Uveitis: role of the physician in treating systemic causes

For older patients with uveitis, defined as any inflammation of ocular structures--including the uvea--there are four typical etiologies: infection, "masquerade syndromes," systemic disease, and idiopathic. Uveitis is associated with a systemic cause in about 40% of cases. It manifests in a number of ways, but common symptoms include sudden onset of pain, redness, and sensitivity to light, chronic floaters, or a gradual decrease in vision. Diagnosis is aimed at finding an underlying cause. Depending on the symptoms, useful diagnostic tests include syphilis serology, chest x-ray, Lyme antibody titer, PPD skin test, and skin test for anergy. Treatment, including the use of corticosteroids or antibiotics, is based on the underlying etiology.