If you’ve read my About page you know I have a daughter with uveitis.  That’s why I first became interested in Cannabidiol (CBD).  Since then I’ve learned about so many ways CBD can promote better health and that’s why this blog was started.

So, can CBD help treat uveitis?  Uveitis is a serious eye condition that causes inflammation in the eye which leads to reduced vision and possible blindness if untreated.  CBD exhibits anti-inflammatory properties and may be useful in the battle against uveitis.  CBD has shown promise for treating uveitis in animal studies.

Unfortunately, as with so many conditions, CBD related research is very preliminary.  But there is great reason for hope.  The currently available treatments for uveitis are corticosteroids and immunosuppression medications.  Neither is a great option, so if CBD proves to be useful it will be a welcome alternative for many individuals who struggle with uveitis.

In some of the sections of this post I’ll include a paragraph or two about our experience with my daughter’s uveitis.  She’s had probably 50 doctor appointments since she was 7 years old and we’ve learned a lot through the process.  Maybe the information will be useful to some people.

What is uveitis

Uveitis is a disease that causes inflammation in the middle region of the eye.  This region is called the uvea and it encompasses the choroid, iris, and ciliary body.  Inflammation can be present in any, or all, of these areas of the uvea.  And uveitis is classified differently based on where it’s located:

• Cyclitis: uveitis located in the ciliary body (my daughter has this form)
• Choroiditis/Retinitis: uveitis in the choroid/back of the eye
• Iritis: uveitis in the iris

Uveitis may affect one or both eyes.  Ashley is affected in both eyes so we had to be pretty aggressive with her treatment.

How is uveitis diagnosed

It all starts with an eye exam.  At the ophthalmologist office you will be asked to provide a thorough health history.  They will dilate your pupils and do a thorough exam of your eyes.  This involves several specialized pieces of equipment.  It should be pretty painless.  There was one procedure that my daughter didn’t like.  It involved pushing on her eyeball through her lower eyelid.  But it was only momentary pain and as soon as the test was done the pain left immediately.

Our experience with diagnosis – Thinking that our daughter just needed glasses, we went to a local optometrist to get her checked out.  When she couldn’t even see the big “E” on the vision chart he dilated her pupils to take a look at her eyes.  He had no idea what he was looking at so he referred us to an ophthalmologist.  If you think you may have uveitis, don’t waste your time with an optometrist.  Just make an appointment with an ophthalmologist.  They are qualified to provide an accurate diagnosis.

What conditions lead to uveitis

In about half of uveitis cases, including my daughter, the cause of the uveitis isn’t clear.  This is referred to as “idiopathic”, which is a fancy word meaning they can’t figure out what’s causing it.  In the other half of cases, uveitis is related to some sort of trauma to the eye, an infection, or an autoimmune disease.  Here’s a short list of some conditions known to cause uveitis (there are more):

• Rheumatoid arthritis
• Ulcerative colitis
• Cat scratch disease
• Psoriasis
• Kawasaki disease
• Syphilis
• Ankylosing spondylitis
• West Nile virus
• Tuberculosis

It may seem ridiculous to consider all of these options but it really is important to rule them all out.  Treatment may not be effective if the underlying cause isn’t determined conclusively and dealt with properly.

Our experience – When Ashley first started seeing her doctors they tested her blood for all sorts of crazy diseases including all the ones listed above plus more.  When none of those turned up to be the cause they looked into possible autoimmune diseases such as juvenile rheumatoid arthritis (JRA.)  She didn’t really test positive for any of these either, although one of the tests was inconclusive.

She does see a rheumatologist twice a year.  He monitors her while she’s on Humira, a medication that’s commonly used to treat rheumatoid arthritis.  He says she has JRA but her uveitis doctor says it’s idiopathic.  The treatment is the same regardless if she has JRA or not.

What actually causes inflammation in the eye

Regardless of what disease is connected to the uveitis, there is an underlying process in the eye that actually leads to the inflammation.  That process involves the uncontrolled activity of a family of molecules called Cytokines.  Cytokines are released by immune cells as needed to fight infection and disease.  This process can take place within your eyes and throughout your body.

In some individuals there is an overactivity of these cytokines in the eye, or the proper functioning of these molecules becomes unregulated.  This leads to inflammation being produced when it isn’t needed.  There’s a lot more to this, but in a nutshell, this is what’s going on when you have uveitis.

Why there’s hope that CBD may help

I’m optimistic that CBD may be helpful because it is known to reduce inflammation in other parts of the body.  CBD is able to reduce inflammation due to the fact that it reduces the ability of immune cells to release cytokines.  CBD interacts with receptors on the surface of immune cells called CB2 receptors.  CB2 receptors are located all over the body which is why CBD can have such a broad influence on overall health.  And the presence of CB2 receptors on immune cells is what makes me optimistic about the use of CBD for uveitis.

There have been some studies done that suggest CBD may be helpful in treating uveitis.  One study involved two groups of rats.  One group was a control group while the other group was given doses of CBD for a few days.  Then both groups of rats were injected with a chemical that’s known to cause uveitis.  24 hours later the rats were checked for cytokine activity in the eyes.  The rats who had received CBD prior to injection had less cytokine activity in their eyes than the control group.

There honestly aren’t a lot of published studies regarding the use of CBD specifically for uveitis.  More are being worked on currently.  But there are quite a few studies that look at how CBD helps reduce inflammation.  There’s no doubt that CBD can help reduce inflammation throughout the body including the eyes.

What traditional treatments are currently available

The cause of the uveitis is going to determine the course of treatment.  If a particular infection can be identified as causing the uveitis, the treatment will certainly focus on curing that.  Antibiotics or anti-viral medications will likely be prescribed, but the inflammation in the eyes will also need to be dealt with.

The most likely initial treatment for uveitis is corticosteroids.  These may be administered orally or as an injection into the eyeball.  While steroids aren’t fun to take and aren’t a good long-term solution, they work pretty fast to stop and reduce the inflammation.

After the steroids, you may be prescribed a drug called methotrexate.  This is a chemotherapy drug that can be hard to tolerate for some people.  Another class of drugs for treating uveitis is immunosuppressive medications.  The goal of these drugs is to basically turn down the immune system a little bit in order to stop the production of inflammation.  Humira is an example of an effective immunosuppressive medications

Our experience – Our daughter’s vision improved pretty quickly once she started the steroids.  But she suffered from several side effects of the steroids.  She had trouble sleeping, started putting on water weight, and she seemed to get pretty moody which was unusual for her.  We were grateful that the steroids were so effective, but glad to move on to something else once things were getting under control.

The next drug we tried was methotrexate.  Ashley took a pill sometime before the weekends.  She would then be sick the entire weekend and would head back to school on Monday.  We hated this drug and didn’t really feel like it was doing much.  At this point the inflammation was already down quite a ways from the steroids.  It felt like methotrexate did nothing except keep it from getting worse again.  It didn’t seem to be helping improve the inflammation at all.  We told the doctors that we wanted her off this drug real quick.

The next medication Ashley was prescribed was Humira.  This is given through a shot in her leg once every two weeks.  Ashley doesn’t like the pain of the shot.  It kind of burns as it goes in.  But she has had no side effects that we’ve noticed from Humira.  She doesn’t feel nauseated, achy, tired, or anything.  And it has proven to be really effective at treating the uveitis.  It is expensive so make sure you have good insurance!

How long does treatment last

Length of treatment is going to vary based on the cause of the uveitis.  Treatment may be relatively short if the inflammation is caused by an infection.  If it’s caused by trauma or an autoimmune disease then the treatment could go on for years.  You’ll likely get to know your doctor quite well.  Don’t be surprised if they try and take you off your medications and the uveitis returns.

Our experience – After about four years of treatment and Ashley’s eyes not producing any more inflammation, her doctor decided it was time to stop treatment and see if her eyes would be OK.  She was slowly weaned off the Humira.

Unfortunately, the inflammation came back pretty quickly.  Within a few months she was noticing floaters coming back into her vision.  So we went back on the Humira and she got a steroid shot in one of her eyes.  Not what we had hoped, but it’s been several years since then and we’ll probably try it again soon.  Her uveitis doctor thinks someday it will just go away and not cause any more problems.

How will we proceed

For now, we’re going to follow the doctor’s orders and stay on the Humira that she’s been taking for several years.  She tolerates it well and it works for her.  However, we’re going to talk with her rheumatologist about starting her on a dose of CBD every day.  Our hope is that it may help with her leg aches she tends to get regularly.  Hopefully it will provide some relief from that.

In addition, the next time her doctor tries to wean her off of Humira, a daily dose of CBD may help keep the uveitis from coming back.  If she had a raging case of uveitis I wouldn’t have much hope of the CBD helping get it under control.  But now that it’s under control, perhaps the CBD will be effective enough to keep it in check.

We won’t waste much time though.  If she starts seeing spots again we’ll get her right back to the doctor.  Uveitis is a serious condition.  You absolutely should receive professional medical attention if it is a problem you think you have.  Your vision is not something to mess around with.

Related questions

Can uveitis be cured?  When uveitis is caused by trauma or an infection it can be treated and cured.  If the uveitis is caused by an autoimmune disease such as rheumatoid arthritis, medication can be used only to treat the symptoms, not to cure the condition.

Is uveitis serious? Uveitis is a serious condition that effects the eyes.  If left untreated it may lead to permanent blindness.  If you suspect you may have uveitis, or you have any of the symptoms, you should make an appointment with your opthamologist as soon as possible.

How to find a uveitis doctor?  If you think you may have uveitis, make an appointment with an opthamologist in your area.  Depending on your condition, once your local opthamologist has evaluated you, he or she may be able to treat your condition themselves or they may refer you to a specialist with more experience in treating uveitis.