Uveitis Eye Condition and Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) not only affects the digestive tract but is also associated with conditions in several other parts of the body. The eyes seem like an unlikely place to be affected, but in fact, there are several eye conditions that are more prevalent in people who have IBD. Uveitis is an uncommon eye condition associated with IBD. If untreated, it can lead to loss of vision.

People with IBD not only need regular care from a gastroenterologist, but regular care from an eye doctor is also needed. Uveitis and other eye conditions associated with IBD aren't common but it is important that they get diagnosed and treated right away if they do develop. People with IBD who have sudden eye pain or other symptoms in the eye should see an eye doctor right away and then call their gastroenterologist.

Uveitis is an inflammation in the middle layer of the eye—the uvea. The uvea contains the iris (the colored part of the eye), ciliary body (tissue that surrounds the eye lens), and choroid (the blood vessels and tissue between the white of the eye and the retina). Uveitis can be a chronic condition. Types of uveitis include:

• Anterior: Inflammation is located in the iris
• Diffuse: Inflammation throughout the uvea
• Intermediate: Inflammation is in the ciliary body
• Posterior: Inflammation of the choroid

Symptoms

When associated with IBD, the onset of uveitis may be insidious, and uveitis could even be present before the IBD is diagnosed. Symptoms of uveitis are different depending on the type:

• Anterior: Sensitivity to light, pain, red-eye, and some loss of vision
• Diffuse: Sensitivity to light, pain, red eye, some loss of vision, blurred vision, and floaters
• Intermediate: Often painless, blurred vision, floaters
• Posterior: Often painless, blurred vision, floaters

Causes

Uveitis is associated with several inflammatory diseases including rheumatoid arthritis, sarcoidosis, lupus, and IBD. Uveitis can also be caused by a bacteria or fungi; injury to the eye; or exposure to certain toxic chemicals. In some cases, no clear cause can be found for the development of uveitis. There may also be a genetic component to uveitis, as a particular gene called HLA-B27 has been found to be associated with as many as half of the cases of uveitis in people who also have IBD.

Prevalence

Somewhere between .5 and 9 percent of people who have IBD will also develop uveitis. Uveitis is 4 times more common in women than men, and approximately 75 percent of those who develop uveitis also have a form of arthritis. Both eyes are commonly affected and the condition tends to be chronic.

Treatments

Noninfectious uveitis is an inflammation of the eye, and treatment often includes a steroid to reduce that inflammation. The form of steroid (eye drop, pill, or injection) will depend upon the type of uveitis. Uveitis in the front of the eye (anterior) might be treated with steroid eye drops. Other eye drops may also be given to treat pain. Posterior uveitis might not be treatable with eye drops, and a steroid in pill or injection form is often used. Steroids in pill form have a variety of associated side effects and are typically only given in cases that are chronic or are resistant to other treatments.

A newer treatment for chronic uveitis involves inserting an implant behind the eye which dispenses corticosteroids continuously over a period of 2 1/2 years. This treatment may cause cataracts or glaucoma.

In cases where an inflammatory condition such as IBD or arthritis is also present, treating the underlying condition is also recommended.

The Bottom Line

Your eyes are important, and it's known that IBD can have an effect on them. Seeing your eye doctor on a regular basis is very important. Don't forget to make your healthcare provider aware of your Crohn's disease or ulcerative colitis. People with IBD will need to take care to stay on top of eye health. Anything unusual with your eyes or your eyesight should be reported to your practitioners as soon as possible. In this way, you can stay on top of your IBD and your eyesight with the goal of treating any problems quickly before they turn into major problems.