential for clear vision. Without prompt treatment it can lead to lasting vision loss, so any new floaters, blurred vision, or blind spots should be evaluated quickly by an eye specialist.
Why doesn't my eye hurt or look red with posterior uveitis?
Inflammation at the back of the eye often causes few surface symptoms, so the eye may look normal and feel comfortable even while vision is being affected. This is why subtle changes like floaters or blurring should not be ignored.
What causes posterior uveitis?
It can result from infections such as toxoplasmosis, tuberculosis, or syphilis, from autoimmune and inflammatory diseases such as sarcoidosis, or sometimes from no identifiable cause. Finding the underlying reason guides treatment.
Can posterior uveitis be cured?
Many cases can be controlled with treatment that reduces inflammation and addresses any underlying cause, and vision can often be preserved. However, the condition can recur or become long-lasting, so ongoing follow-up with an eye specialist is important.
References
- National Eye Institute (NEI). Uveitis.
- American Academy of Ophthalmology. Uveitis.
- MedlinePlus, U.S. National Library of Medicine. Uveitis.