eMedicine Specialties > Ophthalmology > Metabolic Disorders

Gout: Follow-up

Author: Andrew A Dahl, MD, Director of Ophthalmology Teaching, Mid-Hudson Family Practice Institute, The Institute for Family Health; Assistant Professor of Surgery (Ophthalmology), New York College of Medicine
Contributor Information and Disclosures

Updated: Feb 19, 2009

Follow-up

Further Outpatient Care

  • Monitor uric acid levels.

Deterrence/Prevention

  • Reduction of purine intake in the diet can moderate both the frequency and the severity of attacks of gout.

Complications

  • Complications include distal joint pain and kidney stones.

Prognosis

  • The prognosis is favorable with diet and medication control of uric acid.

Patient Education

  • Inform the patient of the importance of both diet control and medication.
  • For excellent patient education resources, visit eMedicine's Arthritis Center. Also, see eMedicine's patient education article Gout.

Miscellaneous

Medicolegal Pitfalls

  • Patients with atypical band keratopathy should be questioned regarding symptoms of gouty arthritis or nephrolithiasis.
 


More on Gout

Overview: Gout
Differential Diagnoses & Workup: Gout
Treatment & Medication: Gout
Follow-up: Gout
References
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References

  1. Bernad B, Narvaez J, Diaz-Torne C, et al. Clinical image: corneal tophus deposition in gout. Arthritis Rheum. Mar 2006;54(3):1025. [Medline].

  2. Choi HK, Atkinson K, Karlson EW, et al. Alcohol intake and risk of incident gout in men: a prospective study. Lancet. Apr 17 2004;363(9417):1277-81. [Medline].

  3. Choi HK, Curhan G. Gout: epidemiology and lifestyle choices. Curr Opin Rheumatol. May 2005;17(3):341-5. [Medline].

  4. Coassin M, Piovanetti O, Stark WJ, et al. Urate deposition in the iris and anterior chamber. Ophthalmology. Mar 2006;113(3):462-5. [Medline].

  5. Fishman RS, Sunderman FW. Band keratopathy in gout. Arch Ophthalmol. Mar 1966;75(3):367-9. [Medline].

  6. Fuchs E. Gout. Graefes Arch Ophth. 1895;21:229.

  7. Kim KY, Ralph Schumacher H, Hunsche E, et al. A literature review of the epidemiology and treatment of acute gout. Clin Ther. Jun 2003;25(6):1593-617. [Medline].

  8. Klein R, Klein BE, Tomany SC, et al. Association of emphysema, gout, and inflammatory markers with long-term incidence of age-related maculopathy. Arch Ophthalmol. May 2003;121(5):674-8. [Medline].

  9. Knapp CM, Constantinescu CS, Tan JH, et al. Serum uric acid levels in optic neuritis. Mult Scler. Jun 2004;10(3):278-80. [Medline].

  10. Margo CE. Use of standard hematoxylin-eosin to stain gouty tophus specimens. Arch Ophthalmol. Apr 2004;122(4):665. [Medline].

  11. Mcwilliams JR. Ocular findings in gout; report of a case of conjunctival tophi. Am J Ophthalmol. Dec 1952;35(12):1778-83. [Medline].

  12. Morris WR, Fleming JC. Gouty tophus at the lateral canthus. Arch Ophthalmol. Aug 2003;121(8):1195-7. [Medline].

  13. Slansky HH, Kubara T. Intranuclear urate crystals in corneal epithelium. Arch Ophthalmol. Sep 1968;80(3):338-44. [Medline].

  14. Wyngaarden JB. Gout. In: The Metabolic Basis of Inherited Disease. 1966:667-728.

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Further Reading

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Keywords

gout, uric acid, urate crystals, ocular tissue, kidneys, kidney stones, urinary collecting system, joint inflammation, joint destruction, tophus, tophi, alcohol, uric acid salts, uric acid metabolism, uric acid nephropathy, chronic tophaceous gout, tophaceous gout, gouty arthritis, primary gout, secondary gout, acute gout, chronic gout, polyarticular gout, hyperuricemia, acute monoarticular arthritis, polyarticular arthritis

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Contributor Information and Disclosures

Author

Andrew A Dahl, MD, Director of Ophthalmology Teaching, Mid-Hudson Family Practice Institute, The Institute for Family Health; Assistant Professor of Surgery (Ophthalmology), New York College of Medicine
Andrew A Dahl, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Richard W Allinson, MD, Associate Professor, Department of Surgery, Texas A&M University Health Science Center; Senior Staff Ophthalmologist, Scott and White Clinic
Richard W Allinson, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

R Christopher Walton, MD, Professor, Director of Uveitis and Ocular Inflammatory Disease Service, Department of Ophthalmology, Assistant Dean for Graduate Medical Education, University of Tennessee College of Medicine; Consulting Staff, Regional Medical Center, Memphis Veterans Affairs Medical Center, St Jude Children's Research Hospital
R Christopher Walton, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Healthcare Executives, American Uveitis Society, Association for Research in Vision and Ophthalmology, and Retina Society
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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