What Are Treatments for Uveitis?
Uveitis is the inflammation of your uvea — the middle layer of your eye. It can happen for many reasons, but up to 70% of cases have unknown causes. It can affect a specific area of your eye or multiple areas. If you have uveitis, it's important to get the right treatment immediately. If it's not taken care of, uveitis can lead to serious eye problems, including blindness. It's a leading cause of blindness worldwide.
The best treatment for your uveitis depends on what's causing it. For example, it may be related to an infection or autoimmune condition. Sometimes, you may be able to get rid of uveitis if the cause of it can be resolved or cured. But 50%-70% of the time, uveitis happens for no known reason.
Your treatment plan should include medicines and other approaches to control the inflammation in your uvea, which is the middle layer of your eye.
Uveitis treatment can also:
- Ease eye pain
- Prevent the worsening of eye damage
- Help restore any lost eyesight
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 another uveitis treatment.
"Uveitis involves inflammation of the eye, and most of the treatments are designed to reduce inflammation," says Rahul Khurana, MD, an ophthalmologist at Northern California Retina Vitreous Associates and clinical spokesperson for the American Academy of Ophthalmology. "The best way to treat uveitis varies on each patient, and your ophthalmologist will tailor the appropriate treatment for your condition."
Corticosteroids for Uveitis
You may know these as steroids. They're usually the first treatment you 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 may give you mydriatic (dilation) eye drops to take with the steroids if your inflammation is in the front part of your eye. That's because iris movement can delay your recovery. These drops widen your pupil, relax your eye muscles, and ease your 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.
You may only need one shot 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.
Implants. Your doctor can put a small device in your eye to give you small amounts of steroids over time.
Pills. If your uveitis doesn't respond to drops or shots, oral steroids are an option. They can also work if you have uveitis in the back of your eye. They're much stronger than other forms of steroids.
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 such as:
- Weight gain
- Acne
- Anxiety
- Mood changes
- Sleeplessness
In the long term, they can cause more serious problems like:
- Osteoporosis
- Cataracts
- Glaucoma
- Diabetes
Take the lowest dose you need, and only for as long as you have to.
Drugs to Treat Uveitis-Related Infection
If your uveitis is caused by a viral or bacterial infection, you may need to take an antibiotic or another medication to fight that type of infection. Once the infection clears, your uveitis should, too.
Immune Suppressants for Uveitis
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.
Such drugs are called immunosuppressants. They include:
You may need to have blood tests regularly while taking these to watch for serious side effects, such as liver damage.
Biologic Therapies for Uveitis
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. They're called biologics because they're made of substances from living cells or tissues. Biologics for uveitis and many other conditions are antibodies. They work by targeting substances that cause inflammatory immune responses. Biologics your doctor may prescribe to treat your uveitis include:
- Abatacept (Orencia)
- Adalimumab (Humira)
- Daclizumab (Zinbryta)
- Infliximab (Remicade)
- Rituximab (Rituxan)
- Tocilizumab (Actemra)
You'll have to take a biologic as an injection or infusion. These drugs can also make it harder for you to fight off infections. They also may raise your chance of having certain types of cancer.
JAK Inhibitors for Uveitis
If your uveitis doesn't get better with other treatments, including biologics, your doctor might consider targeted medicines called JAK inhibitors. Targeted medicines suppress your immune system by blocking specific proteins.
Doctors use or approve JAK inhibitors to treat many different autoimmune conditions. These medicines have also shown some promise for hard-to-treat uveitis. They work by blocking various pathways affecting your immune system and tissue repair.
Using JAK inhibitors is experimental since they aren't approved for uveitis. They may be prescribed only if other treatments don't work for you and your vision is at risk. JAK inhibitors also carry a higher risk of major adverse cardiovascular events and other potentially serious side effects.
Surgery for Uveitis
If your uveitis is severe, keeps coming back after treatment, or is caused by some infections, surgeries like these may help:
Vitrectomy. Your eye surgeon can remove part of the gel inside your eye, known as your vitreous humor. Air, gas, or liquid is pumped in to replace the removed gel, 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, which is harder to treat. The implant stays in for roughly two to three years.
Pediatric Uveitis Treatment
Treating uveitis in kids can be difficult. Fortunately, pediatric uveitis isn't common. But kids with uveitis more often have a posterior form. That means it comes with vision changes.
"Children may not always have symptoms and complain of the visual changes that adults more easily do," Khurana says. "As a result, uveitis is often treated later and sometimes not as aggressively in children, which is necessary to prevent vision loss."
If uveitis only affects the front part of your child's eye, topical treatments or eye drops may be enough. Children often need stronger medicines when other parts of the uvea are affected. Doctors may inject medicines into their eyes. Sometimes, doctors can do this in the regular clinic. Other times, your child may need anesthesia to let doctors examine their eyes and treat uveitis.
Children with uveitis may need to take oral corticosteroids. But steroids aren't suitable for long-term use in kids, as they can affect their growth. Children will more likely take other immune suppressants that don't include steroids, such as:
- Cyclophosphamide
- Cyclosporine
- Methotrexate
- Mycophenolate mofetil
Biologics also may be an option for kids with uveitis that doesn't get better with other treatments.
It's important to treat uveitis in children as soon as possible. Delays can lead to complications and vision loss.
Natural Treatments for Uveitis
It's important to treat uveitis with proven medicines. Don't use home remedies or supplements alone.
"There are no natural remedies proven to treat uveitis," Khurana says. "Smoking can exacerbate uveitis, and it is recommended to always stop smoking."
Some natural products and supplements may be good for your general eye health. Along with treatments your doctor recommends, they may also help with your uveitis. Keep in mind that supplements aren't regulated the way medicines are. There's not much evidence to show they work, but they may be safe enough to try.
Herbs and supplements that might boost your eye health include:
Turmeric (curcumin). Turmeric is a yellow spice often used in curries. It has antioxidant properties. It also may boost your immune system. One small study showed it might help with uveitis. But the results were not clear. Turmeric may also have risks.
Omega-3 fatty acids. You can get these fatty acids in fish oil. It may lower inflammation and improve your immune system. But fish oil can also cause more bleeding. It may not be safe if you take it with certain other medications, such as blood thinners.
Multivitamins. Multivitamins usually include A, C, E, and B vitamins. They also have minerals, such as magnesium, calcium, and zinc, which may be good for your eyes. One study suggested vitamins could help with anterior uveitis. But multivitamins can not replace uveitis treatments.
Lutein. This is another antioxidant that might help with eye health. But the evidence that it can help with uveitis is weak.
Ask your doctor before taking herbs or supplements to help with your uveitis.
Tips to Support Uveitis Recovery
You might also try these therapies to ease your symptoms. They won’t treat the cause of your uveitis but may help with general eyestrain:
- Medicines such as ibuprofen for mild pain
- A warm towel over your eye to ease aches
- Sunglasses in bright or harsh light to cut glare
- Limited screentime
- Saline or artificial tears
- Improved air quality in your home
- Glasses, if you need them
When to See Your Doctor for Uveitis
It's a good idea to reach out to your doctor anytime you notice a change in your vision, or you have questions or other concerns.
"Uveitis can develop suddenly, so don't hesitate to contact your ophthalmologist if you have any questions or are experiencing any symptoms," Khurana says. "To prevent irreversible vision loss, it is important to be treated for all inflammation, and this sometimes does require systemic medication."
Get emergency care if you have:
- Sudden vision loss or changes
- Severe eye pain
- Severe swelling
- Double or blurred vision
- New floaters or flashing lights
- Blood, discharge, or pus in your eyes
- Trouble opening or moving your eyes
- Light sensitivity
Talk to your doctor about symptoms or side effects you should watch out for. Make sure you know who to call in the event of an emergency. When in doubt, call 911 or go to your nearest emergency room.
Takeaways
Uveitis is a serious condition that needs to be treated to protect your vision. Your treatment will depend on what's causing your eye inflammation, if known. There are many treatment options to lower your inflammation. Talk to your doctor about the best treatment for you.
Uveitis Treatment FAQs
Can uveitis go away without treatment?
Uveitis might go away if it's possible to treat the cause of your eye inflammation. However, many people have uveitis without knowing why it happens. It's important to get uveitis diagnosed and treated early. Untreated uveitis can lead to permanent vision loss and blindness. You shouldn't delay treatment in hopes that it'll just go away.
How long does treatment for uveitis take?
It depends on the type of uveitis you have, what's causing it, and what treatment your doctor recommends. If your uveitis is related to an infection, it should go away when you get rid of the infection. But uveitis often has unknown causes, or it may result from a chronic autoimmune condition. You should expect treatment to last at least a few weeks. Sometimes, uveitis is chronic and needs long-term treatment. Ask your doctor how long your uveitis treatment will take.
Can uveitis be treated at home?
You'll likely be able to take your uveitis medicines at home. Home remedies may also help your eyes feel better, but they shouldn’t replace medical treatment for uveitis.
How do I get rid of uveitis permanently?
There's no cure or way to be sure you'll get rid of uveitis for good. The best way to lower your inflammation and protect your vision is to see a doctor experienced in treating uveitis. Make sure to follow their advice, and take your medicines as prescribed.