What are the methods for screening for uveitis (inflammation of the uvea)?

From the Guidelines

Screening for uveitis should be performed by an ophthalmologist and tailored to the patient's risk factors, symptoms, and any known underlying conditions, with a comprehensive eye examination including visual acuity testing, slit-lamp examination, tonometry, and dilated fundus examination, as recommended by the 2019 American College of Rheumatology/American Academy of Pediatrics guideline 1.

Key Components of Uveitis Screening

• Visual acuity testing to assess vision loss
• Slit-lamp examination to visualize inflammatory cells and flare in the anterior chamber
• Tonometry to measure intraocular pressure
• Dilated fundus examination to assess retinal and choroidal structures

Additional Tests

• Optical coherence tomography (OCT) to assess retinal and choroidal structures
• Fluorescein angiography to evaluate blood vessel leakage
• Indocyanine green angiography for choroidal inflammation
• Laboratory tests to identify underlying systemic conditions, including complete blood count, erythrocyte sedimentation rate, C-reactive protein, HLA-B27 testing, syphilis serology, tuberculosis testing, and chest X-ray

Screening Frequency

• Regular eye examinations every 6-12 months are recommended for patients with known systemic diseases associated with uveitis, even without symptoms 1
• The screening approach should be tailored to the patient's risk factors, symptoms, and any known underlying conditions, as outlined in the 2019 American College of Rheumatology/American Academy of Pediatrics guideline 1

Importance of Early Detection

• Untreated uveitis can lead to complications including cataracts, glaucoma, macular edema, and vision loss
• Early detection is crucial to prevent these complications and improve visual outcomes, as emphasized in the 2019 American College of Rheumatology/American Academy of Pediatrics guideline 1

From the Research

Screening for Uveitis

To screen for uveitis, several methods can be employed, including:

• Visual acuity testing 2, 3, 4
• Pupil examination 2
• External examination 2
• Extra ocular movements examination 2
• Visual fields examination 2, 4
• Color vision testing 2
• Slit-lamp examination 2, 5, 6, 3, 4
• Dilated fundus examination 2, 5, 6, 3, 4
• Optical coherence tomography (OCT) 5, 3
• Fluorescein angiography 5, 6, 3
• Laboratory testing 5
• Intraocular pressure measurement 2
• Computed tomography (CT) scan 2
• Ultrasound studies of the eye and orbit 2

Diagnostic Approaches

The diagnostic approach for uveitis may involve:

• A comprehensive eye examination, including a thorough medical history and visual acuity testing 2, 3, 4
• The use of specialized imaging modalities, such as OCT and fluorescein angiography, to assess the extent of inflammation and damage to the eye 5, 3
• Laboratory testing to rule out underlying systemic diseases or infections that may be contributing to the uveitis 5
• A dilated fundus examination to evaluate the posterior segment of the eye for signs of inflammation or damage 2, 5, 6, 3, 4

Screening Schemes

Screening schemes for eye disease, including uveitis, may involve:

• A questionnaire-based algorithm to identify patients at high risk of eye disease 4
• A combination of visual acuity testing, slit-lamp examination, and dilated fundus examination to detect eye disease 4
• The use of tonometry and visual field testing to screen for glaucoma 4