Uveitis Treatment in Ranchi
Expert diagnosis and management of intraocular inflammation at Neurovision Clinic, preserving vision through timely, targeted care.
What is Uveitis (Intraocular Inflammation)?
Uveitis is an inflammatory condition affecting the uveal tract, the middle vascular layer of the eye consisting of the iris, ciliary body, and choroid. It can present acutely or chronically and may involve one or both eyes. The inflammation arises when the body's immune system attacks ocular tissues, triggered by infection, systemic autoimmune disease, or occasionally trauma. Uveitis is categorised anatomically: anterior uveitis (iritis) is the most common form, presenting with a red, painful eye; intermediate uveitis involves the vitreous cavity; posterior uveitis affects the retina and choroid; and panuveitis involves all layers. In India, infectious causes such as tuberculosis and toxoplasmosis are significant contributors. Uveitis can occur at any age but is most prevalent in adults between 20 and 60 years. If inadequately treated, it is a leading cause of preventable blindness, responsible for up to 10% of visual impairment cases worldwide.
Symptoms of Uveitis (Intraocular Inflammation)
- •Eye redness, often concentrated around the limbus (ciliary flush); deep, aching ocular pain that may radiate to the temple or brow; marked photophobia (light sensitivity) in anterior uveitis; blurred or hazy vision; floaters, especially in intermediate and posterior uveitis; a constricted pupil that reacts sluggishly to light; and lacrimation without purulent discharge. In chronic cases, patients may notice gradual visual decline without dramatic redness or pain. Some individuals experience only mild irritation that is easily dismissed. Symptoms may be unilateral or bilateral, and systemic features such as joint pain, skin lesions, or respiratory complaints may accompany uveitis associated with autoimmune disease.
Clinical Observations at Neurovision
Dr. Dibya Prabha at Neurovision observes a higher-than-expected incidence of tubercular uveitis in Jharkhand patients, reflecting the high prevalence of latent and active tuberculosis in eastern India. Additionally, toxoplasma retinochoroiditis is not uncommon and is linked to consumption of untreated water and undercooked meat in rural households.
Standard medical literature states:
Standard uveitis textbooks classify uveitis by anatomic location — anterior, intermediate, posterior, or panuveitis — with a wide differential including autoimmune, infectious, and masquerade aetiologies.
We routinely order chest X-ray and Mantoux/QuantiFERON testing for uveitis patients in Jharkhand before initiating corticosteroids. In suspected infectious uveitis, we treat the underlying infection first — starting steroids without covering for TB can be catastrophic. We counsel patients in Hindi about the need for prolonged treatment and follow-up.
— Dr. Dibya Prabha
Causes & Risk Factors
- •Autoimmune disorders are the most common non-infectious cause, including ankylosing spondylitis (strongly associated with HLA-B27), juvenile idiopathic arthritis, sarcoidosis, Behçet's disease, and Vogt-Koyanagi-Harada syndrome. Infectious aetiologies include tuberculosis, toxoplasmosis, herpes simplex and herpes zoster viruses, cytomegalovirus (particularly in immunocompromised individuals), and syphilis. Trauma to the eye (traumatic iritis) and post-surgical inflammation are additional causes. Certain medications, notably bisphosphonates and some antibiotics, have been implicated in drug-induced uveitis. In approximately 30-40% of cases, no specific cause is identified despite comprehensive investigation, and the condition is labelled idiopathic.
Diagnostic Tests
Slit-Lamp Biomicroscopy
The primary diagnostic tool for uveitis. Dr. Dibya Prabha uses a slit lamp to detect anterior chamber cells and flare, keratic precipitates on the corneal endothelium, posterior synechiae, and iris nodules. The grading of cells and flare according to the Standardisation of Uveitis Nomenclature (SUN) criteria guides treatment intensity. Dilated fundus examination with a 90D or 78D lens is essential to evaluate for vitritis, choroiditis, retinitis, and vasculitis.
Optical Coherence Tomography (OCT)
High-resolution OCT imaging is invaluable for detecting and monitoring uveitic macular oedema, the most common cause of vision loss in uveitis. OCT can reveal cystoid spaces, subretinal fluid, and epiretinal membrane formation. Serial OCT scans at Neurovision Clinic allow Dr. Dibya Prabha to objectively track response to treatment and titrate therapy accordingly.
Fundus Fluorescein Angiography
When posterior segment involvement is suspected, FFA reveals patterns of retinal vasculitis, macular leakage, choroidal neovascularisation, or areas of capillary non-perfusion. It is particularly useful in posterior uveitis and panuveitis to determine disease activity and guide decisions regarding systemic immunosuppression.
Treatment Approach
At Neurovision Clinic, Ranchi, Dr. Dibya Prabha designs an individualised treatment plan based on uveitis type, severity, laterality, and any identified underlying systemic disease. The goal is rapid control of inflammation, prevention of structural complications, and preservation of visual function with the least toxic regimen possible.
- Topical Corticosteroids and Cycloplegics
- First-line management for anterior uveitis. Potent corticosteroid drops such as prednisolone acetate 1% are used frequently during the initial phase and tapered gradually. Cycloplegic agents like homatropine or cyclopentolate relieve pain from ciliary spasm and prevent posterior synechiae by keeping the pupil mobile.
- Periocular and Intravitreal Corticosteroids
- For intermediate and posterior uveitis, or when topical therapy is insufficient, periocular triamcinolone acetonide injections or intravitreal dexamethasone implants (like Ozurdex) deliver sustained-release corticosteroids directly to the posterior segment. Dr. Dibya Prabha performs these office-based procedures under aseptic conditions at Neurovision Clinic.
- Systemic Immunomodulatory Therapy
- Systemic corticosteroids (oral prednisolone) are indicated for bilateral, severe, or sight-threatening uveitis. When long-term control is needed, steroid-sparing agents such as methotrexate, mycophenolate mofetil, or azathioprine are introduced to minimise steroid-related adverse effects. Biologic agents (e.g., adalimumab) are reserved for refractory cases after appropriate infection screening.
- Management of Complications
- Dr. Dibya Prabha actively monitors for and manages complications including secondary glaucoma (managed with ocular hypotensives or filtering surgery), cataract (phacoemulsification once inflammation is quiescent for at least three months), band keratopathy, hypotony, and cystoid macular oedema. Regular follow-up allows early detection and intervention before irreversible damage occurs.
When to See a Doctor
- !You experience sudden eye redness accompanied by deep aching pain and light sensitivity that does not resolve within a few hours.
- !You notice new floaters, flashes of light, or a shadow in your peripheral vision in either eye.
- !You have been diagnosed with an autoimmune condition such as ankylosing spondylitis, sarcoidosis, or juvenile arthritis and require baseline eye screening.
- !Your vision becomes blurred or hazy and does not improve with blinking or artificial tears.
- !You are already under treatment for uveitis but experience a recurrence of symptoms, suggesting a flare-up that may require re-evaluation.
- !You have a history of eye trauma or recent eye surgery followed by persistent redness, pain, or visual decline.
Frequently Asked Questions
What is uveitis and how does it affect the eye?
Uveitis refers to inflammation of the uveal tract, which includes the iris, ciliary body, and choroid. Depending on the anatomical location, it is classified as anterior uveitis (iritis), intermediate uveitis, posterior uveitis, or panuveitis when all layers are involved. The inflammation can cause pain, redness, photophobia, floaters, and blurred vision. If left untreated, uveitis may lead to complications such as glaucoma, cataract, macular oedema, or permanent vision loss. Dr. Dibya Prabha at Neurovision Clinic, Ranchi, uses slit-lamp biomicroscopy, OCT, and fundus photography to accurately classify and grade uveitis before initiating treatment.
What causes uveitis and who is at risk?
Uveitis can result from autoimmune disorders such as ankylosing spondylitis, sarcoidosis, juvenile idiopathic arthritis, or Behçet's disease. Infections like tuberculosis, toxoplasmosis, herpes viruses, and syphilis are also important aetiologies in the Indian context. Trauma to the eye and certain medications can trigger uveitis as well. However, in many cases the cause remains idiopathic despite extensive systemic workup. Dr. Dibya Prabha performs a thorough clinical evaluation at Neurovision Clinic, Ranchi, and when indicated, coordinates with rheumatologists and infectious disease specialists for a multidisciplinary approach.
How is uveitis treated at Neurovision Clinic, Ranchi?
Treatment is tailored to the type, severity, and underlying cause of uveitis. First-line therapy typically includes topical corticosteroid eye drops and cycloplegic agents to control inflammation and prevent synechiae formation. Moderate to severe cases may require periocular or intravitreal corticosteroid injections, systemic oral corticosteroids, or steroid-sparing immunosuppressive agents. Dr. Dibya Prabha also manages uveitic complications such as raised intraocular pressure and macular oedema using the latest evidence-based protocols. For refractory or recurrent cases, biologic agents may be considered after appropriate screening, always with close monitoring at Neurovision Clinic.
Can uveitis cause permanent vision loss, and how can it be prevented?
Yes, untreated or recurrent uveitis can lead to irreversible vision loss through cystoid macular oedema, secondary glaucoma, band keratopathy, hypotony, or retinal detachment. The key to preventing permanent damage is early diagnosis, prompt anti-inflammatory treatment, and regular follow-up examinations. Patients with known systemic autoimmune conditions should undergo periodic eye screening even when asymptomatic. Dr. Dibya Prabha emphasises that compliance with treatment and scheduled reviews at Neurovision Clinic, Ranchi, are critical, as subclinical inflammation can persist without obvious symptoms and still cause cumulative structural damage over time.