Physicians must be able to identify the underlying cause to most effectively treat the uveitis. "Getting to the bottom of it" and identifying the definite cause of uveitis is critical because the best choice of treatment is dependent on the underlying cause. The proper treatment for one cause of uveitis may differ from another.
Regardless of the form of autoimmunity, many autoimmune diseases affecting the eye will require therapy that targets the underlying disease. The components of the immune system reside not in the eye, but rather are systemic and, therefore, regulation of those components may require systemic therapy.
We have a philosophy of complete intolerance to continued uveitis recurrences or the continuance of "low grade" inflammation in the eye.
We employ a "stepladder" approach to the care of our patients with autoimmune uveitis, generally beginning with steroid drops to control inflammation before it damages the eye. As necessary, treatment may advance to steroid injections and/or pills, adding an oral, non-steroidal anti-inflammatory medication. If the patient's uveitis continues or recurs each time the steroid medications are tapered and stopped, an immunomodulatory, chemotherapeutic drug or surgery may be required.
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