Inflammatory Eye Care

Ocular inflammatory disease (OID) is a general term for inflammation affecting any part of the eye or surrounding tissue. Broadly if inflammation develops in the eye(s), or in the optic nerve, blood vessels, muscles or other tissues that surround the eye, the resulting illness is classified as an ocular inflammatory disease.

Literally inflammation means setting on fire.  Inflammation can develop in any part of the body, including the eyes and their surrounding structures.  Inflammation is a characteristic reaction of tissue to injury or disease.  Inflammation results from the body’s attempt to eliminate a foreign body or germ and helps to prevent further injury.  

Inflammation is marked by four signs: swelling, redness, heat, and pain.  

Inflammation is a complex process involving many different kinds of white blood cells:  granulocytes (neutrophils, basophils and eosoniphils) and some immune specific white blood cells called B and T lymphocytes along with their antibodies and cytokines. In all inflammatory diseases there is the migration of these specific types of white blood cells out of the bloodstream into surrounding tissues. These cells release agents (chemicals), such as cytokines, to boost immune responses and kill invading bacteria, viruses, and parasites or anything that the immune system perceives as foreign (antigen), or non-self.  Part of their response is bringing antibodies (proteins in the family of immunoglobulin) to the site; the antibodies then attach to antigens and mark them for death.  Antigens are anything that the immune system recognizes as non-self or foreign and, therefore, trigger an immune response.   The linking of the antibody to the antigen forms an immune complex. Immune complexes circulate through the blood.  Usually they are removed quickly, but occasionally they are lodged into tissues and cause inflammation. 

Normal healthy tissue can be injured by inflammation during this process (innocent bystander injury).   When this happens in or around the eyes, the affected region (the eyes, the eyelids, the sclera, the iris, the uvea, the retina, the optic nerve) becomes red, sore, and swollen. If eye inflammation is long lasting (chronic) or severe, damage to delicate tissues and blood vessels in and around the eye can occur, resulting in vision loss.  

Inflammation can affect any part of the eye or its surrounding structures. The symptoms of inflammation for the most part depend on the area in the eye of the inflammation. Most common signs and symptoms are:

• Pain 

• Redness 

• Floaters 

• Decreased vision 

• Light sensitivity 

 

Eye pain, severe light sensitivity, and any change in vision are considered emergency signs.

There are over 85 causes of OID.  They can be infectious or noninfectious, traumatic, drug-induced, or malignant. Both women and men of any race, ethnicity, or age may develop OID.

Infectious causes may be bacteria, parasites, fungus, viruses such as rubella, HIV; sexually transmitted diseases such as syphilis, Chlamydia, or gonorrhea; or rare infections, such as tuberculosis, toxoplasmosis, or Lyme disease.  

There are several causes of noninfectious OID, one of which is autoimmune disease.  In many cases, the autoimmune disease is systemic (affecting the body) and, also, produces inflammation in specific parts of the eye.  The ocular inflammatory disease will then be identified according to that part of the eye which has inflammation.   For example, juvenile rheumatoid (or idiopathic arthritis) is associated with inflammation in the anterior part of the eye, known as anterior uveitis or iritis. 

Drug or medication can also be the cause of ocular inflammatory disease.  Some drug examples are bisphosphonates, cidofovir, rifabutin, and sulfonamides or topical corticosteroids and latanoprost.  Vaccines and even skin tattoos can be inducers of OID.  Certain cancers can cause ocular inflammatory disease, such as lymphoma, lung cancer, and breast cancer.