Uveitis and Uvulitis Management

Airway and Eye Inflammation Management

• Airway assessment is critical, and any signs of respiratory compromise require immediate intervention and possible intubation, according to the American College of Rheumatology 1
• Antihistamines and H2 blockers should be added for allergic/angioedema presentations, as recommended by the American College of Rheumatology 1
• For anterior uveitis, topical corticosteroids (prednisolone acetate 1% or dexamethasone) are first-line treatment, starting with frequent dosing (every 1-2 hours while awake) then tapering based on response, as suggested by the European League Against Rheumatism 3 4
• The goal is to reduce topical steroid use to ≤2 drops daily to minimize cataract risk (0% cataract incidence at ≤2 drops/day), according to the European League Against Rheumatism 3 4
• If requiring >2 drops daily for >2-3 months, add systemic immunosuppression rather than continuing high-dose topical steroids, as recommended by the American College of Rheumatology 1 2
• Systemic steroids are NOT preferred in children due to growth suppression and osteopenia risks, but may be used short-term for severe cases, as suggested by the European League Against Rheumatism 3 4 5
• Add systemic immunosuppression (methotrexate or TNF inhibitors) if requiring >1-2 drops/day topical prednisolone acetate 1% for ≥3 months, as recommended by the American College of Rheumatology 1 2
• Prolonged high-dose topical steroids (>3 drops/day) dramatically increases cataract risk, according to the European League Against Rheumatism 3 4