If you have uveitis, good communication with your eye doctor is key.
- They should explain your diagnosis and what it means in words you can understand.
- You should know your treatment options, their costs, and their side effects.
- You should have the final say in all decisions about your eye health.
It’s also crucial for you to answer your doctor’s questions as fully as you can. Uveitis is usually diagnosed and treated based on your:
- Medical history
- Symptoms
- Eye exam
The more details your doctor has, the easier it is for them to figure out what’s going on.
“Discussion is the critical piece” in the doctor-patient relationship, says Nisha Acharya, MD, director of the Uveitis and Ocular Inflammatory Disease Service at the University of California, San Francisco.
“This is a partnership,” Acharya says. “We make the treatment plan together and evaluate together. We have to have a continual discussion because we often have to change treatments.
“And people need to understand their options so they can make an educated choice.”
Make Sure Your Doctors Talk to Each Other
Depending on your situation, several doctors may be involved in your care. For example, some people with certain types of autoimmune diseases have uveitis. So they see different specialists for each.
And those doctors need to work together, Archaya says.
“Team effort is key,” she says. “We update them on how the uveitis is doing, and they keep us updated [on the other disease].
“We don’t want to just change an eye drug that [might be helping the other thing].”
Doctor-to-doctor communication is just as important for other health problems commonly associated with uveitis, such as:
- Ankylosing spondylitis
- Psoriatic arthritis
- Sarcoidosis
- Inflammatory bowel disease
- Herpes zoster (shingles)
Have the Talk With Your Eye Doctor
Uveitis is a group of at least 30 different disorders. Most can take your sight if they’re not treated. During office visits, be open and frank with your doctor. You should have lots of questions. Don’t be afraid to ask things like:
What type of uveitis do I have? Uveitis can show up in the front (anterior uveitis), middle (intermediate uveitis), and back (posterior uveitis) of your eye. Sometimes, it happens in all three at once (panuveitis).
Anterior uveitis is the most common type and the easiest to treat. Posterior and panuveitis are more severe and usually need stronger medicine.
What is infectious uveitis? An infection such as TB, herpes, or Lyme disease can sometimes cause uveitis. When the infection clears up, the eye problems usually go away, too.
How long until my symptoms get better? Sometimes uveitis goes away and never comes back, Acharya says. Some people go years without another flare. But others have a chronic form of uveitis and need long-term treatment. Your medical history and exam can often show the type you have.
Why do I have to take corticosteroids? Don’t they cause bad side effects? “Uveitis is an active inflammation. Corticosteroids work faster than anything else to get it under control,” Acharya explains.
Another reason? Until it’s certain your disease is chronic, it’s better to start with a short-acting steroid than something that lasts longer. Steroids can have serious side effects, so you only take them for a brief time.
“We try to [get people off] oral steroids within 3 to 4 months. Drops can be tapered in 6 to 8 weeks,” Acharya says.
What other treatments are there? After steroids, your doctor may prescribe a medicine that suppresses your immune system. This might be an antimetabolite like methotrexate or a calcineurin inhibitor. According to Douglas Jabs, MD, professor of ophthalmology at The Mount Sinai Hospital in New York, people can safely take these medicines for up to 7 years.
If you have severe symptoms, powerful drugs called biologics may be an option. These target cells or chemicals in your body that are involved in inflammation.
What are the side effects of immune-suppressing treatments? Be sure you know the side effects of every medicine you take. You might notice them when you start a new medicine, the dose changes, or you stop treatment. Report any side effects to your doctor right away.
Do uveitis treatments work? For most people, yes. Your doctor can tell you more about your case.
What is a steroid implant? Would it work for me? This is a small capsule a surgeon places inside your eye. It slowly releases a low dose of steroids for 2 to 3 years. At first, it may work faster than other steroids. But Pauline Merrill, MD, assistant professor of ophthalmology at Rush University Medical Center in Chicago, warns about side effects.
“There is a significant risk of glaucoma and cataracts,” she says. “About 30% of people [with implants] may need glaucoma surgery.”
Will I go blind? Uveitis is a leading cause of blindness in the U.S. But you can preserve your sight by getting medical care as soon as you notice symptoms such as:
- Blurry vision
- Eye pain
- Redness
Choose an ophthalmologist with lots of experience in treating uveitis. Primary care doctors and optometrists don’t have the tools to diagnose and treat it.