Diagnosis and Initial Treatment of Uveitis by Non-Ophthalmologists

Goals:
Describe the main signs and symptoms, as well as the initial treatment of a patient with a diagnosis of uveitis with the purpose of avoiding delay in remission and the beginning of the timely management of this pathology.
Methods:
A systematic review of the literature was performed in which the main signs and symptoms that should be taken into account to suspect the diagnosis of uveitis and its indicated treatment were identified. A search was carried out in PubMed during the period of 2010-2015, 439 articles were chosen, which were subjected to two manual filtering processes, choosing by a group of researchers the abstracts that answered our research question. Subsequently, a group of expert ophthalmologists and physicians experienced in ophthalmology conducted a second review.
Results:
After the first filtering process, 73 articles were obtained and submitted to a second selection process where 30 articles were obtained. From the final selection of articles: six were observational studies or clinical trials; the remaining articles were reviews of the literature. The observational studies and randomized clinical trials were evaluated with the GRADE tool being the majority of high evidence. A review of the thirty selected articles was made by our researchers, resulting in recommendations for the diagnosis and treatment of uveitis for non-ophthalmologist medical personnel.
Conclusions:
There is a set of signs and symptoms that can make the doctor, not an ophthalmologist, suspect the diagnosis of uveitis. In the presence of a patient with ocular pain associated with decreased visual acuity, photophobia, red eye without conjunctival secretion, pupillary miosis, retrocheratic deposits and fundus findings such as vitritis or chorioretinitis, a uveitis should be suspected. The early management of anterior non-infectious uveitis can be established by the non-ophthalmologist doctor with topical corticosteroids, however, in case of intermediate and posterior uveitis it is important to refer to the ophthalmologist as soon as possible. We propose an algorithm to help the diagnosis of uveitis and recommendations for its initial management.

Como se trata de una revisión sistemática de la literatura, no requiere la aprobación del comité de ética.