The wall of the eye is divided into three layers, with the uvea being the middle layer, divided into the iris, ciliary body, and choroid. The iris forms the pupil, the ciliary body is the tissue that secretes atrial fluid in the eye, which maintains intraocular pressure, and the choroid provides nutrients to the retina. In addition, if we think of the eye as a camera, these three parts of the uvea together form a dark box for the camera. The inflammatory disease of the uvea is called uveitis. Uveitis is an eye disease that occurs in young adults, has a complex etiology, is classified in many different ways, is easily recurring, and is difficult for some non-specialist ophthalmologists to fully understand, making it difficult to prevent and treat. There are many types of uveitis, with up to 100 reported, and dozens of common types in China. In the United States, it is the second most treatable blinding eye disease after diabetic retinopathy. If we divide them into two categories according to the etiology, infectious and non-infectious, the former includes infections caused by bacteria, fungi, spirochetes, viruses, parasites, etc.; the latter includes idiopathic, autoimmune type, rheumatic diseases, traumatic, pseudophakic syndromes, etc. The latter includes idiopathic, autoimmune, rheumatic, traumatic, and camouflage syndromes. It can be classified according to the site of origin as iritis (inflammation involving the iris alone), iridocyclitis (inflammation involving the iris and ciliary body), posterior uveitis (chorioretinitis, uveoretinitis, optic nerve retinitis, retinal vasculitis, etc.), and total uveitis. Different sites and etiologies of uveitis are subdivided into a variety of specific disease types according to disease characteristics, such as the common variety of retinal vasculitis, Vogt Koyanagi Harada disease, Leukocoria, Fuchs syndrome, and sympathetic ophthalmia. Clinical manifestations of uveitis Because there are many types of uveitis and individual differences, the clinical manifestations are varied, even in the same patient with uveitis in different stages of the disease. For example, acute iritis or iridocyclitis manifests as ocular redness and eye pain, as well as varying degrees of visual acuity loss; Vogt Koyanagi Harada disease mainly manifests as visual acuity loss, even down to no light perception within a few days, and there may be no obvious ocular redness and eye pain, etc. If not treated with standardized treatment, later on, iridocyclitis manifestations such as ocular redness and pain may occur; common uveitis features in leukoaraiosis are recurrent anterior chamber pus accumulation Fuchs syndrome may not have any clinical manifestations and is not detected by the physician until the development of a complicating cataract. Because the choroid, the tissue in the uvea that feeds the retina, is in close proximity to the retina, inflammation of the choroid or of the retina itself can have a serious impact on vision. Vogt-Koyanagi Harada disease, for example, is the most common blinding uveitis in our country. However, with proper treatment, this disease can be effectively controlled and better vision can be preserved. Uveitis may be combined with systemic diseases The eye is an organ prone to infections and immune diseases, so many systemic infections or immune diseases are often associated with ocular pathology, and uveitis is one of them. Approximately 40% of patients with uveitis have disease in other organs of the body. Common systemic immune diseases that uveitis may reflect include ankylosing spondylitis, rheumatism, psoriasis, systemic lupus erythematosus, inflammatory bowel disease, tuberculosis and syphilis, bacterial, fungal and viral infections including AIDS. The focus here is on ankylosing spondylitis combined with acute anterior uveitis, or iridocyclitis. The incidence of this disease is high. There are more than 5 million patients with ankylosing spondylitis in China, and the prevalence of uveitis in this type of disease is as high as 20 to 30 percent. Therefore, patients with ankylosing spondylitis should be vigilant, and patients with acute anterior uveitis should also be screened for ankylosing spondylitis. Its concomitant acute anterior uveitis is characterized by redness of the eyes, photophobia, lacrimation, easy recurrence, and alternating episodes in both eyes. Another is the juvenile form of chronic arthritis, which occurs mostly in adolescents under 16 years of age, with a higher incidence in girls than in boys, and may result in cataracts and glaucoma until blindness if treatment is delayed. Although many types of uveitis may be combined with systemic infections and immune disorders that require vigilance on the part of the physician and patient, not all patients with uveitis need to be tested for systemic infections and immune programs, which requires a reasonable initial determination of the type of uveitis by the physician at the time of the initial consultation. It is difficult to classify and diagnose uveitis. Uveitis varies greatly among individuals and it is not difficult for the average ophthalmologist to diagnose uveitis, but it is quite difficult to distinguish what type it is! Since the treatment and duration of treatment varies from type to type, doctors strive to diagnose the cause and type of uveitis before treating it so that treatment can be targeted. Given the complexity of this type of disease and the fact that some manifestations are not fully revealed at the onset of the disease or for a significant period of time during the course of the disease, the diagnosis requires the physician to take a detailed history and select appropriate ancillary tests and laboratory tests based on the history and examination in order to make the diagnosis as clear as possible. Treatment of uveitis requires good cooperation between the physician and the patient There are many different causes of uveitis, and each type has different clinical manifestations, progression patterns, and medications used for treatment and duration, so the physician needs to develop an individualized treatment plan that is appropriate for the patient. There are many types of uveitis that require long-term treatment, some for more than 2-3 years. Patients need to understand the complexity, difficulty, and long-term nature of treating this disease and have enough patience and confidence to actively cooperate with their doctors in order to obtain better results. Sometimes because the patient may already suffer from cataracts and other diseases affecting vision, in this case surgery is needed only after the inflammation is effectively controlled. This process of inflammation control may take a very long time, but during the treatment process, the patient’s vision may not improve due to the presence of cataracts, so many patients lose their confidence in the treatment and feel that the doctor cannot cure him. Therefore, it is important for the patient and the doctor to communicate and understand fully during the treatment process. Many cases of uveitis require hormonal and immunosuppressive therapy, and these drugs often have many or very serious side effects or toxicity. Many types of uveitis usually require treatment with hormones and immunosuppressants. In the West, about a quarter of patients with uveitis require hormonal and immunosuppressive systemic therapy, and even then, 35% of patients are visually disabled. In addition, no matter how skilled and experienced the physician is, and how optimized and individualized the treatment regimen is, some side effects are still inevitable during the course of treatment. The common side effects of immunosuppressants include liver and kidney function damage, elevated blood sugar, hypertension, infertility, neurological and psychiatric abnormalities, nausea, vomiting, and fatigue, etc. Therefore, regular liver and kidney function and related tests are required during treatment to minimize and avoid the side effects of the drugs. It is also important to remind patients that some patients use hormonal eye drops at home because they know they have uveitis, and once their eyes become uncomfortable, they use hormonal eye drops at home. Since long-term hormonal eye drops can accelerate the process of cataract and glaucoma diseases, it is important not to use hormonal eye drops as daily medication, and whenever you feel uncomfortable or have signs of recurrence, you should go to the hospital for follow-up. Uveitis is a very difficult disease to treat and the prognosis varies greatly from one type to another. There are many different types of uveitis, and treatment and outcomes vary greatly. For example, one type of uveitis is called Fuchs syndrome. This type of uveitis is usually only mildly inflamed and does not require treatment, and even if treated, it is unlikely to eliminate the inflammation. Short-term use of hormonal eye drops is required only when the inflammation has progressed beyond moderate levels. This disease is characterized by a tendency to develop complicating cataracts, glaucoma and vitreous opacities. Cataract surgery or vitrectomy can be performed to restore vision in the presence of cataracts and severe vitreous opacities without waiting for the inflammation to fully resolve. This is also the most misdiagnosed type of uveitis in the clinic. We have many patients with this type of disease who have been seeking medical help for years and have been treated with hormonal medications, but have been told by doctors that it is difficult to cure them, and even when cataracts appear, they are told that cataract surgery cannot be performed because of the presence of inflammation. In fact, it is precisely these hormonal eye drops that accelerate the process of cataract or glaucoma. There is also the Vogt Koyanagi Harada disease mentioned earlier, which is the most common blinding eye disease in China. However, it is characterized by the fact that with proper and reasonable treatment, it can be completely and effectively controlled and retain better vision. However, there are some types of uveitis, such as infectious endophthalmitis, acute retinal necrosis syndrome, intractable Behcet’s disease and many types of uveitis caused by late stage optic nerve atrophy, retinal atrophy, glaucoma and ocular atrophy, etc. There is still a lack of special treatment methods and they cannot be cured or cannot be completely cured, and some patients still inevitably become blind. As mentioned earlier, many types of uveitis require long-term use of hormones and immunosuppressants, which can bring more side effects to the whole body, making it difficult for many patients to adhere to treatment, resulting in prolonged disease, and some types are difficult to control even with larger amounts of medication. Currently, international breakthroughs have been made in new biological agents as well as in mesenchymal stem cell therapy. These treatments can overcome the side effects of traditional therapies.