Uveitis Care in Jacksonville, Florida
Uveitis is inflammation inside the eye. It can start suddenly, it can be nearly painless, and it can damage vision before you notice anything is wrong. It is also treatable. The sooner treatment starts, the more vision there is to protect.
We treat all forms of uveitis at South Atlantic Retina. Dr. Elkeeb is board certified in both Ophthalmology and Internal Medicine — a combination that matters more in uveitis than in almost any other eye condition, because the eye is often where a body-wide disease shows itself first.
What uveitis is
The uvea is the middle layer of the eye — the iris at the front, the ciliary body behind it, and the choroid, the blood-vessel layer that nourishes the retina. Uveitis is inflammation in that layer and the structures around it.
Eye doctors classify uveitis by where the inflammation is centered, because that determines the symptoms, the workup, and the treatment:
- Anterior uveitis — inflammation in the front chamber of the eye, involving the iris and ciliary body. Often called iritis. The most common form.
- Intermediate uveitis — inflammation centered in the vitreous, the clear gel filling the middle of the eye.
- Posterior uveitis — inflammation of the retina and choroid at the back of the eye.
- Panuveitis — inflammation involving the front, middle, and back together.
This is the international standard used by uveitis specialists, set out by the Standardization of Uveitis Nomenclature (SUN) Working Group.
Symptoms to take seriously
- Redness of the eye
- Eye pain, or a deep ache behind the eye
- Sensitivity to light
- Blurred or dimmed vision
- New floaters — specks or strands drifting across your vision
Symptoms often begin suddenly. They can also be mild or absent, particularly in intermediate and posterior uveitis, where inflammation sits behind the part of the eye you can see in a mirror. Children with juvenile idiopathic arthritis can have active, damaging uveitis with no symptoms at all, which is why they need scheduled screening exams even when their eyes feel fine.
If you have any of these symptoms, see an ophthalmologist right away. Uveitis is not a condition to watch and wait on.
Why it is worth treating early
Uveitis accounts for an estimated 10 to 15 percent of blindness in the United States, according to the American Academy of Ophthalmology. Most of that vision loss is not from the inflammation itself but from its consequences — and the single most common one is macular edema, swelling in the macula, the small central part of the retina you read and recognize faces with.
Inflammation left to run can also cause cataract, glaucoma, scarring, and retinal detachment. Each episode can leave a little less vision behind than the one before. That cumulative damage is what treatment is trying to prevent.
Uveitis is often a whole-body question
Roughly a third to a half of uveitis cases have no identifiable underlying cause. About a third are linked to a systemic condition, and a smaller share are infectious.
The systemic associations seen most often include HLA-B27-associated spondyloarthritis, sarcoidosis, Behçet disease, juvenile idiopathic arthritis, and inflammatory bowel disease. Infectious causes include herpes viruses, toxoplasmosis, syphilis, and tuberculosis. The distinction is not academic: infectious uveitis and autoimmune uveitis are treated in opposite directions, and treating one as though it were the other can make things worse.
This is where dual training earns its keep. Dr. Elkeeb completed residencies in both Internal Medicine and Ophthalmology and maintains board certification in both. He is reading your eye and your systemic picture at the same time — and for some patients, uveitis is the first clue to a diagnosis no one had made yet.
How we diagnose uveitis
Diagnosis starts with a dilated examination to find where the inflammation is and how active it is. We image the eye in our office on the same visit using:
- Optical coherence tomography (OCT) — a cross-sectional scan of the retina that shows macular swelling long before it affects vision
- OCT angiography — maps retinal blood flow without an injection
- Ultra-widefield fundus photography — a wide view of the retina to the far periphery
- Fluorescein and indocyanine green angiography — reveals leaking or inflamed blood vessels and choroidal inflammation
More about our imaging and diagnostic testing.
Laboratory testing is targeted, not a blanket panel. Testing every patient for everything produces false positives that lead to wrong diagnoses. We choose tests based on where the inflammation sits, how it looks, your history, and your symptoms elsewhere in the body.
How we treat uveitis
Treatment depends first on the cause. Infectious uveitis needs the infection treated. Non-infectious uveitis is treated by controlling the immune response, using a stepwise approach that is escalated according to how severe the inflammation is and where it sits. Not every patient starts at the first step — sight-threatening disease at the back of the eye often begins with systemic treatment straight away.
Topical therapy
Corticosteroid eye drops, often with a drop to relax the pupil and relieve pain. Effective for anterior uveitis; drops do not reach the back of the eye in useful concentrations.
Local corticosteroid injections and implants
Delivering steroid to the eye itself treats the inflammation where it is and avoids exposing the whole body to steroid. We use:
- Triamcinolone — injected around or into the eye, generally lasting weeks to a few months
- Dexamethasone implant — a dissolving implant placed in the eye that releases steroid for roughly three to six months
- Fluocinolone acetonide implant — a long-acting implant that can control inflammation for up to about three years
These are effective, and they carry real trade-offs we will discuss with you before choosing one. Steroid inside the eye raises the risk of cataract and of increased eye pressure, and the risk grows with how long the steroid is present. Patients on these treatments are monitored for both.
Systemic therapy
Oral corticosteroids work quickly and are useful for getting severe inflammation under control, but they are not a long-term answer. When uveitis is chronic, bilateral, or keeps returning as steroids are tapered, the right move is steroid-sparing immunosuppressive therapy — medication that controls the immune response without the long-term cost of steroids. Biologic therapy is available for non-infectious intermediate, posterior, and panuveitis that does not respond adequately to other treatment.
Working with your rheumatologist
Dr. Elkeeb manages some systemic immunosuppression himself and works closely with rheumatology for the rest. That relationship is deliberate. Systemic immunosuppression requires ongoing laboratory monitoring and careful attention to infection risk, and the decisions are better made by physicians who are talking to each other than by two specialists working from separate notes.
If you already have a rheumatologist, we will coordinate with them. If your uveitis turns out to be the first sign of a systemic disease, we will help you get to the right specialist.
When to seek urgent care
Call us at (904) 666-5050 without waiting for a scheduled appointment if you have:
- A sudden drop in vision
- Severe eye pain
- A sudden shower of new floaters, flashing lights, or a shadow or curtain across your vision
- Symptoms returning after your uveitis had been quiet
- New redness or pain after eye surgery or an eye injection
Questions patients ask
Is uveitis an emergency?
Treat it as one until you have been examined. New eye redness, pain, light sensitivity, or blurred vision needs to be looked at right away. Inflammation that has been evaluated and is being treated can usually be managed on a scheduled basis — but a sudden change in vision or pain always warrants a call.
Does uveitis mean I have an autoimmune disease?
Not necessarily. Roughly a third to a half of cases never have an identifiable cause. About a third are linked to a systemic condition. Part of our job is working out which group you are in, using targeted testing rather than a broad panel.
Will I need steroid drops forever?
Usually not. Many patients have a single episode that resolves with treatment. For those with chronic or recurring uveitis, the goal is to move off long-term steroids onto treatment that controls inflammation with fewer consequences.
Can uveitis come back?
Yes. Some forms are one-time events and others are chronic or relapsing. Because a recurrence can be quiet, patients with a history of uveitis are followed on a schedule rather than only when symptoms appear.
Will I lose vision?
Most people who are diagnosed and treated do well. The vision loss associated with uveitis comes overwhelmingly from inflammation that went untreated or was allowed to smoulder. We cannot promise an outcome for any individual, and any doctor who does should be treated with suspicion — but the single biggest factor in your favour is getting it treated properly and staying followed.
Getting seen
We prioritise urgent cases. If you have symptoms of uveitis, or another physician has told you that you have inflammation in the eye, call (904) 666-5050 and tell our staff it is a uveitis question. We see patients at 3627 University Blvd S, Suite 605, Jacksonville, FL 32216.
Referring physicians: our referral information is here, and we accept urgent uveitis referrals.
Sources: American Academy of Ophthalmology; National Eye Institute; Standardization of Uveitis Nomenclature (SUN) Working Group, Am J Ophthalmol 2005;140:509–16; Dick AD et al., Fundamentals of Care for Uveitis (FOCUS) Initiative, Ophthalmology 2018;125:757–73.
This page is general information about a medical condition and is not a substitute for examination and advice from your own physician.