If you have uveitis, medications called corticosteroids (aka steroids) are usually the first ones you’ll try.  They work fast to ease inflammation inside your eye.

But there are potential problems with taking steroids for the long term. Taken in high doses or for a long time, they can cause serious side effects like:

  • Brittle bones
  • Diabetes
  • Glaucoma

If a short course of steroids doesn’t ease your symptoms, you and your eye doctor have other options.

Antimetabolites

You might hear these called “steroid-sparing medicines.”

They don’t work as fast as steroids, but you can take them for longer. The most common ones for uveitis are:

  • Azathioprine (Imuran)
  • Methotrexate (Rheumatrex)
  • Mycophenolate mofetil (CellCept)

They control inflammation by powering down your immune system. But they also make it harder for your body to fight off infections. Tell your doctor right away if you have signs of infection like a cough or fever.

If you take these, you’ll need regular blood tests to make sure your liver and bone marrow stay healthy.

Calcineurin Inhibitors

They block an enzyme called calcineurin that sparks inflammation. Examples include:

  • Cyclosporine (Neoral)
  • Tacrolimus (Prograf)

Your doctor may try them when antimetabolites don’t work well enough.

They can cause high blood pressure and kidney problems, so your doctor should check for these often once you start taking them.  

You shouldn’t use cyclosporine if you’re an older adult because it can harm your kidneys.

Biologics

They ease inflammation by blocking the work of chemicals or cells in your body that cause it. If your uveitis is severe or comes back after treatment, your doctor may decide to try one.

You get these powerful medicines through a shot or IV. You should have tests for TB, pneumonia, and other infections before you start treatment. Biologics can make infections worse. They might also raise your chance of some types of cancer.

One biologic has been approved by the FDA for uveitis. It’s called adalimumab (Humira). But doctors sometimes prescribe others that they think might work. If your doctor does, check with your insurance company. It may not cover a medicine if the FDA hasn’t approved it for your condition.

Steroid Implant

A surgeon places this tiny capsule inside your eye. It’s used for uveitis in the back of your eye, where it’s hard to treat. The implant releases a low dose of steroids for 2 or 3 years.

It may work faster than steroids you take by mouth. But it can cause other eye diseases like glaucoma and cataracts. Scientists are working on an implant that contains less steroid. This might cut down on side effects.

Surgery

A few people may need an eye operation called vitrectomy. It removes the vitreous, the jelly-like part of your eye. Saline, a gas bubble, or oil is used to replace what your surgeon takes out. In time, your eye makes new fluid to fill in the space. After a vitrectomy, you may see more clearly. As with most surgeries, there is a chance of complications. They can include:

  • Bleeding
  • Infection
  • Cataracts
  • Glaucoma

Antibiotics and Antivirals

If an infection caused your uveitis, your eye doctor will prescribe antibiotics or antiviral medicine to treat it. You might take steroids at the same time.  

WebMD Medical Reference

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WebMD Voices

Kat C., 36
Broomfield, CO
Skip the ER or urgent care and go straight to an ophthalmologist whenever you have concerns. Get comfortable with your doctor, get used to eye exams with the SLIT scope, IOP [intraocular pressure] tests, and learn how to properly use eye drops so they don’t drip down your nasal passages and wreak havoc.
Ashley L., 41
Memphis, TN
Things will get more manageable over time -- you’ll start to recognize your symptoms prior to the flares. That makes it easier to manage your flares in a quick and timely manner, so they don’t last as long.
Amanda L., 38
Atlanta
I have had many flare-ups over the years. I have taken oral steroids, topical steroid eye drops, dilation drops, and injections in my eye. The best advice I can give is to find a great ophthalmologist that will work with you.
Libby S., 35
St. Petersburg, FL
Speak up when things don't feel right with your body. My vision went from excellent to blurry and weird practically overnight. After my conjunctive uveitis diagnosis, I was treated by a special laser to help strengthen my retina. And now, 10 years later, I’m still symptom-free.
Kat C., 36
Broomfield, CO
Uveitis may be lifelong, but it’s manageable. It’s normal to feel helpless and depressed. People around you can’t fully understand the pain, fear, and distress of this condition. Just know you are not alone, and there are even support groups and organizations you can join for free.
Sharon G., 64
Abingdon, VA
Uveitis is a chronic condition, so you need to have a good relationship with your retinal specialist and ophthalmologist and keep all your appointments. If you have any flare-up of symptoms, no matter how small, have it checked out immediately.
Ashley L., 41
Memphis, TN
I did a year of yo-yoing with eyedrops and attempting slow tapers with no success. I finally found my answer in an injectable biologic therapy to manage my now chronic anterior uveitis. I will likely always carry emergency steroid and IOP-lowering drops on me at ALL times, which is a good idea for anyone dealing with uveitis.
Amanda L., 38
Atlanta
I have a prepared kit that is prescribed by my ophthalmologist that I carry with me all the time. If a flare starts, I go ahead and dilate, start my steroid drops, and call my doctor. I don’t recommend doing any of these things without consulting your ophthalmologist first.
Meg R., 50
Tyler, TX
In retrospect, even as a physician, I didn’t understand just how much damage uveitis was doing to me, in part because my symptoms were not always typical. Unlike many people with uveitis, my eye rarely turned red. I knew the attacks were happening primarily by vision changes and most importantly the headaches.
Sharon G., 64
Abingdon, VA
One thing I discovered through my uveitis treatments is that I’m a 'steroid responder,' meaning that instead of helping eye pressure, steroids actually make my eye pressure worse. Figuring that out wasn’t a fun process. But in the end, I think it helped me see that when it comes to my uveitis, the more honest communication with my eye doctor, the better.
Libby S., 35
St. Petersburg, FL
The best advice I have is to be as proactive as possible in treating the disease and get a second opinion sooner than later if you feel that things are progressing, or that your doctor is not paying attention to your complaints.
Amanda L., 38
Atlanta
Don’t be discouraged if your uveitis promptly returns when you taper meds. This just means you have to develop a long-term plan to manage it.

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