Panuveitis

Panuveitis is a rare and serious form of uveitis, inflammation in the middle layer of your eye (your uvea). The word “panuveitis” means that you have inflammation all throughout your uvea, from the front to the back of your eye.

The middle layer of your eye includes your:

• Choroid
• Ciliary body
• Iris

Inflammation in these parts can cause irritation. It can also spread to other nearby parts, including your:

• Optic nerve
• Retina
• Vitreous humor

These parts are important to your vision, and inflammation in these parts can lead to vision loss.

Panuveitis can cause noticeable signs and symptoms of eye irritation and sensitivity, as well as vision changes. Having both types of symptoms is a sign that the inflammation in your eye is widespread. Seek care right away.

Symptoms of panuveitis

Signs and symptoms of panuveitis may include:

1. Blurred vision
2. Eye flashes
3. Eye floaters
4. Eye pain
5. Eye watering
6. Light sensitivity
7. Reduced visual acuity

You may notice symptoms in only one eye (unilateral) or in both eyes (bilateral panuveitis).

Panuveitis causes

Causes of panuveitis include infections, autoinflammatory diseases, eye trauma, certain medications and cancer. Some of these are temporary and others are chronic conditions, sometimes making panuveitis chronic, too.

• Eye infections can spread to your uvea from the surface of your eye if they’re severe. A penetrating injury to your eye can also introduce a bacterial infection into your eye.
• Eye injuries that cause deep trauma to your eye can also cause inflammation on their own. An injury in one eye can even cause inflammation in both. This is called sympathetic ophthalmia.
• Infectious diseases in other parts of your body can spread to your eyes through your bloodstream. Syphilis, toxoplasmosis and tuberculosis are common causes of panuveitis.
• Autoimmune diseases that cause inflammation throughout your body may also affect your eyes. Sarcoidosis, Vogt-Koyangi-Harada syndrome and Behçet’s disease are some examples.
• Idiopathic panuveitis is what healthcare providers call it when they can’t identify the cause precisely. This type acts like an autoimmune disease, but it doesn’t match any known profile.
• Certain medications to treat other diseases in other parts of your body can cause panuveitis; these include certain cancer medications and bisphosphonates, which help with bone loss.
• Cancer in your eye can cause widespread inflammation, although it’s very rare. Examples include intraocular melanoma, intraocular lymphoma, retinoblastoma and orbital carcinoma.

Complications of this condition

Severe or long-lasting inflammation can do permanent damage to parts of your eye, causing permanent visual impairment. Having panuveitis raises your risk of several secondary conditions, including:

• Band keratopathy
• Cataracts
• Cystoid macular edema
• Glaucoma
• Posterior synechiae
• Retinal detachment

How doctors diagnose this condition

To diagnose panuveitis, an eye care specialist will ask you about your symptoms, then thoroughly examine your eye. They’ll do a slit lamp exam with additional lenses to look at the back of your eye.

Your provider will look for evidence of inflammation in all the different parts of your eye. If they find evidence in the front, middle and back parts of your uvea together, they’ll diagnose panuveitis.

Additional tests

Diagnosing the cause of panuveitis can be another story, especially if you haven’t had any recent eye injury or infection. Your provider will ask you all about your health history and preexisting conditions.

They might ask you questions or check for signs and symptoms that seem to have nothing to do with your eyes. This helps them narrow down possible causes. They might want to run additional tests, like:

• Blood tests to check for infections, antibodies or other clues
• Imaging tests on your eye, like ultrasound biomicroscopy or optical coherence tomography
• Fluorescein angiography or indocyanine green angiography to look at blood vessels in your eye
• Imaging tests of other parts of your body, like X-rays or a CT scan

How is panuveitis treated?

Corticosteroids are the primary treatment for panuveitis. They’ll help bring the inflammation down to protect your vision and also treat your discomfort. This is the first priority when treating panuveitis.

Your provider may prescribe steroid pills, steroid eye drops or a steroid injection into your eye — or all of the above, depending on your condition. Some people may need to take them on a long-term basis.

You may need additional treatment for the condition causing your panuveitis, like:

• Antibiotics or antivirals to treat an infection
• Immunosuppressants or DMARDs to treat inflammatory diseases
• Other cancer treatments if a rare cancer is the cause of the inflammation

These treatments can affect people in different ways. Let your provider know how they work for you and if you experience any side effects. They’ll adjust your medications until they find the right fit.

You may also need additional treatment for complications of panuveitis that damage your vision. After treating panuveitis, your provider might recommend eye surgery to treat some of these complications.

What can I expect if I have panuveitis?

Panuveitis is treatable, but you need to get treatment right away. Some of the damage it can do is irreversible. Your prognosis will depend on how severe it is and how soon you can get treatment.

If you have a chronic condition that causes panuveitis, it may come back again after treatment. You might need to treat it on a recurring basis. Some people might need to take medications long-term.

Is there anything I can do to feel better?

The most important thing you can do to take care of yourself is to get treatment quickly. Once you do, keep in touch with your provider about how you’re doing so they can adjust your plan if needed.

While you’re recovering, it might also help to:

• Apply warm compresses to your closed eye or eyes
• Wear sunglasses to protect your eyes from bright light
• Use NSAIDs (if recommended) to reduce pain and inflammation