Before calling uveitis non-infectious and starting systemic steroids or immunosuppression, exclude the infections that mimic it. In India, tuberculosis and syphilis are the priorities, along with toxoplasmosis and viral retinitis where the picture fits.
Test for syphilis serology and screen for latent or active tuberculosis with an interferon-gamma release assay or tuberculin test and a chest radiograph. Treating infectious uveitis with immunosuppression alone can cost the eye.
- Check syphilis serology in every new uveitis.
- Screen for tuberculosis before systemic immunosuppression.
- Consider toxoplasmosis and viral retinitis in posterior disease.
- Reassess for infection if uveitis worsens on steroids.
Why it matters
Infectious uveitis treated as autoimmune can progress rapidly to irreversible sight loss.
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