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Anterior Uveitis

Writer's picture: Stittsville Kanata Veterinary HospitalStittsville Kanata Veterinary Hospital



Basic Information

The anterior uvea is composed of the iris (the tissue around the pupil) and the ciliary body, which sits directly behind the iris and is usually not visible. Any inflammation of these tissues is termed anterior uveitis.


Causes

Uveitis can develop as an isolated eye problem, but it is more commonly a sign of an underlying illness elsewhere in the body.

  • Eye conditions that cause uveitis include corneal ulcers, cataracts, trauma, and tumors.

  • More than 25 different infections can cause uveitis, including fungal, tick-borne, bacterial, viral, protozoal, and parasitic infections. Some infections are more common in dogs, while others are more frequent in cats.

  • In rare cases, the immune system may attack the uvea. Other body systems may also be affected in such instances.

  • Tumors originating elsewhere in the body may metastasize to the eye.

  • Hypertension (high blood pressure), elevated circulating levels of protein or fat, and other blood disorders may trigger uveitis.

Sometimes uveitis arises for unknown reasons, such as pigmentary uveitis in Golden Retrievers, or when the cause remains unidentified, it is called idiopathic. In these cases, laboratory test results may be normal.


Clinical Signs

Signs of anterior uveitis include redness and pain in the eye. Animals may squint, especially in bright light, and the eye may appear cloudy or discolored. If only one eye is affected, the pupil size and mobility may differ between the eyes. Vision can be reduced, and severe cases may lead to blindness. In cases where glaucoma develops, the eye may become enlarged. If the uveitis is caused by a systemic infection, the animal may show signs of illness beyond the eye, such as lethargy or fever.


Treatment and Follow-up

Treatment Options


Treatment of anterior uveitis involves addressing both the eye condition and any underlying systemic causes. Common eye medications include topical anti-inflammatory drugs (usually corticosteroids), pupil dilators/pain relievers (such as atropine), and, in some cases, antibiotics and anti-glaucoma medications. The severity of the inflammation dictates how frequent and intense the treatment should be.


Once an underlying cause is identified, appropriate treatments are initiated. Examples include antibiotics, antifungal agents, or drugs to manage conditions such as hypertension and blood disorders. Oral anti-inflammatory drugs may also be necessary, but steroids are often delayed until infectious causes are ruled out to prevent exacerbating infections.

In severe cases, removal of the affected eye may be recommended, especially in cases of suspected intraocular tumors, blind, painful eyes, or unresponsive glaucoma. This is also considered if there is concern that an infection in the eye could spread to other parts of the body (e.g., certain fungal infections).


Follow-up Care

Uveitis can either develop suddenly or progress slowly and go unnoticed for a long time. If symptoms worsen, particularly with increased pain (such as squinting) or cloudiness, this should be reported immediately to the veterinarian. Recheck visits are essential to monitor the animal’s response to treatment and to check for complications such as glaucoma. In some cases, laboratory tests are repeated to monitor for side effects from medications.


Diagnostic Tests

The presence of uveitis is confirmed by an eye examination, which may include tear testing, fluorescein staining of the cornea, and glaucoma testing. If these tests are inconclusive, referral to a veterinary ophthalmologist may be necessary. Additionally, a general physical examination is often performed to search for signs of systemic illness.

Diagnostic tests such as blood work, chest and abdominal x-rays, and abdominal ultrasound may be recommended to identify potential underlying causes. Finding the cause of uveitis can be challenging and may require extensive testing.


Prognosis

The outcome for uveitis depends on the underlying cause, the severity of the inflammation, and the consistency of treatment. Many cases resolve with proper therapy, but the animal must be closely monitored for recurrence of inflammation as medications are tapered. Some cases may lead to blindness or even the loss of the eye if they do not respond well to treatment. Chronic uveitis in cats, for instance, may require extended therapy, sometimes lasting months or even years.

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