Presentation: ocular pain, photophobia, and excessive tearing; VA not usually affected
Hallmark signs: "cells and flare"
Uveitis can be either acute or chronic.
Chronic is more often associated with the following systemic problems but not limited to, ankylosing spondylitis, Bechets syndrome, IBS, Reiter's syndrome, juvenille rheumatoid arthritis, sarcoidosis, syphilis, Lyme's disease and/or tuberculosis.
Tx:
-Immobilize ciliary body to decrease pain and lessen the problem-Homatropine 5% QID, Scopolamine 0.25% QID, or Atropine 1% BID.
-Stop the inflammatory response-Pred Forte 1% q15 min for the first 6 hours, then continue q1h for the rest of the day. Have the patient follow-up within 24 hrs (at the longest wait 72 hours).
-Depending on the severity of the uveitis, discontinue the cycloplegic and taper the steroid.
Clinical Pearls:
-Don't taper the steroid until the "cells and flare" are gone.
-Treat this aggressively but follow the condition closely.
That's all for today's lesson.
