Anterior uveitis
The most common form, affecting the iris and ciliary body at the front of the eye.
Uveitis: Protecting Your Vision From Eye Inflammation
Uveitis is inflammation of the uvea, the middle layer of the eye, and it is one of the leading causes of serious vision loss in working-age adults. At The Eye Center, our visiting retina and uveitis specialists serve patients across Northern Virginia with advanced diagnostic tools and a full range of treatment options. Understanding uveitis, its symptoms, and your treatment choices is the first step toward protecting your sight.
Watch: how inflammation inside the eye affects vision.
Understanding Uveitis
Uveitis is not a single disease. It is a group of more than 30 different inflammatory conditions that affect the eye's middle layer and the structures surrounding it. Knowing which type you have and where the inflammation is located directly guides how it is treated.
The uvea is the middle layer of the eye and contains a rich network of blood vessels that carry oxygen and nutrients to eye tissue. It has three main parts: the iris (the colored ring that controls how much light enters the eye), the ciliary body (which sits behind the iris and produces the fluid inside the eye), and the choroid (a layer of blood vessels lining the back of the eye beneath the retina). When any of these structures become inflamed, vision can be significantly affected.
Explore the basics
The Four Types of Uveitis
Uveitis is classified by where in the eye the inflammation occurs. Each type carries different risks and requires a tailored treatment approach.
Intermediate uveitis
Affects the vitreous (the gel-like substance that fills the eye) and the area just behind the ciliary body.
Posterior uveitis
Involves the choroid and retina at the back of the eye.
Panuveitis
Inflammation that extends through all layers of the uvea at once.
What Inflammation Does
When the immune system triggers inflammation inside the eye, white blood cells and proteins flood into delicate eye tissue. In anterior uveitis, inflammatory cells collect in the chamber behind the cornea. In posterior uveitis, the choroid or retina is targeted directly. This process can cause swelling in the macula, the central part of the retina responsible for sharp, detailed vision. Without timely treatment, this swelling and tissue damage can lead to permanent vision loss.
Uveitis can follow several different patterns. Acute uveitis develops suddenly and may resolve within weeks with treatment. Recurrent uveitis involves repeated flare-ups separated by quiet periods. Chronic uveitis persists for months or years and requires ongoing therapy to keep inflammation under control. Knowing which pattern you have helps your Retina Specialist plan for both immediate and long-term care.
Who Is at Risk
Uveitis can affect people of all ages, but certain factors raise the risk considerably. Understanding those factors helps ensure the right people receive timely screening and evaluation.
How Common Is Uveitis?
Uveitis affects tens of thousands of adults across the United States every year. It most commonly develops in young and middle-aged adults, typically between the ages of 20 and 60. Children can also develop uveitis, and because symptoms may be mild or absent in younger patients, regular eye exams are especially important for children with known risk factors.
Autoimmune and Inflammatory Conditions
The majority of uveitis cases in developed countries are noninfectious, meaning they are not caused by a germ or virus. In these cases, the body's immune system mistakenly attacks its own tissue inside the eye. Conditions commonly linked to uveitis include sarcoidosis (an inflammatory disease that can affect many organs), Behcet disease, Vogt-Koyanagi-Harada syndrome, and juvenile idiopathic arthritis in children. A thorough evaluation helps connect the dots between eye inflammation and any underlying systemic disease.
Genetic Risk Factors
A genetic marker called HLA-B27 plays a significant role in uveitis risk, particularly for anterior uveitis. People who carry this marker and also have conditions such as ankylosing spondylitis (a type of inflammatory arthritis affecting the spine) or psoriatic arthritis face an elevated risk of developing uveitis. Knowing whether you carry this marker can help guide how closely you and your doctors monitor your eyes.
Infectious Causes
Some cases of uveitis are caused by infections, including syphilis, tuberculosis, and herpes viruses. Infectious uveitis requires specific antimicrobial treatment alongside anti-inflammatory therapy, making an accurate diagnosis essential. Your Retina Specialist will determine whether an infection is involved through blood tests and a careful review of your medical history before recommending treatment.
Recognizing the Symptoms
The symptoms of uveitis vary depending on which part of the eye is inflamed. Some forms cause obvious, uncomfortable symptoms right away, while others may develop quietly without any pain, which makes them particularly dangerous.
Many people with uveitis experience one or more of the following:
- Eye pain, often described as a deep ache
- Redness of the eye
- Light sensitivity, also called photophobia
- Blurred or reduced vision
- Floaters, which are dark spots, strings, or shadows that drift across the field of vision
The combination and severity of symptoms depend on the type and location of inflammation. Some symptoms require immediate medical attention. Seek care right away if you experience sudden eye pain, a rapid increase in floaters, flashes of light, or sudden loss of vision. A shadow or curtain-like blockage across part of your visual field is also an emergency. Delays in treating severe uveitis can result in permanent vision damage, so do not wait to be seen.
Symptoms by Type, and Getting a Diagnosis
Accurately diagnosing uveitis requires more than identifying symptoms. A Retina Specialist uses a detailed examination combined with specialized imaging and laboratory testing to determine the type, cause, and extent of inflammation before recommending treatment.
Anterior uveitis symptoms
Anterior uveitis, the most common type, tends to come on quickly over a few days. It typically causes noticeable pain, redness, and sensitivity to light. The pupil of the affected eye may appear smaller than normal, and tearing is common. Because the symptoms are often uncomfortable and hard to ignore, most people seek care fairly quickly, which works in their favor.
Posterior uveitis symptoms
Posterior uveitis can be far more difficult to detect in its early stages. It may develop gradually with no pain or redness at all. The first noticeable sign is often blurred vision or an increase in floaters. Because inflammation affects the retina and choroid at the back of the eye, significant damage can occur before any obvious discomfort appears. This is why routine dilated eye exams are so important for anyone with known risk factors for uveitis.
Comprehensive eye examination
The evaluation begins with a slit-lamp exam, which uses a narrow beam of light and a special microscope to examine the structures inside the eye in fine detail. Your Retina Specialist looks for inflammatory cells in the fluid chambers, protein deposits on the inner surface of the cornea, and signs of retinal swelling or damage. A dilated exam is also performed to evaluate the back of the eye, including the retina and choroid.
Imaging tests we use
Several advanced imaging tools help map the extent of inflammation and guide treatment decisions. Optical coherence tomography (OCT) creates detailed cross-sectional images of the retina and can detect macular edema, which is swelling at the center of the retina. Fluorescein angiography uses a special dye injected into a vein to highlight leaking or abnormal blood vessels. Indocyanine green (ICG) angiography provides additional detail about vessels in the choroid. Color fundus photography and B-scan echography round out our imaging capabilities for a complete picture of retinal and vitreous health.
Laboratory and systemic testing
Because uveitis is frequently connected to a condition affecting the whole body, blood tests and other laboratory work are often part of the evaluation. Testing may check for the HLA-B27 genetic marker, signs of sarcoidosis, syphilis, tuberculosis, and other autoimmune markers. Chest imaging or referral to a rheumatologist may also be recommended. Identifying the underlying cause allows both the eye inflammation and the root condition to be treated together for the best possible outcome.
Treatment Options
Treatment for uveitis is highly individualized. It depends on which type of uveitis you have, where it is located, how severe the inflammation is, and whether an underlying systemic condition is involved. Our visiting retina and uveitis specialists work closely with each patient to find the most effective and least burdensome approach.
Corticosteroid eye drops
For anterior uveitis, corticosteroid (steroid) eye drops are usually the first treatment. These drops reduce inflammation inside the eye. A dilating drop may also be prescribed to relieve pain and prevent the iris from adhering to the lens, a complication called a posterior synechia. Treatment is gradually tapered rather than stopped suddenly, as discontinuing too quickly can trigger a flare-up.
Steroid injections and long-acting implants
When inflammation affects the back of the eye or does not respond well to drops, your Retina Specialist may recommend a steroid injection or a sustained-release implant placed in or near the eye. Options include dexamethasone implants that release medication over several months and fluocinolone acetonide implants designed to provide ongoing drug delivery for one to three years. These approaches reduce the need for frequent eye drops or systemic medications in some patients, making long-term management more manageable.
Biologic therapy
For patients with noninfectious intermediate, posterior, or panuveitis who need stronger systemic treatment, adalimumab (brand name Humira) is an FDA-approved biologic therapy. It works by blocking a protein called tumor necrosis factor-alpha that drives the inflammatory process. Adalimumab is given as a self-administered injection under the skin, typically every two weeks. Biosimilar versions of this medication have also become available, expanding access to this treatment. Your Retina Specialist will discuss which option is appropriate for your situation.
Immunosuppressive medications
When corticosteroids alone are not sufficient or when long-term steroid use creates unacceptable side effects, immunosuppressive medications may be added to the treatment plan. These include methotrexate, mycophenolate, azathioprine, and cyclosporine. Infliximab, another biologic agent, is also used in some cases. These medications work by calming the overactive immune response that drives chronic uveitis. Regular blood tests are required to monitor for side effects throughout treatment.
Treating uveitic macular edema
When uveitis causes macular edema (swelling of the central retina), additional targeted treatment may be needed to protect central vision. Intravitreal injections, meaning injections delivered directly into the eye, may be used to reduce swelling and suppress local inflammation. Your Retina Specialist will determine the most appropriate approach based on the severity of the edema and your overall treatment plan.
Uveitis at a Glance
30+
Inflammatory conditions grouped as uveitis
4
Types, defined by where inflammation sits
20–60
Age range where it most often develops
1–3
Years of drug delivery from a long-acting implant
These are general reference figures. Your own diagnosis, treatment plan and timeline are determined by your Retina Specialist based on the type and behavior of your uveitis.
What to Expect During and After Treatment
Managing uveitis is often an ongoing process that evolves over time. Knowing what to expect during treatment, recovery, and long-term follow-up helps patients stay engaged and prepared.
Treatment for uveitis often involves frequent office visits, particularly at the start. Your Retina Specialist will monitor inflammation levels closely and adjust medications as needed. Eye drops may need to be used several times each day initially and then gradually reduced. Patients receiving injections or implants will have these procedures performed in our office or an outpatient setting. Your specialist will also monitor for side effects such as elevated eye pressure or early cataract formation, both of which can result from steroid use.
The course of uveitis varies considerably from person to person. Some patients experience a single episode of anterior uveitis that resolves completely with treatment. Others face recurrent episodes or chronic inflammation that requires years of ongoing care. Early detection and consistent treatment offer the best chance of preserving vision. Even with excellent care, some patients may develop complications such as glaucoma, cataracts, or retinal scarring, and managing these promptly is an important part of long-term uveitis care.
Long-term monitoring is essential for anyone with a history of uveitis. Chronic inflammation and prolonged steroid use can raise eye pressure, lead to cataract formation, or cause macular edema to recur. Retinal damage and calcium deposits on the cornea are also possible over time. Regular dilated eye exams and imaging tests allow your Retina Specialist to catch these problems early and treat them before they result in significant vision loss.
Living Well With Uveitis
Uveitis often requires management that goes beyond eye drops and office visits. Taking an active role in your care and staying connected with your medical team makes a meaningful difference in outcomes.
Uveitis frequently requires a team approach. A Retina Specialist manages the eye inflammation directly, while a rheumatologist or primary care physician may oversee any underlying systemic condition. Keeping all of your providers informed about your current medications and any changes in symptoms helps ensure everyone is working from the same picture. Never stop medications without first consulting your Retina Specialist, as doing so abruptly can trigger a flare.
Wearing sunglasses outdoors can help ease light sensitivity during active flares. If you smoke, quitting is strongly encouraged, as smoking has been associated with worsening inflammation in some studies. A balanced diet, regular physical activity, and good sleep habits support overall immune health. Keeping a simple symptom journal that notes when flares occur and what may have preceded them gives your Retina Specialist useful information at each follow-up visit.
Living with a chronic eye condition can bring real emotional stress, especially when vision is affected or uncertain. It is completely normal to feel anxious about flare-ups or worry about the future. Patient advocacy and support organizations focused on uveitis and autoimmune disease can provide both practical information and a sense of community. Ask your Retina Specialist about resources that may be helpful to you.
Frequently Asked Questions
These questions address common concerns that patients bring to their appointments. If you have additional questions, our team is here to help.
Can stress cause uveitis to flare up?
Stress does not directly cause uveitis, but it can influence immune system activity in ways that may lower your threshold for a flare if you already have an underlying autoimmune condition. Managing stress through healthy habits is a reasonable part of a broader wellness plan, but it is not a substitute for medical treatment. If you notice that flares seem to follow periods of high stress, share that pattern with your Retina Specialist.
Will I need injections, or can drops manage my uveitis?
Many patients with anterior uveitis are managed successfully with eye drops alone. However, intermediate, posterior, or panuveitis often involves structures that eye drops cannot reach effectively. In those cases, injections, sustained-release implants, or systemic medications may be recommended. Your Retina Specialist will always aim for the least invasive approach that adequately controls inflammation and protects your vision.
Is uveitis the same as pink eye?
They are very different conditions. Pink eye, or conjunctivitis, is inflammation of the clear outer membrane covering the white of the eye, and it is usually mild. Uveitis is inflammation inside the eye, affecting deeper structures such as the iris, ciliary body, choroid, and retina. Uveitis carries a much greater risk of permanent vision loss. While both can cause redness, uveitis also involves pain, light sensitivity, and vision changes that conjunctivitis typically does not.
How do I know if my uveitis is connected to another health condition?
Many patients are surprised to learn their uveitis is linked to a systemic condition they may already know about, or sometimes one that has not yet been diagnosed. Blood tests ordered during your eye evaluation can screen for markers associated with autoimmune diseases, infections, and genetic risk factors. If a systemic condition is identified, coordinating care between your Retina Specialist and your other physicians leads to better control of both the eye and the underlying condition.
How long will I need to be on treatment?
Treatment duration depends on the type and behavior of your uveitis. A single episode of acute anterior uveitis may resolve after a few weeks of eye drops. Chronic or recurrent forms may require months or years of therapy, which can include immunosuppressive medications or long-acting implants. Your Retina Specialist will reassess your treatment plan at each visit and make adjustments based on how well inflammation is being controlled. The goal is always to use the minimum amount of medication needed to keep your eyes stable and your vision protected.
Where is the retina clinic located, and who provides uveitis care?
Our retina and uveitis care is provided by a visiting team of fellowship-trained specialists, including vitreoretinal surgeons and a specialist in uveitis and ocular inflammatory disease. The retina clinic is located at our Lansdowne office. This team brings subspecialty expertise in complex retinal and inflammatory eye disease, working alongside our broader ophthalmology team to coordinate your complete care plan.
Schedule Your Evaluation at The Eye Center
If you are experiencing eye pain, light sensitivity, floaters, or vision changes, please do not wait to be seen. The Eye Center provides comprehensive uveitis evaluation and management through our visiting retina and uveitis specialists, serving patients throughout Northern Virginia from our Lansdowne retina clinic and multiple office locations. We are here to help you protect your vision with expert, compassionate care and the advanced diagnostic tools needed to get answers quickly and start treatment without delay.
