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Immunology and Uveitis
The autoimmune Uveitis is a immunological disorders,
caused by your own immune system.
What is uveitis?
Uveitis is inflammation inside the eye, affecting one or more of the
three parts of the eye that make up the uvea: the iris (the colored
part of the eye), the ciliary body (behind the iris, responsible for
manufacturing the fluid inside the eye), and the choroid (the
vascular lining tissue underneath the retina).
Uveitis is the THIRD leading cause of blindness in the United
States, after diabetes and macular degeneration.
Approximately 60 different things - infectious, non-infectious, as
well as malignant etiologies - can cause uveitis. If the cause of
uveitis is infectious, it is possible that you "catch" that
infectious agent from somebody, some thing, or some animal,
including your household pets. These are the triggering events. In
most cases Uveitis will resolve , in others it becomes a chronic
autoimmune disorder,
The immune system, generally protecting us from germs and cancer
cells, can become deranged, dysregulated, with the result being an
immune attack on part of one's own body. This state is termed
autoimmunity, or immune attack against self.
Autoimmune disease are those that result from the existence of
autoimmunity. the most famous autoimmune disease is rheumatoid
arthritis (RA). In RA, the white blood cells of the immune system
become dysregulated or "confused" and begin to attack the
individual's joints.
A number of autoimmune diseases exist in which the eye or various
parts of the eye may be attacked by white blood cells. Often the
autoimmune disease is systemic, i.e., a variety of organs throughout
the body system are being attacked. Examples of such diseases
include rheumatoid arthritis, systemic lupus erythematosus,
polyarteritis nodosa, scleroderma, relapsing polychondritis, and
inflammatory bowel disease (ulcerative colitis and Crohn's disease).
All these can affect the eye, causing corneal ulcers, sclerosis,
uveitis, or other inflammation.
Physicians must be able to identify the underlying cause to most
effectively treat the uveitis. "Getting to the bottom of it," and
definitely identifying the cause of the uveitis is critical, since
the best choice of treatment is so dependent on the underlying
cause. The proper treatment for one cause would in many instances be
deleterious in the care of patients with uveitis from another cause.
Regardless of the form of autoimmunity, any autoimmune disease
affecting the eye will require systemic (e.g., oral as opposed to
local, topical, ocular) therapy. the components of the immune system
reside not in the eye, but rather are systemic and, therefore,
regulation of those components will require systemic therapy.
The treatment is generally beginning with steroid drops, advancing
to steroid injections and/or pills, adding an oral, non-steroidal
anti-inflammatory medication, and culminating in the use of an
immunomodulatory, chemotherapeutic drug if the patient's uveitis
continues or continues to recur each time the steroid medications
are tapered and stopped.
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