Uveitis for the non-ophthalmologist

• Published in: BMJ (Online) Vol. 372; p. m4979
• Main Authors: Burkholder, Bryn M, Jabs, Douglas A
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 03.02.2021
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - adverse effects; Adrenal Cortex Hormones - therapeutic use; Arthritis; Chicken pox; Corticosteroids; Cytomegalovirus; Diagnostic Techniques, Ophthalmological; Edema; Endothelium; Glaucoma; Herpes viruses; Humans; Immunosuppression; Immunosuppressive agents; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Infections; Inflammation; Iris; Lyme disease; Medical imaging; Ophthalmology - methods; Optic nerve; Patients; Prednisone; Retina; Sarcoidosis; Syphilis; Systemic diseases; Tuberculosis; Uveitis; Uveitis - classification; Uveitis - diagnosis; Uveitis - drug therapy; Uveitis - physiopathology; Visual impairment
• ISSN: 1756-1833; 1756-1833
• DOI: 10.1136/bmj.m4979

AbstractThe uveitides are a heterogeneous group of diseases characterized by inflammation inside the eye. The uveitides are classified as infectious or non-infectious. The non-infectious uveitides, which are presumed to be immune mediated, can be further divided into those that are associated with a known systemic disease and those that are eye limited,—ie, not associated with a systemic disease. The ophthalmologist identifies the specific uveitic entity by medical history, clinical examination, and ocular imaging, as well as supplemental laboratory testing, if indicated. Treatment of the infectious uveitides is tailored to the particular infectious organism and may include regional and/or systemic medication. First line treatment for non-infectious uveitides is corticosteroids that can be administered topically, as regional injections or surgical implants, or systemically. Systemic immunosuppressive therapy is used in patients with severe disease who cannot tolerate corticosteroids, require chronic corticosteroids at >7.5 mg/day prednisone, or in whom the disease is known to respond better to immunosuppression. Management of many of these diseases is optimized by coordination between the ophthalmologist and rheumatologist or internist.