Uveitis in Sub-Saharan Africa is mostly idiopathic likewise globally but could be
linked to infections like toxoplasmosis and sometimes due tuberculosis or HIV/AIDS leading to significant ocular inflammation and potential vision loss. Limited access to specialized eye care and diagnostic facilities in remote settings result in delayed diagnosis and treatment. Addressing this issue requires public health initiatives and improved access to healthcare services to manage and mitigate the impact of uveitis in the region.

Symptoms of Uveitis

1. Eye Redness: Persistent redness due to inflammation.
2. Eye Pain: Often described as aching or sharp.
3. Blurred Vision: Reduced clarity due to inflammation and possible involvement of the retina.
4. Light Sensitivity (Photophobia): Discomfort or pain when exposed to light.
5. Floaters: Dark spots or shapes that drift across the field of vision.
These symptoms require prompt attention to prevent complications and preserve vision.

Clinical findings of Uveitis

Elevated intraocular pressure. Anterior segment inflammation with cells and flare,
granulomatous features such as mutton-fat keratin precipitates, hypopyon in severe
cases, and synechiae formation leading to irregular pupil shape. Posterior segment
involvement like retinal infiltrates and vasculitis. Thorough evaluation and
management are essential to address underlying causes and prevent complications.

Differential diagnoses

Differential diagnoses of uveitis in Sub-Saharan Africa include infectious causes like
tuberculosis, HIV/AIDS, toxoplasmosis, syphilis, and leprosy. Non-infectious
systemic diseases such as sarcoidosis, Behçet's disease, and juvenile idiopathic
arthritis can also cause uveitis. Other ocular conditions like Fuchs' heterochromic
iridocyclitis and lens-induced uveitis, as well as autoimmune conditions like
ankylosing spondylitis and reactive arthritis, are also considered. Comprehensive
clinical evaluation and laboratory investigations are essential for accurate diagnosis
and tailored treatment.

Investigating uveitis in Sub-Saharan Africa

Involves a detailed slit-lamp examination, measuring intraocular pressure, and
conducting laboratory tests for infectious causes like tuberculosis, HIV, syphilis, and
toxoplasmosis. Imaging studies such as fundus photography and OCT are used to
assess retinal and choroidal involvement. A chest X-ray helps screen for sarcoidosis
or tuberculosis, and PCR testing of ocular fluids may identify specific infectious
agents. These investigations guide diagnosis and treatment in resource-limited
settings.

Treatment of uveitis in Sub-Saharan Africa

This involves using anti-inflammatory medications such as corticosteroids, both topically and systemically, tailored to the severity and cause of inflammation. Antimicrobial therapy is crucial for infectious causes, including tuberculosis, syphilis, and HIV-related infections. Cycloplegic agents help manage pain and prevent complications like synechiae. Managing secondary conditions such as glaucoma and cataracts is also important. Patient education and regular follow-up ensure adherence to treatment and monitor disease progression. These efforts aim to control inflammation, address underlying causes, and preserve vision despite resource limitations.
Follow-up of uveitis in low-income countries involves regular monitoring to assess inflammation, intraocular pressure, and visual acuity. Treatment adjustments are made as needed based on disease activity, with a focus on managing complications such as glaucoma and cataracts. Patient education on medication adherence and recognizing symptoms of worsening uveitis is crucial, supported by efforts to ensure access to care through community outreach and integration with primary healthcare services. These strategies aim to maintain vision and improve outcomes despite resource constraints.

Prevention and control of uveitis

In Sub-Saharan Africa, prevention and control of uveitis focus on raising awareness through health education, promoting immunization against infectious diseases, screening and treating systemic conditions like tuberculosis and HIV/AIDS promptly, improving access to healthcare services including eye care, and promoting environmental and occupational safety measures. These efforts aim to reduce the incidence of uveitis, prevent complications, and preserve vision, thereby improving overall eye health outcomes in the region.

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