Vitritis is a medical condition characterized by inflammation of the vitreous humor, a gel-like substance that fills the eyeball. This inflammation affects the eye’s internal environment, potentially leading to visual disturbances. The vitreous plays a role in maintaining the eye’s shape and allowing light to reach the retina for clear vision. When inflamed, it can significantly impact a person’s ability to see clearly.
Recognizing the Signs
Individuals experiencing vitritis often notice various changes in their vision. A common symptom is the appearance of “floaters,” which are small, shadowy shapes, specks, or cobwebs that drift across the field of vision. These floaters become more noticeable against bright backgrounds, such as a clear sky or a white wall, and are caused by inflammatory cells or debris within the vitreous.
Blurred or distorted vision is also frequently reported. The inflammation within the vitreous interferes with the clear passage of light to the retina, making tasks that require sharp visual acuity, like reading or driving, more challenging. Some individuals may also experience eye pain or redness.
Understanding the Causes
Vitritis can arise from a variety of underlying factors, ranging from infections to systemic conditions. Infections are a common cause, with various agents like viruses, bacteria, fungi, and parasites capable of triggering inflammation in the vitreous. For instance, toxoplasmosis, a parasitic infection, is a frequent infectious cause, while viral infections such as herpes simplex and cytomegalovirus can also lead to vitritis.
Autoimmune diseases represent another significant category of causes. Systemic autoimmune disorders like sarcoidosis, Behçet’s disease, and lupus can induce inflammation throughout the body, including the eyes, where it can extend to the vitreous. Physical injury to the eye or surgical procedures, especially those involving the vitreous or retina, can also sometimes result in postoperative inflammation. In some instances, despite thorough investigation, the exact cause of vitritis remains undetermined; these cases are referred to as idiopathic vitritis.
Diagnosing Vitritis
Diagnosing vitritis involves a thorough examination by an eye specialist to assess the extent and nature of the inflammation. The process typically begins with a comprehensive eye examination, including an assessment of vision and pupil response to light. A slit-lamp examination is then performed, utilizing a microscope with an intense line of light to magnify and illuminate the front of the eye, allowing the ophthalmologist to identify microscopic inflammatory cells in the anterior chamber and vitreous.
An ophthalmoscopy, or funduscopy, is also conducted, where the pupil is dilated with eye drops to allow for a detailed examination of the back of the eye, including the retina. Further diagnostic tests may include Optical Coherence Tomography (OCT) to map the retina and choroid for swelling, or fluorescein angiography, which involves injecting a dye to photograph swollen blood vessels. If an underlying systemic or infectious cause is suspected, laboratory tests, blood tests, or even imaging tests like CT or MRI scans may be recommended to help identify the root of the inflammation.
Treatment Options and Why Early Intervention Matters
Treatment for vitritis is highly dependent on the underlying cause and aims to reduce inflammation, manage symptoms, and prevent complications. If an infection is identified, specific antimicrobial medications are prescribed; this may include antibiotics for bacterial infections, antivirals for viral infections like herpes simplex, or antifungals for fungal causes.
Corticosteroids are frequently used to reduce inflammation in the eye. They can be administered in various forms, such as eye drops for inflammation in the front of the eye, oral medications for more widespread inflammation, or injections directly into or around the eye for more severe cases or inflammation affecting the back of the eye. These injections, known as periocular or intravitreal injections, deliver the medication directly to the affected area. For cases linked to autoimmune diseases, medications that suppress the immune system, known as immunosuppressive agents, may be necessary. In some difficult-to-treat cases, an implantable device that slowly releases corticosteroids into the eye over months or years may be an option.
In severe instances or when complications arise, other interventions might be considered. Dilating eye drops can be prescribed to relieve eye pain and to prevent the formation of adhesions within the eye. Rarely, surgical procedures like a vitrectomy, which involves removing some of the vitreous gel, may be performed to address the condition or its complications.
Early diagnosis and timely treatment are important in managing vitritis. Delaying treatment can lead to serious and potentially irreversible complications. Untreated vitritis can result in the development of cataracts, where the eye’s natural lens becomes cloudy, or glaucoma, a condition characterized by increased pressure within the eye that can damage the optic nerve. Prompt medical attention can help preserve vision and prevent these irreversible damages.