Arrange emergency/same-day ophthalmology assessment for suspected uveitis; diagnosis requires slit-lamp examination and dilated fundus examination, and delay in appropriate treatment can result in permanent visual loss NICE CKS.
Escalate immediately if there is significant reduction in vision, severe pain, or suspected significantly raised intraocular pressure NICE CKS.
Do not initiate corticosteroid treatment for presumed infectious uveitis in primary care without ophthalmology direction. Infective causes should be excluded before starting uveitis therapy with intraocular corticosteroid treatment SmPC ILUVIEN.
Review corticosteroid-related cautions before any steroid is considered: corticosteroids should be used cautiously in people with previous ocular viral infection, such as herpes simplex, and should not be used in active ocular herpes simplex infection SmPC Ozurdex.
Check the current medicines and relevant ocular history, including anticoagulants or antiplatelets, as ocular steroid treatment may raise intraocular pressure and the Ozurdex SmPC advises caution with concomitant anticoagulant or antiplatelet medicines SmPC Ozurdex.
Provide the ophthalmology team with a focused handover, including visual symptoms, pain severity, examination findings, relevant systemic history, and current medicines; a detailed history and review of systems are particularly important because definitive ocular examination is usually unavailable in primary care NICE CKS.