[PDF] Current Approach in the Diagnosis and Management of Uveitic Glaucoma | Semantic Scholar (2024)

FAQs

How to treat uveitic glaucoma? ›

Treatment consists of corticosteroids and antiglaucoma medications during episodes. Juvenile rheumatoid arthritis (JRA) is the most common known cause of childhood uveitis and a frequent cause of uveitic glaucoma. Glaucoma is reported to occur in up to 44 percent of patients with JRA with long-term follow-up.

Miotics: Miotics should not be used in uveitic glaucoma due to their potential to induce formation of posterior synechiae, aggravate the symptoms of inflammation caused by ciliary spasm, and worsen inflammation by disrupting the BAB.

Glaucoma is treated by lowering intraocular pressure. Treatment options include prescription eye drops, oral medicines, laser treatment, surgery or a combination of approaches.

Successful treatment of uveitis relies on accurate diagnosis and prompt efficient therapy. History taking, physical and ocular examinations, systemic evaluations, and response to treatment provide crucial information to differentiate possible etiologies involved in the pathophysiology of intraocular inflammation.

The surgical procedure of choice is a glaucoma drainage implant if there is active inflammation. Studies have shown that all 3 common types of valves (Ahmed, Baerveldt, and Molteno) are effective in lowering intraocular pressure and reducing the number of glaucoma medications.

Conclusions: These results suggest cannabinoids may have a potential role in treating uveitis. Its ability to suppress cytokine release reduces the trigger for ERK activation which may play a critical role in protecting the retina from inflammation and apoptosis due to LPS damage.

“Steroids are the main medicine that can raise eye pressure for patients with open-angle glaucoma,” Dr. McKinney says. Taking steroid drugs in any form – orally, topically, through an inhaler or IV – can worsen glaucoma for these patients. Steroids applied closest to the eye carry the highest risk.

The timeline over which the IOP will rise depends on the potency of the glucocorticoid, the dose, as well as the route of administration. With topical steroid use, the IOP rise most commonly occurs between three to six weeks from initial use, and typically normalizes within two weeks of the cessation of therapy.

Intraocular inflammation: Latanoprost may worsen intraocular inflammation (uveitis) and should be avoided in the actively inflamed eye. Reactivation of herpetic keratitis: This may occur with latanoprost, and patients with active herpetic keratitis should avoid latanoprost.

A warm, cozy mug of green tea (or a glass of iced, if you'd like) might be helpful for easing some of that eye pressure for an hour or two after sipping, found one small study published in the International Journal of Ophthalmology.

What is the best vitamin to take for glaucoma? ›

Supplements that include Vitamins B1, B12, C, A, E, thiamine, magnesium and mirtogenol may be the most effective in fighting glaucoma. Herbal supplements that may have a positive effect on glaucoma include ginkgo biloba, bilberry and forskolin.

Drinking a quart of water in less than five minutes has been shown to increase intraocular pressure; instead, advise your patients to drink small amounts of water often to stay hydrated.

Interleukin-6 inhibitors are a new frontier for treating noninfectious uveitis. “IL-6 antibodies, like tocilizumab, are relatively new,” Dr. Arepalli continues. “I've had really nice success in certain patients, particularly those with posterior uveitis and uveitic macular edema.

Your doctor may first prescribe eye drops with an anti-inflammatory medication, such as a corticosteroid. Eye drops are usually not enough to treat inflammation beyond the front of the eye, so a corticosteroid injection in or around the eye or corticosteroid tablets (taken by mouth) may be necessary.

Uveitis can be caused by a misguided attack from the body's own immune system. It can also result from infections or tumors, bruises to the eye, or toxins. Noninfectious uveitis is often first treated with oral corticosteroids like prednisone to control inflammation.

Your doctor may first prescribe eye drops with an anti-inflammatory medication, such as a corticosteroid. Eye drops are usually not enough to treat inflammation beyond the front of the eye, so a corticosteroid injection in or around the eye or corticosteroid tablets (taken by mouth) may be necessary.

Topical corticosteroids and cycloplegia are the mainstays of treatment. Raised IOP is usually self-limiting in these cases, and topical ocular antihypertensives are generally sufficient to control raised IOP in most cases.

Uveitis can cause permanent damage to the eyes and vision loss that cannot be reversed. Also, uveitis may be caused by another disease or condition that, if left untreated, can lead to serious illness.