How Should You Treat Chronic Anterior Uveitis?

This external photograph of the right eye shows keratic precipitates on the corneal endothelium, corneal edema and hemorrhagic hypopyon in the setting of acute herpetic anterior uveitis.

Review our article: "Uveitis: A Brief Primer for the Rheumatologist," The Rheumatologist, November 2020.

Uveitis is an umbrella term for intraocular inflammatory diseases that can lead to vision loss. It occurs in 6–9% of patients with psoriatic arthritis and 25% of patients with reactive arthritis. The prevalence may be as high as 33% in patients with ankylosing spondylitis.

If chronic anterior uveitis cannot be controlled with three or fewer drops a day of prednisolone acetate 1%, the next step would be:

A. Systemic treatment with corticosteroids and methotrexate

B. Systemic treatment with corticosteroids and concurrent adalimumab

C. TNF inhibitor monotherapy

D. Systemic corticosteroids only