Author: Lee Wilson, Access Consultant, Universal Design Consultant

Introduction

Inflammation of the eyes can manifest as uveitis. It has an impact on the uvea, the middle layer of tissue in the eye wall. Warning signs of uveitis frequently appear unexpectedly and worsen rapidly. These include blurred vision, discomfort, and redness in the eyes. The illness can affect people of all ages, including children, and can impair one or both eyes.

An autoimmune or inflammatory condition, an accident, or an infection may bring on uveitis. Frequently, it is impossible to pinpoint the cause. Serious uveitis can result in irreversible visual loss. Early diagnosis and treatment are crucial to avoid issues and protect your vision.

Signs and Symptoms

The following are possible indications, symptoms, and traits of uveitis:
      1. Redness of the eyes.
      2. Eye discomfort.
      3. Sensitivity to light.
      4. Visual impairment.
      5. Spots in your fields of vision that are dark and floats (floaters).
      6. Reduced vision.

Though they might often develop gradually, symptoms can sometimes appear unexpectedly and worsen rapidly. One or both eyes may be affected. Sometimes, there are no symptoms, and a routine eye check reveals signs of uveitis.

The middle layer of tissue in the eye’s wall is called the uvea. It is made up of the choroid, ciliary body, and iris. The white portion of the eye, known as the sclera, and the coloured portion, known as the iris, is visible when you gaze in the mirror.

The component or sections of the eye that are inflamed determine the type of uveitis you have:

• The ciliary body and the inside of the front of your eye, between the cornea and the iris, are both impacted by anterior uveitis. It is the most prevalent kind of uveitis, also known as iritis.
• The retina, blood vessels directly behind the lens (pars plana), and the gel in the middle of the eye (vitreous) are all impacted by intermediate uveitis.
• The retina or choroid, two layers on the inside of the rear of your eye, is impacted by posterior uveitis.
• From the front to the rear of your eye, all layers of the uvea become inflamed when you have panuveitis.

Causes

The exact etiology of uveitis is unknown in roughly half of cases, and the condition may be classified as an autoimmune illness that solely affects one or more eyes.

One of the following could be the cause if one can be identified:

• An inflammatory or autoimmune condition, like Crohn’s Disease or systemic lupus erythematosus.
• Back discomfort may result from ankylosing spondylitis; uveitis is one of the most frequent side effects of ankylosing spondylitis.
• An infection, such as tuberculosis, herpes zoster, syphilis, toxoplasmosis, or cat scratch disease.
• Adverse effect of medication.
• Eye damage or surgery.
• On rare occasions, an eye malignancy, such as lymphoma.

Risk Factors

Uveitis may be more common in people with specific gene alterations. Smoking cigarettes has been linked to more challenging-to-manage uveitis.

Diagnosis

An ophthalmologist will probably perform a comprehensive eye examination and take a detailed medical history when you visit them.

The following are typically included in the eye exam:

• Evaluation of your eyesight:  including how your pupils react to light and whether you often wear glasses.
• Tonometry: An intraocular pressure (IOP) test monitors the pressure inside your eye. For this examination, numbing eye drops may be utilised.
• A slit-lamp analysis: A slit lamp is a type of microscope that shines a bright line of light in front of your eye, magnifying it. To find microscopic inflammatory cells in the front of the eye, this examination is required.
• Ophthalmology: This examination, sometimes called a funduscopy, uses eye drops to dilate the pupil and then shines a strong light into the eye to look at the back of the eye.

Treatment

Treatment for uveitis may concentrate on the underlying condition if it is the cause. The treatment is typically the same as long as the underlying cause of uveitis is not contagious. Treatment aims to reduce ocular swelling and, if present, swelling in other areas of the body. In certain situations, months or even years of treatment may be required. There are numerous alternatives for treatment.

Medication

• Inflammatory-reducing medications
• Medications that reduce spasms.
• Medications that fight viruses or bacteria.
• Medications that damage cells or have an impact on the immune system.

Procedures Such as Surgery

• Vitrectomy
• An implant that releases medication.

LumiLab guides, webpages, and articles discussing optometry and ophthalmology are intended only for educational and informative purposes and do not serve as medical or professional advice.

The information presented, including but not limited to text, graphics, images, and other material, is for informational purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult your physician, optician, or other health care professional if you have questions about your eye health or vision.

Download this Ophthalmology & Optometry Information Guide

A macular hole is a small tear or opening in the macula. The macula is the part of your retinas essential for sharp, detailed central vision. When a macular hole forms, it can blur or distort your central vision, making everyday tasks like reading, driving, or recognizing faces more challenging.

Causes

The most common cause is simply aging. As you get older, the gel-like substance inside your eye (called the vitreous) begins to shrink and pull away from the retina. Usually, this process is harmless, but if the vitreous tugs too hard on the macula, it can cause a tear or hole. Other possible causes include:

• Eye injuries.
• Retinal detachment
• Severe nearsightedness (high myopia): This stretches the retina, increasing the risk of damage.
• Inflammation or swelling caused by other eye issues can also trigger a hole.

Prevalence

Macular holes are uncommon, affecting about 3 in 1,000 people, with the risk increasing after age 60.

Risk Factors

Certain factors can raise the chances of developing a macular hole:

• Aging (especially after 60)
• high myopia
• Past eye injuries or surgeries
• Chronic eye conditions like diabetic retinopathy or retinal detachment
• A family history of macular holes

Symptoms

Macular holes develop slowly, so you might not notice symptoms immediately. Symptoms include the following:

• Straight lines may look bent or wavy.
• A dark or empty spot in the centre of your vision.
• Central vision is disturbed, causing trouble reading fine print or recognizing faces.

Impact on Contrast Sensitivity

A macular hole reduces contrast sensitivity, making distinguishing between light and dark areas harder. The following may be experienced:

• Faded or Washed-Out Appearance: Colors and details appear less vivid or distinct.
• Reduced Clarity in Shadows: Items in shadowed areas become harder to see.
• Difficulty with Low-Contrast Edges: Objects blend into backgrounds, such as light grey text on white paper.

Luminance contrasting surfaces are especially important.

Treatment Options

Treatment for macular holes depends on the severity of the condition:

• Small holes sometimes heal on their own. Your doctor might recommend regular checkups to monitor any changes.
• A vitrectomy procedure is typically used for Larger or more advanced holes. The surgeon removes the vitreous gel, pulling on the macula and may insert a gas bubble into your eye to help the hole close.

Can You Prevent a Macular Hole?

While you can’t always prevent a macular hole, there are steps you can take to protect your eye health:

• Get regular eye exams.
• Wear safety goggles when doing activities that might cause injury.
• Manage chronic conditions like diabetes and high blood pressure under control.

LumiLab guides, webpages, and articles discussing optometry and ophthalmology are intended only for educational and informative purposes and do not serve as medical or professional advice.

The information presented, including but not limited to text, graphics, images, and other material, is for informational purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Always consult your physician, optician, or other health care professional if you have questions about your eye health or vision. Stock images by Freepik – www.freepik.com

Download this Ophthalmology & Optometry Information Guide

A coloboma is a congenital (present from birth) condition in which a portion of the eye structure fails to develop properly, resulting in a gap or hole in one or more parts of the eye. This condition can affect various parts of the eye. Depending on the location and size of the coloboma, the severity and impact on vision can vary significantly.

Types of Colobomas

Eye colobomas are classified based on the location of the defect within the eye’s anatomy or which part of the eye is affected.

Iris Coloboma

The iris is the coloured part of the eye that controls the amount of light entering the eye by adjusting the size of the pupil.

An iris coloboma occurs when part of the iris fails to develop properly, leading to a gap in the iris. This can result in a characteristic keyhole or cat-eye appearance in the affected eye. The size and location of the defect can vary.

Iris colobomas may lead to cosmetic changes and light sensitivity (photophobia) but typically do not result in significant vision loss if the defect affects the pupil’s ability to constrict and dilate properly.

Retinal Coloboma

This involves a gap in the retina. Retinal colobomas are more likely to result in severe vision problems than iris colobomas.

Retinal colobomas can lead to significant vision problems, including vision loss in the affected area, reduced peripheral vision, or even total vision loss, depending on the location and size of the defect. If they involve the macula, they can significantly impact central vision.

Optic Nerve Coloboma

The optic nerve is crucial in transmitting visual information from the eye to the brain. A gap or defect in the optic nerve head, where the optic nerve connects to the eye, can lead to serious vision problems. This form of coloboma can result in partial or complete vision loss, sometimes causing blindness in the affected eye. It may also lead to complications like glaucoma or an increased risk of retinal detachment.

Choroidal Coloboma

Choroidal colobomas are defects in the choroidal tissue, with varying sizes and severity. They can cause visual impairments, especially if the defect affects areas that supply the retina. However, compared to retinal or optic nerve colobomas, they generally result in less severe vision loss, though complications such as retinal detachment can still occur.

Causes of Eye Coloboma

The optic fissure is a natural gap in the developing eye that typically closes early in gestation. An incomplete closure of the fetal optic fissure during eye development results in a gap or hole in structures like the iris, retina, choroid, or optic disc.

Alcohol consumption during pregnancy can increase the risk of birth defects, though it is not specifically linked to colobomas.

Colobomas are more commonly associated with genetic mutations (e.g., PAX6) and family history, which can predispose individuals to eye abnormalities.

Complications of Eye Colobomas

The complications associated with eye colobomas depend on the defect’s type, size, and location. Some of the primary complications include:

• Vision Impairment – An eye coloboma can affect vision, colour perception, and contrast sensitivity, depending on its location and severity.
• Strabismus (Crossed Eyes) – Individuals with eye colobomas may develop strabismus, particularly those with more severe visual impairments.
• Amblyopia (Lazy Eye) – Children with significant visual impairment from colobomas may develop amblyopia, leading to poor vision development in that eye.
• Glaucoma – Colobomas in specific locations, especially optic nerve colobomas, can increase the risk of glaucoma.
• Retinal Detachment – In some cases, colobomas of the retina can predispose individuals to retinal detachment. This serious complication can lead to blindness if not treated promptly.
• Cataracts – Colobomas can sometimes be associated with the development of cataracts.
• Photophobia – Iris colobomas may cause an increased sensitivity to light (photophobia), which can be uncomfortable and make it difficult to function in bright environments.

Treatment and Management

The following are standard treatment methods:

• Corrective Lenses: Eyeglasses or contacts to correct refractive errors.
• Surgery: For complications like retinal detachment or cataracts.
• Vision Therapy: Helps develop skills to cope with vision loss.
• Low Vision Aids: Tools like magnifiers to assist with daily tasks.

LumiLab guides, webpages, and articles discussing optometry and ophthalmology are intended only for educational and informative purposes and do not serve as medical or professional advice.

The information presented, including but not limited to text, graphics, images, and other material, is for informational purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Always consult your physician, optician, or other health care professional if you have questions about your eye health or vision.

Stock images by Freepik – www.freepik.com

Download this Ophthalmology & Optometry Information Guide