According to a recent article, a medical professional shared the importance medication history has on diagnosing drug-induced uveitis.

Uveitis

Uveitis is a term that refers to inflammation of a part of the eye called the uvea. The uvea is the middle layer of the eye; it protects the eyeball and provides most of the blood supply to the retina. There are multiple types of uveitis, as detailed below. Uveitis is often connected with other diseases or conditions. It can occur in all ages, but primarily affects people between 20 and 60 years of age.

Types:

• Iritis, or anterior uveitis: Affects the front of the eye. The most common type of uveitis.
• Cyclitis, or intermediate uveitis: Affects the ciliary body, the area just between the iris and the choroid.
• Choroiditis, or posterior uveitis: Affects the retina and/or the optic nerve, and may lead to permanent vision loss. The most uncommon form of uveitis.
• Pan-uveitis: Affects all three major parts of the eye.

Symptoms:

Symptoms often come on suddenly and can worsen rapidly. They include, but are not limited to:

• Eye redness
• Eye pain
• Sensitivity to light
• Blurry vision
• Dark spots in one’s field of vision, or “floaters”
• Vision loss

It is recommended to contact an ophthalmologist as soon as possible after symptoms arise.

Causes:

In many cases, the cause of uveitis is unclear. Typical causes include:

• Eye injury
• Eye surgery
• Autoimmune disorders like sarcoidosis or ankylosing spondylitis
• Inflammatory disorders like Crohn’s disease or ulcerative colitis
• Infection
• Toxins that penetrate the eye
• Eye cancers like lymphoma

Inflammation is the body’s natural response to tissue damage, toxins and germs, which is why inflammation is a characteristic feature of uveitis. 

Diagnosis:

Uveitis is diagnosed using the following procedures:

• A complete eye exam
• Thorough recording of medical history
• Lab tests
• Blood test
• Analysis of fluid from the eye
• X-rays

Treatments:

Treatment plans depend on the kind of uveitis the patient has. Treatment includes, but is not limited to:

• Treating the underlying infection or immunological disorder, often through:
  • Drugs that reduce inflammation
  • Drugs that fight bacteria or viruses
  • Drugs that affect the immune system
• Eye drops
• Steroids
• Surgery
• Follow up appointments to make sure the uveitis doesn’t come back

Drug-Induced Uveitis

Sanjay Kedhar, MD, emphasized that uveitis can be caused by medications. Although drug-induced uveitis is uncommon, it is also underrecognized. Therefore, it is important to educate patients and medical professionals on this potential cause.

Being Aware of Medications

Medications that can cause uveitis including topical therapies, TNF-alpha inhibitors, some vaccines, and other systemic medications. More specifically, sulfonamides, fluoroquinolones, and bisphosphonates have been proven to cause uveitis. Despite these medications being proven to cause uveitis, they are often overlooked as a cause during a diagnosis. Bisphosphonates can also cause a 25% to 50% higher risk for ocular inflammation and elevations in C-reactive protein and cytokines. Kedhar also noted that glaucoma medications, especially brimonidine, can cause uveitis.

Kedhar is spreading awareness about drug-induced uveitis to emphasize the importance of knowing the risks before a patient is put on a medication. As more patients are using these medications, it is increasingly important to stay vigilant about them causing uveitis.