This article discusses uveitis caused by ankylosing spondylitis, including its symptoms, why it occurs, how it is treated, and how to prevent it.
Types of Uveitis
The eye has three layers, the middle of which is called the uvea. The uvea contains many blood vessels and is made up of the iris, the ciliary body, and the choroid. Uveitis is a condition that occurs when the uvea is inflamed.
There are four types of uveitis that affect different parts of the uvea. They are:
Anterior uveitis is the most common type and affects the iris, or colored part of the eye. Intermediate uveitis occurs when the ciliary body and fluid in the middle of the eye are inflamed. The ciliary body helps the lens of your eye focus. Posterior uveitis affects the choroid and retina in the back of the eye. Panuveitis occurs when all the parts of the uvea are inflamed.
Anterior uveitis is the most common type of eye inflammation that occurs with ankylosing spondylitis.
Why AS Is a Risk Factor for Uveitis
Ankylosing spondylitis is an autoimmune condition causing inflammation throughout the body. The body’s immune system attacks healthy tissues—including the uvea—because it mistakenly believes it is harmful. Uveitis is a common clinical sign of many types of inflammatory disease.
The exact reason why uveitis occurs with AS is not clear, but researchers have found that people with both conditions often have a specific mutation of the HLA-B27 gene. However, not all people with AS and uveitis have this genetic marker.
Symptoms of Uveitis
Uveitis can affect one or both eyes. Symptoms include:
Floaters (dark shapes or squiggly lines that “float” in your vision) Eye redness Pain in the eyes Blurry vision Sensitivity to light
Complications from uveitis can also occur, especially if left untreated. These include:
High pressure in the eyes Cataracts Glaucoma Eye atrophy Permanent blindness
Treatment for Uveitis
Medications used to treat ankylosing spondylitis can help reduce inflammation throughout the body, including the eyes. These include:
Corticosteroid eye drops: These medications interrupt gene pathways to control inflammation. In some cases, steroid medications may be injected into the eye. Your eye doctor will determine the best steroid drop for you. Increased pressure can be a side effect of both steroids and uveitis, so it is important to follow up with your eye doctor if you feel any change in eye pressure. Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs): These medications help reduce pain and inflammation early in the disease process. Examples include Aleve (naproxen), Advil (ibuprofen), and Bayer (aspirin). TNF (tumor necrosis factor) blockers: These drugs target a protein called tumor necrosis factor that causes inflammation in the body. There are several different TNF blockers, but Humira (adalimumab) or Remicade (infliximab) are often tried first. IL-17: This is another type of biologic drug that might be prescribed if TNF blockers are ineffective. These medications target an inflammatory protein called interleukin-17. Examples of IL-17 drugs include Cosentyx (secukinumab) and Taltz (ixekizumab).
Summary
Uveitis affects around one-third of people who have ankylosing spondylitis—an inflammatory condition that primarily affects the spine. Uveitis causes eye redness, pain, blurry vision, floaters, and, if left untreated, can lead to permanent blindness. Treatment includes medications that reduce inflammation throughout the body and steroid drops or injections to the affected eye.
A Word From Verywell
If you’re living with ankylosing spondylitis, it’s important to recognize if inflammation spreads to other parts of your body, including your eyes. Even if you don’t have symptoms of uveitis, consider seeing a healthcare provider to establish a baseline and schedule regular follow-up appointments to monitor for early signs of this condition. Being proactive can prevent serious side effects down the road, including blindness.
