A clinical approach to the medical treatment of uveitis

Uveitis is divided into five clinical groups based on its severity and natural history. By using this classification appropriate and graded forms of therapy can be applied to individual patients with uveitis. In Group 1 patients (anterior uveitis syndrome) topical cortisone drops or ointment will control the disease. Group 2 (posterior uveitis) patients require local steroids (topical, subconjunctival or retrobulbar) and systemic steroids. Appropriate specific therapies are indicated if a causal organism can be identified. Patients in Groups 3 (cyclitis), Group 4 (uveitis in children) and Group 5 (severe intractable uveitis) are exposed to a high risk of cystic macula degeneration and must be treated with local and systemic cortisone and cytotoxic drugs if the steroid fails to control the inflammation or if cortisone has to be used excessively high dosage. The recommended regime of treatment is summarised in the diagram in figure 7.