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Controversies between how to handle uveitis and glaucoma. The point of view of the uveitis specialist
Author(s) -
Kestelyn P.
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2016.0139
Subject(s) - uveitis , medicine , glaucoma , trabeculectomy , ophthalmology , sympathetic ophthalmia , intraocular pressure , intermediate uveitis , secondary glaucoma , ciliary body , glaucoma surgery , dermatology , anterior uveitis
Summary Uveitic glaucoma is often associated with high pressures and may damage the optic nerve faster than other forms of glaucoma. Therefore, early diagnosis and adequate treatment are essential. The key to successful treatment is an understanding of the pathogenetic mechanisms (secondary open‐angle, secondary angle closure, forward rotation of the ciliary body, etc.) Moreover, one should realize that combined mechanisms are more common in uveitic glaucoma than in other forms of glaucoma. Steroid‐induced pressure rise is common in uveitis patients and should be dealt with in a proper way: do not cut on steroids, but treat the glaucoma agressively. In those patients who have chronic uveitis and are steroid responders, surgery is a better option than medical treatment. Tubes are preferred over trabeculectomy with mitomycin in eyes with chronic inflammation. Contrary to some recommendations, prostaglandins should not be avoided in uveitis patients for fear of cystoid mcular oedema. They should be avoided however in uveitis of herpetic origin.