IOP Spike in Uveitis: What It Is and How to Handle It

If you have uveitis, you’ve probably heard doctors mention “IOP spike.” That’s short for an unexpected rise in intraocular pressure, the fluid pressure inside your eye. A sudden jump can damage the optic nerve and threaten vision, so knowing the signs and steps to take is crucial.

What Triggers an IOP Spike?

Uveitis itself inflames the uveal tract, but a few specific factors often push eye pressure up:

Inflammatory cells and debris clog the trabecular meshwork, the eye’s drainage system.
Corticosteroid use – eye drops, oral pills, or injections that calm inflammation can also raise pressure, especially in steroid‑responsive people.
Poorly controlled disease – when uveitis flares repeatedly, scar tissue can form and block fluid outflow.
Secondary angle‑closure – swelling of the iris can narrow the angle where fluid exits, causing a bottleneck.

Typical symptoms include blurry vision, eye pain, halos around lights, and a noticeable headache. Some people feel a pressure sensation like a balloon being filled; others notice it only during a routine eye exam.

How to Treat and Prevent It

The first rule is to get checked right away. An eye doctor measures IOP with a tonometer and looks for signs of inflammation. Treatment usually follows a two‑pronged approach:

Control the inflammation – topical steroids, non‑steroidal anti‑inflammatory drops, or systemic meds are used based on severity. If steroids are the cause, the doctor may switch to a steroid‑sparing agent like methotrexate or mycophenolate.
Lower the pressure – pressure‑lowering eye drops (beta‑blockers, carbonic anhydrase inhibitors, alpha agonists) are added. In acute spikes, a short course of oral acetazolamide can bring the pressure down quickly.

Long‑term prevention means keeping uveitis quiet. Regular follow‑ups, adhering to medication schedules, and reporting any flare‑up symptoms early are key. Some patients benefit from a “taper‑down” plan where steroid use is gradually reduced while a steroid‑sparing drug takes over.

Lifestyle tweaks can help too. Stay hydrated, avoid excessive caffeine, and protect your eyes from trauma. If you wear contact lenses, make sure they’re not irritating the eye, as that can worsen inflammation.

When you should seek urgent care: a sudden increase in pain, vision loss, or seeing flashes of light. Those are red‑flag signs that pressure is rising fast and needs immediate treatment to prevent permanent damage.

Bottom line: an IOP spike during uveitis is a warning sign, not a dead‑end. With prompt diagnosis, proper medication, and close monitoring, most people keep their pressure in check and preserve their sight.