| Q. I have
uveitis. I know traditional ways of curing this disease with
corticosteroids, but I wanted to avoid side effects. Do you know any
alternative ways to cure uveitis?
Uveitis is a generic term that covers inflammation of any
part of the uveal tract - iris, ciliary body and choroid. Depending on
the exact site of the inflammation, the name given to the disease will
vary. For example, if the inflammation is localized to the iris it is
referred to as iritis, to the ciliary body and vitreous - cyclitis, to
the anterior chamber and anterior vitreous - iridocyclitis, and to the
choroid - choroiditis. If all parts are involved -
panuveitis. Symptoms depend on what part of the eye is affected and
may include red eye, watery discharge, sensitivity to light, decreased
vision, floaters, pain and even abnormal pupils. The causes of uveitis
are numerous, and include sources within the eye itself as well as
sources from other parts of the body (e.g., fungal , viral and bacterial
infections). The purpose of treatment is to eliminate the cause of the
inflammation, suppress the inflammation and, hopefully, avoid
complications of treatment.
In general, the earlier the treatment the better.
Unfortunately, due to the multifactorial nature of uveitis, the specific
type of treatment depends on the cause. This is why a through medical
history is probably one of the most important parts of the diagnostic
evaluation. As you suggest, corticosteroids, which can be considered a
type of nonspecific anti-inflammatory therapy, have numerous and
sometimes very serious complications. As a consequence, new therapies
are being developed which involve focused anti-inflammatory therapies as
well as specific antimicrobial therapies - again, depending on the
cause. There is an ongoing clinical trial on the effects of
cyclosporine on noninfectious uveitis (for further information see the
NIH Web site: no longer available). Also,
there has been a clinical trial on the use of acetazolamide (but with
significant side effects) for uveitis associated with cystoid macular
edema (for more information see NIH Web site: No
longer available).
Due to the complex nature of uveitis - your eye doctor would
know the best and most prudent therapy for your type of uveitis. Ask
your eye doctor if there are alternatives to corticosteroids but
remember; uveitis can be a real nasty disease, don't avoid therapy -
your sight may depend upon it.
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