Uveitis Prevention: Reducing Your Risk of Developing Uveitis


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Uveitis prevention should be considered an important aspect in the management of uveitis. Uveitis is the inflammation of the uveal tissue of the eye. If untreated, it has the potential to cause pain and, more importantly, sight loss and blindness.

No doubt that the inflammation from uveitis can generally be treated but as with most diseases, prevention is certainly more preferable. This is relevant because uveitis treatment medications, especially the stronger ones, can be associated with multiple side effects.

(Image adapted from the internet)

Two examples of how uveitis may manifest. Uveitis can cause visual loss by damaging the macula (central part of the retina that is important for seeing fine detail) and the optic nerve (which conveys nerve impulses from your eye to your brain). Not only that, uveitis can also cause other complications such as cataract and glaucoma. It can also act as the spark that triggers age-related macular degeneration.


At present, there are no truly effective ways to completely stop uveitis from happening. There is currently no evidence yet from medical research for any form of uveitis prevention treatment. However, there are measures that you can take to reduce your risk of developing or worsening your uveitis. If you can follow these 5 simple yet golden rules of uveitis prevention, then you will decrease your risk of vision loss from uveitis.



UVEITIS PREVENTION RULE #1: RECOGNIZE SYMPTOMS EARLY

Okay, so this isn't exactly uveitis prevention. But there's a lot to be said for recognizing the symptoms early, so that the inflammation can be treated early. The earlier uveitis is treated, the easier it is to get the inflammation under control. If you haven't experienced uveitis before, then it will be a bit more difficult to know what symptoms to expect. In general, the 3 commonest symptoms are: extra sensitivity to light (photophobia), tenderness of the eyeball (especially when touched or pressed on) and floaters.

If you are someone who gets recurrent episodes of uveitis, you will often know when an attack is coming. Often you will feel the discomfort in your eyes even before any evidence of inflammation is seen clinically. This is the ideal time to be started on treatment. You will find that treatment works much faster, your symptoms settle much quicker and you can discontinue or reduce your medications earlier.

Treating and controlling the uveitis early means that you put it out before it has any chance to do any damage to your eyes. If you are unsure whether or not you have symptoms yor uveitis, it is best to arrange to have your eyes examined by an ophthalmologist.



UVEITIS PREVENTION RULE #2: LIFESTYLE CHANGES

Surprisingly, despite all the well-recognized eye problems (including macular degeneration and cataract) that smoking is associated with, there is no conclusive evidence that smoking worsens or triggers uveitis. This is mainly due to the lack of well-conducted research in this area. As with any eye disease, the less harmful chemicals circulating in your body and eyes the better. The toxins contained within cigarette smoke (tobacco-specific N-nitrosamines (TSNAs), benzene, pesticides, arsenic, cadmium, cyanide) will affect your health and how your body responds to illness. So if you do develop uveitis, it is possible that smoking may potentially delay your recovery from the inflammation.

In some people, stress is a trigger factor for uveitis and also other eye conditions, such as central serous chorioretinopathy. Having sufficient rest ensures that your body and eyes recover from daily exertions. Schedule some time to relax your mind and body daily, even if only for 5 minutes. You can meditate, go for a walk, have a massage or simply do something you enjoy doing that will take your mind off your worries. This will make you feel much better overall and may help to reduce the recurrence of your uveitis.



UVEITIS PREVENTION RULE #3: A HEALTHY DIET

In general, having a healthy diet with plenty of fruits and vegetables while minimizing trans-fatty acids will benefit your overall eye health. Many fruits and vegetables contain antioxidants that are good for your eye health, such as spinach, peppers, cherries and blueberries. Antioxidants may help to boost the immune system and may play a role in uveitis prevention.

One small study looked at the role of vitamins C and E, and found that they may decrease the symptoms of anterior uveitis. When taken twice daily by those with uveitis, the combination of vitamin C and vitamin E improved vision more than placebo after a 2-month period.

Turmeric (Curcuma longa) is also known for its antioxidant properties. Standardized extract of turmeric 300 mg 3 times daily may help to boost the immune system. In another small (but not well designed) study, turmeric was found to help reduce the symptoms of chronic uveitis. If you do wish to start taking turmeric, please note that it may increase your risk of bleeding. Make sure you consult with your family doctor first especially if you also take aspirin or warfarin to thin your blood.

(Image adapted from the internet)



UVEITIS PREVENTION RULE #4: REDUCE INFECTION EXPOSURE

Infections are well-recognized as important causes of uveitis. Many infections can cause uveitis, and these include tuberculosis, malaria, Lyme disease, toxoplasmosis, syphilis and herpes (both herpes simplex and herpes zoster). Fortunately, your risk of such infections can be reduced by taking simple and common sense precautions.

When you travel, especially to exotic foreign lands, it is very important that you take all the necessary precautions. This includes taking the necessary prophylactic medications and ensuring that your immunizations are up to date. One of the most lethal infections is tuberculosis. It is caused by various strains of mycobacteria, most commonly Mycobacterium tuberculosis. It is an airborne disease, and spreads through the air when an infected person coughs, speaks, sneezes or spits out. When travelling to tuberculosis-endemic countries, make sure that you are immunized and avoid overcrowded areas with poor sanitation.

Another serious infection is malaria. Malaria is caused by Plasmodium parasites that are transmitted through bites from the Anopheles mosquito (left). When in malaria-endemic countries, take your medications as prescribed, use insecticide-impregnated bed nets, and wear long sleeves to minimize exposed skin.

(Image adapted from the internet)


Be aware also of infections that are associated with animals, and try to avoid unnecessary contact with animals that you are not familiar with. For example, Lyme disease is an infection caused by the bacteria Borrelia burgdoferi, which is transmitted by deer tick bites. Another example is toxoplasmosis, caused by the parasite Toxoplasma gondii which lays its spores in cat litter. If contact is unavoidable, make sure you wear gloves and wash yourself thoroughly afterwards.

Finally, some infections that can cause uveitis are also transmitted sexually. One of the most important is syphilis. Syphilis is caused by the spirochete Treponema pallidum, and can result in skin, kidney, liver, heart and neurological problems if not treated. The message is clear: always practise safe sex for the sake of your general and eye health.



UVEITIS PREVENTION RULE #5: PROTECT FROM TRAUMA

When your eye suffers an injury, inflammation will occur. This is called traumatic uveitis. Traumatic uveitis will generally settle with treatment with steroid eye drops unless the injury is severe.

In cases of severe injury (especially in penetrating eye injury and also including multiple eye surgery), the other eye becomes at risk of developing uveitis. This form of uveitis is called sympathetic ophthalmia. Inflammation occurs because the immune system becomes exposed to the uveal tissues of the eye and recognizes them as being foreign. When this happens, the immune system starts attacking the uveal tissues of both eyes. Although rare, sympathetic ophthalmia is a potentially blinding condition that needs to be aggresively managed with steroids and immunosuppression medication if required.

(Image adapted from the internet)

An example of sympathetic ophthalmia:
A. Penetrating injury to the left eye, resulting in a damaged iris and distorted pupil
B. Sympathetic ophthalmia, with Dalen Fuchs nodules (white arrows) in the right eye


Avoiding eye trauma in the first place is thus one of the most important uveitis prevention measures. So protect your eyes by wearing seat belts when driving, and wearing protective goggles when operating machinery, playing sport and handling firearms. Don't forget about your child's eye health - cushion sharp corners on furniture, remove any easily accessible sharp or pointed objects, and choose your child's toys wisely.




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