What Is Uveitis and How Eye Inflammation Manifests
Uveitis is an inflammatory disease of the vascular coat of the eye (uveal tract) that can lead to severe visual impairments up to total vision loss. The clinical picture often includes eyeball pain, redness, photophobia, and decreased visual acuity [2], [5]. However, in ophthalmological practice, there are conditions that mimic classic uveitis, which significantly complicates diagnosis and the choice of therapy.
For example, in severe metabolic disorders or diabetes mellitus, pseudouveitis can develop. In such cases, lipemic aqueous humor (a milky-white exudate) accumulates in the anterior chamber of the eye, resembling an inflammatory process, although the root cause is pronounced dyslipidemia and microvascular dysfunction [2].
Main Causes and Non-Standard Risk Factors
The causes of eye inflammation are diverse: from autoimmune pathologies and systemic infections to mechanical injuries and iatrogenic factors. Among the key triggers are:
- Chronic systemic diseases (type 1 and type 2 diabetes mellitus, lipid metabolism disorders) [2], [3].
- Manifestations of UGH syndrome (uveitis-glaucoma-hyphema), arising from mechanical friction of the intraocular lens against the structures of the uveal tract (e.g., during lens haptic displacement) [1].
- Infectious agents and severe bacterial complications, such as endogenous endophthalmitis caused by aggressive pathogens like *Klebsiella pneumoniae* against the background of internal organ abscesses [5].
- Autoimmune and neurodegenerative processes, including the connection of bilateral Fuchs' syndrome with multiple sclerosis [8].
Diagnostic Challenges in Atypical Forms
Timely diagnosis of uveitis requires a comprehensive approach. The patient is prescribed a slit-lamp examination, gonioscopy, and modern imaging methods such as anterior segment optical coherence tomography (AS-OCT), which allows the detection of abnormal lens positioning or microstructural changes [1].
In some cases, atypical manifestations are observed, such as bilateral acute iris transillumination (BAIT) with pronounced mydriasis and photophobia, but without signs of active inflammation or elevated intraocular pressure at onset [4]. This emphasizes the importance of differential diagnosis between true eye inflammation and other ophthalmological syndromes.
Modern Approaches to Treating Uveitis and Complications
Treatment tactics depend on the root cause of the inflammatory process. Therapy may include the following directions:
- Drug therapy: antiglaucoma medications to control intraocular pressure, corticosteroids, and antibacterial therapy for an infectious nature of the lesion [1], [5].
- Surgical intervention: reposition of displaced elements of the artificial lens into the capsular bag, implantation of antiglaucoma valves (e.g., Ahmed valve) with concomitant hypertension [1].
- Correction of metabolic disorders under the supervision of specialized professionals (endocrinologists) in combined systemic pathologies [2], [3].
Early identification of inflammation triggers and a multidisciplinary approach help prevent severe complications and preserve patients' vision.
Sources
- 1. Uveitis-Glaucoma-Hyphema Syndrome Secondary to Asymmetric Intraocular Lens (IOL) Haptic Fixation... PubMed
- 2. Lipemic anterior chamber mimicking uveitis in severe hypertriglyceridemia... PubMed
- 3. Cataracts as the presenting symptom of type 1 diabetes mellitus... PubMed
- 4. Atypical Bilateral Iris Transillumination without Pigment Dispersion... PubMed
- 5. Clinical Series of Endogenous Klebsiella Endophthalmitis... PubMed
- 6. Glaucoma in retinopathy of prematurity: A review... PubMed
- 7. Assessment of real-life visual outcomes and treatment efficacy of diabetic macular edema... PubMed
- 8. Bilateral fuchs uveitis syndrome and its association with multiple sclerosis... PubMed
Disclaimer: The information presented in this article is for reference purposes only and does not replace an in-person consultation with an ophthalmologist. At the first symptoms of eye inflammation, it is necessary to consult a specialist.