Management of uveitis.

The management of uveitis continues to rely on the relatively nonspecific use of topical, periocular, and systemic steroids. A notable exception is infectious causes of uveitis, which often require specific antimicrobial agents. This is particularly true in immunosuppressed patients in whom infectious diseases such as toxoplasmosis and herpes zoster may have atypical and fulminant clinical courses necessitating early therapeutic intervention. Analysis of local antibody production in the aqueous or vitreous humor may aid in the diagnosis. Severe forms of endogenous uveitis such as Behçet's disease have often required the use of nonspecific cytotoxic agents such as chlorambucil or cyclophosphamide. Agents such as cyclosporine and FK-506 are newer immunosuppressives that may have less severe long-term systemic side effects. Chorioretinal biopsy offers an additional tool for the specific etiologic diagnosis of uveitis. The role of posterior chamber lens implantation in patients with a history of uveitis continues to evolve.