Uveitic glaucoma presents a treatment challenge because of the need to control two conditions. Furthermore, side effects of conventional treatments for uveitis—corticosteroids and systemic immunomodulatory agents—limit their use.
Fortunately, new treatments for uveitis are enabling safer and effective management of uveitic glaucoma, and others are on the horizon, said Terri Pickering, MD.
Speaking at the 23rd Annual Glaucoma Symposium during the 2019 Glaucoma 360 meeting, Dr. Pickering reviewed the etiology, diagnosis, and management of uveitic glaucoma. She is a clinical instructor, California Pacific Medical Center, San Francisco.
Dr. Pickering said there are multiple classification systems for uveitis, but it is most often categorized as infectious or non-infectious, and the latter group may be further divided according to whether it is associated with a systemic disorder.
With so many possible causes for uveitis, the work-up for a patient with intraocular in-flammation may seem daunting, but establishing the etiology is important to avoid overlooking a treatable cause for uveitis (i.e., infection) or a concurrent systemic disease that needs treatment. A targeted work-up is facilitated based on the patient’s demographics and findings from the history and physical examination.
“Identifying the cause for the uveitis can also help with counseling patients about their prognosis,” Dr. Pickering said.
She recommended, however, that all patients be tested for syphilis, which is considered “the great masquerader,” and have a chest X-ray or CT scan to look for sarcoidosis or tuberculosis.