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Ocular Inflammation and Immunology

Overview
Importance of the Uvea
Types of Ocular Inflammation
Causes
Diagnoses
Treatment Options
Where to Seek Treatment
Singapore National Eye Centre
Contributed by Ocular Inflammation & Immunology Service

OCULAR INFLAMMATION AND IMMUNOLOGY

 

What Is Ocular Inflammation And Immunology?

Ocular Inflammation is inflammation of the uvea, the middle layer of your eye. The eye is shaped much like a tennis ball, with three different layers of tissue surrounding a central gel-filled cavity.

The innermost layer is the retina, which senses light and helps to send images to your brain. The middle layer between the sclera and retina is called the uvea. The outermost layer is the sclera, the strong white wall of the eye.

  

  
 

 
 
What Is The Importance Of The Uvea?

The uvea contains many blood vessels, the veins and arteries that carry blood flow to the eye. Since it nourishes many important parts of the eye (such as the retina), inflammation of the uvea can damage your sight.

Are there different types of ocular inflammation?

A simple way to classify types of ocular inflammation is according to the part of the eye that is affected into (see diagram) :

• Episcleritis /Scleritis
• Anterior uveitis (also known as iritis or iridocyclitis)
• Intermediate uveitis (including pars planitis)
• Posterior uveitis (including retinitis, choroiditis, chorioretinitis and neuroretinitis)
• Panuveitis (when the whole eye is inflamed from anterior to posterior aspect)

What causes Ocular Inflammation?

Ocular inflammation may be the result of a wide variety of causes, including infection and inflammatory disorders (see below). Some conditions may affect other parts of the body. In many cases however, despite thorough investigations, the cause remain unknown.

 Condition  Symptoms Possible diagnosis
 Episcleritis
 Scleritis
 
 Redness, pain, Watering
 
 
 Idiopathic episcleritis Anterior scleritis
 (diffuse or nodular, with or without necrosis)
 Posterior scleritis
 Anterior uveitis
 Iritis
 Iridocyclitis
 
 
 
 
 Redness, pain,
 Photophobia,
 Watering,
 Eye pressure may be raised;
 Vision may or may not be
 affected
 
 Idiopathic Anterior Uveitis
 HLA-B27 related uveitis
 Herpetic keratouveitis
 Posner Schlossman syndrome
 Fuch’s Heterochromic iridocyclitis
 Cytomegalovirus anterior uveitis
 
 Intermediate
 uveitis
 Vitritis
 Pars Planitis
 Floaters,
 Blurred vision
 
 
 Idiopathic intermediate uveitis
 Underlying systemic disease
 (Multiple sclerosis, sarcoidosis, syphilis,
 Tuberculosis, Lyme disease)
 Posterior uveitis
 Retinitis
 Choroiditis
 Chorioretinitis
 Neuroretinitis
 
 Blurred vision
 
 
 
 
 
 Infective :
 Toxoplasmosis
 Viral retinitis (including acute retinal necrosis) :
 Varicella zoster virus, herpes simplex virus, 
 cytomegalovirus, Epstein-Barr virus
 Dengue-associated disease
 Retinal Vasculitis
 
 
 
 
 
 
 
 Blurred vision, floaters
 
 
 
 
 
 
 
 Eales Disease
 Behcet’s disease
 Sarcoidosis
 Systemic lupus erythematosus,
 polyarteritis nodosa
 Wegener’s granulomatosis
 Infective :
 Tuberculosis, syphilis, viral, toxoplasmosis
 Panuveitis
 (infective )
 (Endophthalmitis)
 
 
 All of above
 
 
 
 
 Exogenous – from open wound
 eg. Trauma,post-op
 Endogenous – from internal source
 through the blood stream eg. Hepatobiliary disease, Urinary tract infection
 Panuveitis
 (non-infective)
 
 
 
 All of above
 
 
 
 
 Behcet’s Disease
 Vogt-Koyanagi-Harada Disease
 Sympathetic Ophthalmia
 Sarcoidosis
 Masquerade syndromes (tumour related)

 
How Is Ocular Inflammation Diagnosed?

A careful eye examination by an ophthalmologist is extremely important when symptoms occur. Inflammation inside the eye can permanently affect sight or even lead to blindness, if it is not treated.

Your ophthalmologist will examine the inside of your eye. He or she may order blood tests, skin tests or X-rays to help make the diagnosis. Since uveitis can be associated with disease in the rest of the body, your ophthalmologist will want to know about your overall health. He or she may want to consult with your primary care physician or other medical specialists.

What kind of treatment are available for Ocular Inflammation?

Ocular Inflammation is a serious eye condition that may scar the eye. You need to have it treated as soon as possible. Eye drops, especially steroids and pupil dilators, can reduce inflammation and pain. For more severe inflammation, oral medication or injections may be necessary.

Uveitis can have these complications:

• Glaucoma (increased pressure in the eye)
• Cataract (clouding of the eye's natural lens)
• Neovascularization (growth of new, abnormal blood vessels)

These complications may develop in chronic severe inflammation.  Specialist care is essential to ensure your condition is appropriately managed.

Please visit the following relevant links :-

Ocular Inflammation & Immunology Service
Ocular Inflammation & Immunology Clinical Staff
I Want an Eye Examination / an Appointment
Feedback


Where to Seek Treatment

The medical institutions within SingHealth that offer consultation and treatment for this condition include:

1. Singapore National Eye Centre
Ocular Inflammation & Immunology Service
11 Third Hospital Avenue, Singapore 168751

Appointments Hotline:
Tel : +65 6227 7266

International Enquiries, please contact:
Tel : +65 6100 9393
Email : ips@snec.com.sg
2. KK Women's and Children's Hospital
Children's - KK Eye Centre
100 Bukit Timah Road Singapore 229899

Appointments Hotline:
Tel : +65 6294 4050

International Enquiries, please contact:
Tel : +65 6394 8888
Email : international@kkh.com.sg


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