Complications
Synechia, in which the iris adheres to the either the cornea (i.e., anterior synechia) or lens (i.e., posterior synechia), occurs with iris inflammation, most commonly in anterior uveitis. Cycloplegics are recommended to dilate the iris with corticosteroids to control inflammation.
Inflammation and infection in the posterior chamber may lead to retinal scarring and irreversible visual compromise. Treatment with periocular or intraocular corticosteroids is often used to prevent and treat posterior uveitis. Proper identification of the infectious organism is important for the treatment of infectious posterior uveitis.
Common in patients with uveitis, as a result of inflammation and corticosteroid treatment, most commonly used for anterior uveitis. Fluocinolone implants in particular are associated with cataracts. In patients with juvenile idiopathic arthritis-associated uveitis, cataract and decreased vision may be the initial presentation of uveitis. Cataract surgery in uveitis patients is complicated by the synechiae and pupillary membrane. Uveitis needs to be controlled for 3 months before surgery.
An opacity that develops in the interpalpebral fissure area of the cornea, caused by deposition of calcium. Initially asymptomatic, the band may thicken and cause discomfort and epithelial breakdown. Treatment, when required, is usually by chemical removal.
Very common; may or may not respond to successful control of the uveitic inflammation. Treatments include corticosteroids, immunosuppression, surgery, and hyperbaric oxygen.
May occur secondary to corticosteroid treatment, usually given for anterior uveitis. Response to corticosteroids commonly develops after several weeks of continuous treatment. Intraocular pressure should be monitored regularly by an ophthalmologist. Synechia (iris adhering to the cornea or lens), a complication of anterior uveitis, may cause acute angle-closure glaucoma.
A rare but serious complication of posterior uveitis, associated with visual impairment. Usually able to be seen on careful clinical examination, and thought to be related to the severity of the inflammation and to poor retinal perfusion. Initial treatment is usually with local or systemic corticosteroids.
Retinal detachment (RD) is typically a progressive condition in which the 9 layers of the neuroretina separate from the retinal pigment epithelium. Patients present with sudden appearance of disturbance in the visual field and/or loss of central vision. The cause is the accumulation of subretinal fluid due to the inflammatory process.
RD following uveitis rarely requires acute intervention, unless there are thick submacular bleedings, where delay may lead to irreversible damage
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