Diagnostic tests are needed to recognize anterior uveitis and exclude other diseases. These tests include: Complete medical history and physical examination. Because anterior uveitis is commonly linked to a systemic disease, attention should be directed to the whole body, not just the eyes. The history that you give to your veterinarian can be helpful in determining exposure to infectious disease.
A complete examination of the eye. Your veterinarian or veterinary ophthalmologist will use various tools such as a direct and indirect ophthalmoscope, a tonometer, and a slit lamp. Among other things, an exam can determine if the inflammation affects one or both eyes; if the anterior and/or posterior segment of each eye is affected; if the lens is normal; and if there are any signs specific to the various causes, like pigment spattering in the eye of a golden retriever with pigmentary uveitis.
General blood tests to evaluate the red and white blood cells, platelets and general organ function like kidneys, pancreas and liver. These are basic tests to determine if the problem is confined to the eye or if it is affecting the rest of the body as well.
Specific blood tests directed toward finding an underlying cause. Blood tests can evaluate the immune system and specific organ function and can diagnose many infectious diseases.
Blood pressure measurement to determine if there is hypertension
Blood culture for bacteria if a widespread infection is suspected
Ultrasound of the eye. If an eye is so inflamed that an examination is difficult, an ultrasound of the eye can help locate a tumor or perhaps a lens that has either become a cataract or has fallen out of place in the eye.
An X-ray of the chest when the cause of uveitis can be traced to a tumors or fungal diseases
Ultrasound and X-rays of the rest of the body to identify and localize tumors that may be present in other organs of the body.
Treatments for anterior uveitis may include one or more of the following:
Symptomatic therapy, regardless of the cause. Symptomatic therapy includes general supportive care of a sick animal such as fluids, nutritional support, antibiotics and pain relief. Examples of symptomatic therapy for the eye may include:
Topical Medications (drops and ointments for the eye) Anti-inflammation medication. Steroids: prednisolone, dexamethasone, betamethasone. Non-steroidal drugs: flurbiprofen, diclofenac, suprofen.
Cycloplegic drugs such as atropine stabilize the blood vessels and dilate the pupil. This can provide comfort by paralyzing muscles of the iris, since they spasm when there is inflammation.
Oral and Injectable Medications Anti-inflammatory medicine including corticosteroids (prednisone, dexamethasone) and nonsteroidal drugs like carprofen and aspirin. Oral corticosteroids are not used when infectious diseases are present. They are used primarily to treat immune-mediated disease.
Specific therapy is only used when there is a definitive diagnosis or high suspicion of a specific cause. Some examples:
Itraconazole is used for fungal diseases.
Doxycycline is used for tick-transmitted diseases, including Lyme disease.
Other antibiotics for certain other infections such as leptospirosis and toxoplasmosis.
Immune suppressants (prednisone, azathioprine) are used for immune-mediated diseases.
Insulin is administered to diabetic animals.
Surgical intervention is most common for tumors in the eye or when complications such as glaucoma cannot be controlled with medications. Frequently in these cases, the eye is surgically removed (enucleation). If a cataract or wound to the lens is responsible for the uveitis, then the entire lens may need to be removed.
Proper medication administration is essential. Pets with anterior uveitis may need frequent medicating (such as drops to the eyes four times daily) and this can be difficult with our busy schedules. Speak to your veterinarian or veterinary ophthalmologist to work out a good plan.
Since pets can't vocalize their problems, noticing even mild behavioral changes can be a sign that there is systemic disease and not just eye disease. Pets that aren't feeling well may stop eating or drinking, may hide under furniture, may not want to go outside or let you pet them around the head, may be depressed, and may sleep more than usual.
Become comfortable looking at your pet's eyes. Inflammation inside of the eye can change rapidly and lead to secondary disease like glaucoma, so it is important to be able to recognize and to describe to your veterinarian or veterinary ophthalmologist what has changed. Frequent rechecks are generally necessary to determine a cause, adjust medications and monitor progression of the disease.
See your veterinarian as soon as possible if you notice a change in the eye, such as the eye becoming red, or your dog squinting or holding the eye closed, rubbing or pawing at the eye. Scratching at the eye may induce more self-trauma. An Elizabethan collar may be recommended.