Uveitis, Anterior, Granulomatous Follow-up
- Author: Andrew A Dahl, MD, FACS; Chief Editor: Hampton Roy, Sr, MD more...
Further Outpatient Care
Patients should be observed closely, and steroids should be tapered as the inflammation resolves. It is prudent to reexamine the patient 2-3 weeks after all medications have been tapered to ensure that no residual inflammation is present and that no recurrence is beginning.
In chronic granulomatous iritis, it may not be possible to taper corticosteroids completely, especially without corticosteroid-sparing agents. These are often continued for 2-3 years before discontinuation if there is good control, and often they need to be used much longer. Some diseases are chronic and require very long-term treatment. When stopping immunomodulatory agents, it may take several months before disease recurs, so long-term vigilance is needed.
Consultations with other subspecialists should be arranged, if warranted by the patient's history and laboratory workup. Consultation with a uveitis subspecialist should be considered in unusual or difficult cases, cases not responding or progressing despite appropriate maximal therapy, or cases at risk for significant visual loss.
Recurrent episodes of iritis and subsequent therapy may lead to cataract formation and to the development of glaucoma (or secondary to medication use). Long-term hypotony due to ciliary body dysfunction (atrophy or detachment) is particularly ominous.
Most patients will more than likely have a recurrence of their inflammatory process.
The overall visual prognosis for patients with recurrent iritis is good in the absence of cataracts, glaucoma, or posterior uveitis.
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