Intended for healthcare professionals

Clinical Review State of the Art Review

Uveitis for the non-ophthalmologist

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.m4979 (Published 03 February 2021) Cite this as: BMJ 2021;372:m4979
  1. Bryn M Burkholder, assistant professor of ophthalmology1,
  2. Douglas A Jabs, professor of ophthalmology, director12
  1. 1Wilmer Eye Institute, Department of Ophthalmology, the Johns Hopkins University School of Medicine, Baltimore, MD, USA
  2. 2Center for Clinical Trials and Evidence Synthesis, the Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
  1. Correspondence to BM Burkholder bburkho1{at}jhmi.edu

Abstract

The 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.

Footnotes

  • Series explanation: State of the Art Reviews are commissioned on the basis of their relevance to academics and specialists in the US and internationally. For this reason they are written predominantly by US authors

  • Grant support: Supported in part by grant R01 EY026593 from the National Eye Institute, the National Institutes of Health, Bethesda, MD, US.

  • Contributorship statement: Both DAJ and BMB performed the literature search, wrote the article, and participated in its revisions. DAJ is the guarantor.

  • Patient involvement: No patients were involved were directly involved in the creation of this article.

  • Competing interests The BMJ has judged that there are no disqualifying financial ties to commercial companies. The authors declare the following other interests: none.

  • Further details of The BMJ policy on financial interests are here: https://www.bmj.com/about-bmj/resources-authors/forms-policies-and-checklists/declaration-competing-interests

  • Provenance and peer review: commissioned; externally peer reviewed.

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