Link: Uveitis

Don’t be afraid to knock it out from the get-go—or it may get back up to fight another round.

If synechiae have developed, the best approach, according to Dr. Rittenbach, is what she calls the blasting technique. “I soak a Weck-Cel sponge in a mixture of 1% atropine and 10% phenylephrine. After giving a drop of proparacaine to the eye, I place the sponge in the inferior fornix, where it remains for about 10 to 15 minutes with the eye closed,” says Dr. Rittenbach. She says that she may see some of the synechiae break that day, but more often will see the greatest results the following day. “Don’t be afraid to prescribe the atropine and 10% phenylephrine for advanced cases, BID to QID; but, you should probably have these drops on hand, as most pharmacies don’t carry them.”

Dr. Dexter's Take

Patients presenting with uveitis can be challenging to handle. Determining which steroid to use and how often to dose it, when to taper the steroid, what to do if the inflammation is not responding to your initial treatment, and when to order lab testing can vary greatly from patient to patient. One important thing that I have learned throughout the years is to not be afraid to hit the patient hard with a strong steroid and frequent dosing. This article reviews some key clinical pearls when it comes to treating stubborn uveitis. 

Read the full article from Review of Optometry

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