Reoccurring Uveitis

Patient presentation

• 67 year old female u/a thyroid ulcerative colitis  
• meds levothyroxine aspirin artelac hylocare Lipitor / Atorvastatin 
• Had previous uveitis episodes when living in the states  
• FH uncle glaucoma no diabetes

Reoccurent uveitis RE pain photophobia reduced vision ciliary injection iris nodules constricted pupil IOPs within normal limits 2 cells in AC.

Diagnosis and Management

• The patients presenting condition was reoccurent uveitis RE pain photophobia, reduced vision, ciliary injection iris nodules constricted pupil, IOPs within normal limits and 2 cells in AC 
• Administrated cyclopentolate 1%, referred to GP to prescribe prednisolone. GP would not prescribe as patient had not been seen in Ophthalmology in northern Ireland no previous notes on NIECR
• Phoned Altnagelvin Ophthalmology same day appointment arranged
• Patient prescribed tapered prednisolone and cyclopentolate, uveitis resolved  

Conclusion

I would have prescribed prednisolone 1% hourly and cyclopentolate 1%  tds for 7 days and reviewed patient in practice 3 days later to monitor steriod induced ocular hypertension and to make sure uveitis was resolving. Tapered prednisolone if resolving. If no improvement I would have referred to ophthalmology. Considered referral to gastroenterologist as ulcerative colitis previously noted as systemic cause.

This would have benefited the patient as it would have led to reduced anxiety, reduce travel/travel costs/ uveitis would have been managed quicker and patient would have been in less pain.