There are many types of uveitis and treatments which might be steered by cause, if one has been found.
For a significant number of patients, clinical exams, blood tests and x-rays will not reveal a cause at the time uveitis is first diagnosed. For these patients, the treatment of their “idiopathic” uveitis may be governed by the part of the eye that is inflamed.
The majority of uveitis patients have anterior uveitis. Those patients whose condition is not chronic are often treated with eye drops alone, especially if no other disease has been found.
Patients with chronic, complicated anterior uveitis, or with intermediate, posterior or pan-uveitis may have to have oral drugs, self injected drugs or infused treatments.
The drugs taken for the sight threatening forms of uveitis sound frightening, and we all have to find our own peace about taking them, or giving them to our child. Those who are losing sight may have an easier time accepting that these immunosuppressant treatments are necessary if remaining sight is to be preserved and lost sight be recovered, but those who are still enjoying good sight, and parents who have to make decisions about their child’s treatment, often have a particularly hard time. This BMJ publication may allay some fears.
The following treatment information is arranged according to the severity of the disease, starting with eye drops and corticosteroid, moving through the immunosuppressants and ending with treatments, which may become available in the future, if current trials show effectiveness.
Not all drugs work well for all uveitic disease and it is common for patients to take combinations of drugs before their inflammation is controlled. When this disease is chronic and serious enough to require immunosuppressants, many patients will also be seen by a rheumatologist who works with the eye clinic doctors. We don’t need to have rheumatism or arthritis to acquire a rheumatologist!