After beginning treatment, re-evaluate the patient every one to seven days depending on the severity of the reaction. Generally, it is better to taper slowly rather than abruptly, and patients may need to remain on steroid drops daily or every other day for several weeks. In recalcitrant uveitis which is unresponsive to conventional therapy, consider injectible steroids such as methylprednisolone 60mg or even oral steroids such as prednisone 60 to 80mg. In most instances, these cases resolve without incident and do not recur when properly managed. Consider any cases of recurrent uveitis, defined as three or more unexplained incidents, to be representative of underlying systemic inflammatory disease until proven otherwise.
Hematologic testing is indicated for any recurrent, chronic or bilateral presentation.
A chest X-ray is also important in identifying both sarcoidosis and tuberculosis. A Lyme titer is also recommended if you suspect that the patient may have been bitten by a deer tick. Always perform a comprehensive, dilated fundus evaluation in these cases.