Uveitis: Symptoms, Causes, and Treatment

What is the uvea and why does it become inflamed?

The uvea consists of three connected structures: the iris (the colored ring around the pupil), the ciliary body (which controls the lens shape and produces aqueous fluid), and the choroid (the vascular layer at the back of the eye). Inflammation in any of these areas — or all of them — is called uveitis.

Uveitis can be caused by: 1Ref 1Mehta NS, Emami-Naeini P (2022).A Review of Systemic Biologics and Local Immunosuppressive Medications in Uveitis.Overview of uveitis causes, classification, and treatment including corticosteroids, immunosuppressives, and biologic agents for noninfectious uveitis

• Autoimmune and inflammatory conditions — including sarcoidosis, ankylosing spondylitis, psoriatic arthritis, inflammatory bowel disease (Crohn's disease and ulcerative colitis), rheumatoid arthritis, and multiple sclerosis
• Infections — including herpes viruses, toxoplasmosis, syphilis, tuberculosis, and Lyme disease
• Eye trauma or surgery
• Unknown cause — a substantial proportion of cases (sometimes called idiopathic uveitis) have no identified trigger

Population-based data suggest ankylosing spondylitis carries one of the highest risks for uveitis among systemic conditions, alongside Crohn's disease and ulcerative colitis. 2Ref 2Mora González M, Masís Solano M, Porco TC, Oldenburg CE, Acharya NR, Lin SC, Chan MF (2018).Epidemiology of uveitis in a US population-based study.US population-based prevalence data for uveitis; strong associations with ankylosing spondylitis, ulcerative colitis, and Crohn's disease Because uveitis frequently accompanies systemic inflammatory disease, an ophthalmologist managing it will often coordinate with a rheumatologist or infectious disease specialist.

What are the symptoms of uveitis?

Symptoms depend on which part of the uvea is affected:

Anterior uveitis (iritis) — the most common form, affecting the iris and ciliary body: - Eye pain, often described as aching or pressure - Redness, especially around the edge of the iris - Sensitivity to light (photophobia) - Blurred vision - Small or irregular pupil compared to the other eye

Intermediate and posterior uveitis — affecting the middle or back of the eye: - Floaters - Blurred or hazy vision - Often less pain than anterior uveitis

Panuveitis — involving all layers — can cause all of the above and carries the greatest risk to vision.

Anterior uveitis often comes on suddenly and feels like a very irritated, painful eye. Posterior forms can be more insidious, developing quietly until vision is noticeably affected. Both require professional evaluation. 1Ref 1Mehta NS, Emami-Naeini P (2022).A Review of Systemic Biologics and Local Immunosuppressive Medications in Uveitis.Overview of uveitis causes, classification, and treatment including corticosteroids, immunosuppressives, and biologic agents for noninfectious uveitis

How is uveitis diagnosed?

Diagnosis requires a slit-lamp examination by an ophthalmologist — a magnified view of the eye's interior that can detect white blood cells in the aqueous humor (the fluid inside the front of the eye), protein deposits (flare), and changes to the iris or other structures.

Because uveitis is frequently linked to systemic disease, the evaluation commonly includes blood tests, imaging, and sometimes referral to rheumatology or infectious disease. The workup is individualized based on the pattern and location of inflammation, the patient's age, demographics, and systemic symptoms. 1Ref 1Mehta NS, Emami-Naeini P (2022).A Review of Systemic Biologics and Local Immunosuppressive Medications in Uveitis.Overview of uveitis causes, classification, and treatment including corticosteroids, immunosuppressives, and biologic agents for noninfectious uveitis A comprehensive adult eye evaluation by an ophthalmologist sets the framework for this kind of multi-system assessment. 3Ref 3Wallace DK (Chair), Flaxel CJ, Gedde SJ, Jacobs DS, Kopplin LJ, Lee BS, Mah FS, Oetting TA, Varu DM, Musch DC (2026).Comprehensive Adult Medical Eye Evaluation Preferred Practice Pattern® 2025.Ophthalmologic evaluation framework including slit-lamp examination as the diagnostic standard for inflammatory conditions

How is uveitis treated?

Treatment depends on the cause and the location of inflammation:

Corticosteroids are the cornerstone of most uveitis treatment. They may be given as: 4Ref 4José-Vieira R, Ferreira A, Menéres P, Sousa-Pinto B, Figueira L (2022).Efficacy and safety of intravitreal and periocular injection of corticosteroids in noninfectious uveitis: a systematic review.Evidence for corticosteroid delivery routes in noninfectious uveitis: intravitreal injection more effective than periocular; comparison of adverse event profiles - Eye drops (for anterior uveitis) - Periocular or intravitreal injections (for intermediate or posterior disease) - Oral or intravenous forms (for severe or bilateral disease)

Evidence from a systematic review of 19 studies covering nearly 2,000 eyes found that intravitreal corticosteroid delivery is more effective than periocular injection, though it carries a higher rate of adverse effects such as elevated intraocular pressure and cataract. 4Ref 4José-Vieira R, Ferreira A, Menéres P, Sousa-Pinto B, Figueira L (2022).Efficacy and safety of intravitreal and periocular injection of corticosteroids in noninfectious uveitis: a systematic review.Evidence for corticosteroid delivery routes in noninfectious uveitis: intravitreal injection more effective than periocular; comparison of adverse event profiles

Pupil-dilating drops (cycloplegics) are often added to anterior uveitis treatment to relieve pain and prevent adhesions between the iris and lens.

Immunosuppressive medications — including methotrexate, mycophenolate, azathioprine, or biologic agents such as adalimumab — are used for chronic or recurrent uveitis that does not respond adequately to steroids, or when long-term steroid use would cause unacceptable side effects. 1Ref 1Mehta NS, Emami-Naeini P (2022).A Review of Systemic Biologics and Local Immunosuppressive Medications in Uveitis.Overview of uveitis causes, classification, and treatment including corticosteroids, immunosuppressives, and biologic agents for noninfectious uveitis

Treating the underlying cause is essential when uveitis is infectious — antiviral or antibiotic therapy is used alongside anti-inflammatory treatment.

Even after a single episode, follow-up with an ophthalmologist is important to monitor for complications including glaucoma, cataracts, and macular edema.

When should I be seen urgently for possible uveitis?

Seek prompt evaluation — within 24 hours — for:

• A painful, red eye that is also sensitive to light
• Sudden decrease in vision
• Eye floaters with pain or redness

These symptoms overlap with several other serious conditions — including angle-closure glaucoma and endophthalmitis — that also require urgent care. Self-diagnosis or treatment with over-the-counter drops is not appropriate. An ophthalmologist examination is the only way to distinguish between these possibilities.