How Your Uveitis Can Be Treated

It’s important to get the right treatment for your uveitis as soon as you can. If it’s not taken care of, uveitis can lead to serious eye problems, including blindness.

Your treatment plan should include things to control your inflammation. Treatment can also:

  • Ease eye pain
  • Prevent the damage to your eyes from getting worse
  • Help get back eyesight you’ve lost

What your doctor will prescribe depends on what kind of uveitis you have, where it is in your eye, and if you have it in both eyes. If your first course doesn't work well, your doctor can switch you to something else.

Corticosteroids

You may know these as steroids. They’re probably the first treatment you’ll try. They block a chemical that causes inflammation.

They can be given in a few different forms.

Eye drops. If your uveitis is at the front of your eye and isn't caused by an infection, steroid drops probably will be your first treatment.

How often you’ll put these drops in will depend on how much your eyes are inflamed. Use them until your doctor tells you it’s OK to stop.

You may have short-term blurred vision.

Your doctor also may give you mydriatic eye drops to take with your steroids. These drops dilate your pupil, relax your eye muscles, and ease pain. They can lower your risk of glaucoma, too.

Shots. You may need these if your uveitis is in the middle or back of your eye, or if your eye drops don’t work.

The good news is that you may only need one shot. The bad news is that you’ll get it in your eye, usually on the side. Your eye doctor can give you drops to numb the area so you don’t feel the shot.

Pills. If your uveitis doesn’t respond to drops or shots, oral steroids are an option. They can also work if you have disease in the back of your eye. They’re much stronger than other forms of steroids.

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Take your steroid pills for as long as your doctor says. Your dose will get smaller toward the end of your treatment. If the pills don’t work, you’ll probably try something else.

If you take steroid pills for a short time, you may have side effects. They can include:

  • Weight gain
  • Acne
  • Anxiety
  • Mood changes
  • Sleeplessness

In the long term, they can cause more serious problems like:

  • Osteoporosis
  • Cataracts
  • Glaucoma
  • Diabetes

Because of all this, you’ll take the lowest dose you need, and only for as long as you have to.

Drugs to Treat Infection

If your uveitis is caused by a viral or bacterial infection, you may need to take an antibiotic or another medication used to fight that type of infection. Once the infection clears, your uveitis should, too.

Immunotherapy

It’s not likely, but uveitis can happen when your immune system attacks your body by mistake. That’s also known as autoimmunity. In that case, you might need to take a drug that powers down your immune system to stop the inflammation.

The drugs you’d take are called immunosuppressants. They include:

  • Azathioprine
  • Cyclosporine
  • Methotrexate
  • Mycophenolate

You may need to have blood tests regularly while you take these. This would be to watch for serious side effects, like liver damage.

Targeted Therapies

Biologic drugs target certain parts of your immune system to stop inflammation. You may need these if other uveitis treatments don’t work well enough.
Biologics your doctor may prescribe include:

  • Abatacept (Orencia)
  • Adalimumab (Humira)
  • Daclizumab (Zinbryta)
  • Infliximab (Remicade)
  • Rituximab (Rituxan)

These drugs can make it harder for you to fight off infections. They also may raise your chance of having certain types of cancer.

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Surgery

If your uveitis is severe, if it keeps coming back after treatment, or if it’s caused by some infections, surgeries like these may help:

Vitrectomy. Your eye surgeon can take out part of the gel inside your eye, known as your vitreous humor. Air, gas, or liquid is pumped in to replace what your surgeon takes out, but your eye will eventually fill up the space with its own fluid.

You can have this under either local or general anesthesia.

Implant surgery. A tiny capsule is put into your eye that slowly releases steroids to treat your inflammation. It’s used on uveitis in the back of the eye that’s harder to treat. The implant stays in for roughly 2 to 3 years.

For Symptoms Only

You might also try these therapies to ease symptoms. They won’t treat the cause of your uveitis:

  • Drugs for mild pain, like ibuprofen
  • A warm towel over your eye to ease aches
  • Sunglasses in bright or harsh light to cut glare
WebMD Medical Reference Reviewed by Alan Kozarsky, MD on November 16, 2018

Sources

SOURCES:

American Academy of Ophthalmology.

MayoClinic.org: “Uveitis.”

National Eye Institute: “Facts About Uveitis.”

National Health Services UK: “Uveitis -- Treatment.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Methotrexate.”

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