Uveitis Treatment in Ranchi
Expert diagnosis and management of intraocular inflammation at Neurovision Clinic, preserving vision through timely, targeted care.
What is Uveitis (Intraocular Inflammation)?
Uveitis is an inflammatory condition affecting the uveal tract, the middle vascular layer of the eye consisting of the iris, ciliary body, and choroid. It can present acutely or chronically and may involve one or both eyes. The inflammation arises when the body's immune system attacks ocular tissues, triggered by infection, systemic autoimmune disease, or occasionally trauma. Uveitis is categorised anatomically: anterior uveitis (iritis) is the most common form, presenting with a red, painful eye; intermediate uveitis involves the vitreous cavity; posterior uveitis affects the retina and choroid; and panuveitis involves all layers. In India, infectious causes such as tuberculosis and toxoplasmosis are significant contributors. Uveitis can occur at any age but is most prevalent in adults between 20 and 60 years. If inadequately treated, it is a leading cause of preventable blindness, responsible for up to 10% of visual impairment cases worldwide.
Symptoms of Uveitis (Intraocular Inflammation)
- •Eye redness, often concentrated around the limbus (ciliary flush); deep, aching ocular pain that may radiate to the temple or brow; marked photophobia (light sensitivity) in anterior uveitis; blurred or hazy vision; floaters, especially in intermediate and posterior uveitis; a constricted pupil that reacts sluggishly to light; and lacrimation without purulent discharge. In chronic cases, patients may notice gradual visual decline without dramatic redness or pain. Some individuals experience only mild irritation that is easily dismissed. Symptoms may be unilateral or bilateral, and systemic features such as joint pain, skin lesions, or respiratory complaints may accompany uveitis associated with autoimmune disease.
Causes & Risk Factors
- •Autoimmune disorders are the most common non-infectious cause, including ankylosing spondylitis (strongly associated with HLA-B27), juvenile idiopathic arthritis, sarcoidosis, Behçet’s disease, and Vogt-Koyanagi-Harada syndrome. Infectious aetiologies include tuberculosis, toxoplasmosis, herpes simplex and herpes zoster viruses, cytomegalovirus (particularly in immunocompromised individuals), and syphilis. Trauma to the eye (traumatic iritis) and post-surgical inflammation are additional causes. Certain medications, notably bisphosphonates and some antibiotics, have been implicated in drug-induced uveitis. In approximately 30–40% of cases, no specific cause is identified despite comprehensive investigation, and the condition is labelled idiopathic.
Diagnostic Tests
Slit-Lamp Biomicroscopy
The primary diagnostic tool for uveitis. Dr. Dibya Prabha uses a slit lamp to detect anterior chamber cells and flare, keratic precipitates on the corneal endothelium, posterior synechiae, and iris nodules. The grading of cells and flare according to the Standardisation of Uveitis Nomenclature (SUN) criteria guides treatment intensity. Dilated fundus examination with a 90D or 78D lens is essential to evaluate for vitritis, choroiditis, retinitis, and vasculitis.
Optical Coherence Tomography (OCT)
High-resolution OCT imaging is invaluable for detecting and monitoring uveitic macular oedema, the most common cause of vision loss in uveitis. OCT can reveal cystoid spaces, subretinal fluid, and epiretinal membrane formation. Serial OCT scans at Neurovision Clinic allow Dr. Dibya Prabha to objectively track response to treatment and titrate therapy accordingly.
Fundus Fluorescein Angiography
When posterior segment involvement is suspected, FFA reveals patterns of retinal vasculitis, macular leakage, choroidal neovascularisation, or areas of capillary non-perfusion. It is particularly useful in posterior uveitis and panuveitis to determine disease activity and guide decisions regarding systemic immunosuppression.
Treatment Approach
At Neurovision Clinic, Ranchi, Dr. Dibya Prabha designs an individualised treatment plan based on uveitis type, severity, laterality, and any identified underlying systemic disease. The goal is rapid control of inflammation, prevention of structural complications, and preservation of visual function with the least toxic regimen possible.
Topical Corticosteroids and Cycloplegics
First-line management for anterior uveitis. Potent corticosteroid drops such as prednisolone acetate 1% are used frequently during the initial phase and tapered gradually. Cycloplegic agents like homatropine or cyclopentolate relieve pain from ciliary spasm and prevent posterior synechiae by keeping the pupil mobile.
Periocular and Intravitreal Corticosteroids
For intermediate and posterior uveitis, or when topical therapy is insufficient, periocular triamcinolone acetonide injections or intravitreal dexamethasone implants (like Ozurdex) deliver sustained-release corticosteroids directly to the posterior segment. Dr. Dibya Prabha performs these office-based procedures under aseptic conditions at Neurovision Clinic.
Systemic Immunomodulatory Therapy
Systemic corticosteroids (oral prednisolone) are indicated for bilateral, severe, or sight-threatening uveitis. When long-term control is needed, steroid-sparing agents such as methotrexate, mycophenolate mofetil, or azathioprine are introduced to minimise steroid-related adverse effects. Biologic agents (e.g., adalimumab) are reserved for refractory cases after appropriate infection screening.
Management of Complications
Dr. Dibya Prabha actively monitors for and manages complications including secondary glaucoma (managed with ocular hypotensives or filtering surgery), cataract (phacoemulsification once inflammation is quiescent for at least three months), band keratopathy, hypotony, and cystoid macular oedema. Regular follow-up allows early detection and intervention before irreversible damage occurs.
⚠️ When to See a Doctor
- !You experience sudden eye redness accompanied by deep aching pain and light sensitivity that does not resolve within a few hours.
- !You notice new floaters, flashes of light, or a shadow in your peripheral vision in either eye.
- !You have been diagnosed with an autoimmune condition such as ankylosing spondylitis, sarcoidosis, or juvenile arthritis and require baseline eye screening.
- !Your vision becomes blurred or hazy and does not improve with blinking or artificial tears.
- !You are already under treatment for uveitis but experience a recurrence of symptoms, suggesting a flare-up that may require re-evaluation.
- !You have a history of eye trauma or recent eye surgery followed by persistent redness, pain, or visual decline.