Uveitis in adults: What do rheumatologists need to know?

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Adult uveitis diagnosis and management require rheumatologist expertise.
• No prospective study has validated a diagnostic strategy for uveitis.
• Investigations depend on clinical presentation and ocular abnormality location.

Purpose of the Study:

• To review the etiological diagnosis and therapeutic management of adult uveitis.
• To highlight the association between uveitis and various systemic conditions.
• To emphasize the importance of evaluating for spondyloarthritis in uveitis patients.

Main Methods:

• Review of existing literature and clinical guidelines.
• Analysis of potential causes of uveitis, including infections and inflammatory diseases.
• Discussion of diagnostic approaches based on clinical features and anatomical location.

Main Results:

• Infections (syphilis, Lyme, tuberculosis, Whipple's disease) and sarcoidosis are potential causes of uveitis.
• Spondyloarthritis is the leading cause of uveitis in Western countries, often diagnosed during uveitis evaluation.
• Recurrent uveitis affects 50-60% of cases; blindness risk is low.

Conclusions:

• Spondyloarthritis should be routinely evaluated in patients with back pain.
• Sulfasalazine can be used prophylactically to reduce uveitis recurrence frequency, duration, and severity.
• Comprehensive etiological diagnosis is essential for effective uveitis management.