Although it is the third cause of preventable blindness between the ages of 20 and 50 in developed countries, uveitis remains a great unknown. This inflammation of the uvea, the middle layer of the eye, usually manifests itself subtly and silently, making it difficult to detect. But its impact is not minor: in Spain, it is estimated that the disease affects around 47,000 people, according to data from the Hospital Clinic Barcelona. Without prompt diagnosis and treatment, it can seriously compromise vision.
Uveitis can manifest itself in very different ways. Some appear suddenly, with redness, pain, and extreme sensitivity to light—characteristic symptoms of anterior uveitis. Others are camouflaged by more subtle signs, such as blurred vision or the appearance of “floaters” and tiny cobwebs in the visual field, without causing redness or pain. Furthermore, uveitis encompasses a heterogeneous set of pathologies that have inflammation within the eye in common.
It is a disease that alters daily routine, but to which one can adapt and live relatively normally.
Uveitis is neither hereditary nor degenerative, and its evolution depends on the cause and the treatment applied. Its origins are very diverse: it can be caused by infections such as toxoplasmosis or tuberculosisor by autoimmune processes. In some cases, specialists cannot identify its cause, which is called “idiopathic uveitis.” “It is a disease that alters the daily routine, but to which one can adapt and live relatively normally,” explains Esma, a patient at Hospital Clínic Barcelona, who highlights the importance of information and medical follow-up to face the disease with tranquillity. Alfredo Adán, an ophthalmologist at the same hospital, emphasizes that “the message for patients is one of hope,” since “today we have multiple therapeutic options, faster and more effective, which translate into an increasingly better quality of life.”
The message for patients is one of hope. Today we have multiple therapeutic options, faster and more effective, which translate into an increasingly better quality of life.
Uveitis mainly affects young adults at work, making it easier for its symptoms, such as pain, redness, blurred vision or floating spots, to go unnoticed. Given these signs, specialists recommend going to the ophthalmologist without delay to act quickly and prevent serious complications. Without adequate and timely treatment, the disease can lead to severe problems, such as macular edema, cataracts, glaucoma or retinal detachment, with potentially harmful consequences for vision. Once diagnosed, a multidisciplinary approach is often required. In addition to specialists in ophthalmology, its management usually requires assistance from professionals in internal medicine, rheumatology, immunology or infectology, since uveitis is related to rheumatic and infectious diseases and even some types of cancer.
Advances in research, together with the improvement of imaging techniques—such as retinography, fundus angiography, and optical coherence tomography—and improvements in diagnostic tools, have allowed the development of more precise and personalized treatments. In addition to traditional corticosteroids, which are effective in controlling acute outbreaks, there are currently drugs that offer longer-lasting solutions with fewer side effects.
We seek to personalize treatment based on the underlying cause of uveitis. Thus, we will be able to control the disease without resorting indefinitely to corticosteroids or immunosuppressants, reducing adverse effects and improving quality of life.
Research is advancing with the aim of identifying biomarkers that allow earlier diagnosis and therapies adapted to each patient. “We seek to personalize treatment based on the underlying cause of uveitis. Thus, we will be able to control the disease without resorting indefinitely to corticosteroids or immunosuppressants, reducing adverse effects and improving quality of life,” says Dr. Adán.
The message from specialists is clear: uveitis can be controlled. Although it requires close monitoring and prolonged treatments, technological and pharmacological advances have significantly improved its prognosis. Far from the feared outcome of blindness, today people with uveitis have more favorable prospects, allowing them to lead full and productive lives.
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