In an article published in 2001 on the Ocular Immunology and Uveitis Foundation website, Dr. C. Stephen Foster notes that 5 percent of patients who develop ulcerative colitis will develop recurrent uveitis--an inflammation of the layer of tissue under the retina. Other parts of the eye may develop inflammation as well. According to the ASCRS Textbook of Colon and Rectal Surgery published in 2007, iritis, episcleritis and uveitis occur in 2 to 8 percent of ulcerative colitis or Crohn's disease patients. However, it appears that the bouts of inflammation in the bowel typically do not coincide with the bouts of inflammation in the eye.
Episcleritis
Episcleritis is an inflammation of the thin covering of the sclera. This presents with irritation, redness and tearing. Episcleritis is generally not vision threatening and often will resolve on its own. The eye doctor may treat the condition with a topical steroid medication or artificial tears if the eye is uncomfortable.
Iritis
Iritis is an inflammation involving the anterior chamber of the eye--the space between the colored iris and the clear cornea. Patients with iritis have sensitivity to light, pain, red eye and decreased visual acuity. Complications of iritis include cataract, glaucoma and a spread of the inflammation to other parts of the eye; these complications can lead to vision loss and sometimes blindness. Iritis can be treated with topical or oral corticosteroids; in patients with systemic inflammatory diseases such as ulcerative colitis, immunosuppressant medications may be used.
Uveitis
Another type of inflammation associated with ulcerative colitis is uveitis. Uveitis is an inflammation of the layer of blood vessels that lies underneath the retina in the back of the eye. Red eye, pain, decreased vision and sensitivity to light are symptoms of uveitis; inflammatory process is similar to that seen in iritis with the main different being the location of the process. As with iritis, there is a significant risk of serious eye complications; glaucoma, loss of vision, cataract development and retina disease can all occur with uveitis. The use of corticosteroid eye drops may be an effective treatment for this condition. However, since the inflammation is located in the rear of the eye, corticosteroids may be given by mouth or by injection into the eye. Immunosuppressant medications are also prescribed in some cases. Some patients require a vitrectomy surgery to diagnose and manage the condition.
References
- MayoClinic.com: Uveitis
- Handbook of Ocular Disease Management: Episleritis
- AAPOS: Iritis
- Ocular Immunology and Uveitis Foundation: Association of Ocular Inflammatory Disease with Inflammatory Bowel Disease
- "The ASCRS textbook of colon and rectal surgery"; Bruce G. Wolff, James W. Fleshman, David E. Beck; 2007.
