Ophthalmic Education:

Principles and Guidelines of a Curriculum for Education of the Ophthalmic Specialist: Chapter 13. Uveitis

On this page:

• Basic Level Goals: PGY-2
  
  
• Standard Level Goals: PGY-3
  
  
• Advanced Level Goals: PGY-4

Basic Level Goals: PGY-2

A. Cognitive Skills

1. Describe basic principles of history taking and examination of patients with uveitis, and related diseases (e.g., scleritis, pemphigus).
   
   
2. List signs and symptoms of anterior and posterior uveitis (e.g., red eye, blurred vision, anterior segment cell and flare, vitreous opacities, pars planitis, retinal or choroidal infiltrates).
   
   
3. Describe the different types of uveitis (e.g., acute and chronic uveitis, granulomatous and non- granulomatous uveitis, anterior, intermediate, and posterior uveitis).
   
   
4. Describe typical features and differential diagnosis of anterior uveitis, including infectious (e.g., bacterial, viral, protozoal, parasite), inflammatory (e.g., sarcoid, HLA-B27-associated, Behcet's disease, collagen vascular disease), neoplastic (masquerade syndromes), postsurgical, post-traumatic, Fuchs' heterochromic uveitis, juvenile rheumatoid arthritis.
   
   
5. Describe typical features and differential diagnosis of the following posterior segment uveitis:
   
   
   1. Toxoplasmosis
      
      
   2. Sarcoidosis
      
      
   3. Pars planitis
      
      
   4. Acute retinal necrosis
      
      
   5. Vogt-Koyanagi-Harada syndrome
      
      
   6. Large cell lymphoma
      
      
   7. Postoperative uveitis
      
      
   8. Endophthalmitis (e.g., postoperative, traumatic, endogenous, fungal, phacoanaphylactic, sympathetic ophthalmia)
      
      
   9. Unusual infectious etiologies for uveitis (e.g., human immunodeficiency virus, herpes simplex virus, herpes zoster virus, pneumocystis carinii, Lyme disease)
      
      
   10. Acquired and congenital ocular syphilis
       
       
   11. Cytomegalovirus retinitis
       
       
   12. Multiple sclerosis

B. Technical/Surgical Skills

1. Perform an examination of the anterior and posterior segment for uveitis (e.g., slit lamp biomicroscopy, scleral depression, magnified posterior segment exam, vitreous evaluation for cells, retinal, choroidal, and pars plana evaluations).
   
   
2. Describe indications for ancillary testing in the evaluation of uveitis (e.g., fluorescein angiography, ultrasound, laboratory testing, radiologic testing).

Standard Level Goals: PGY-3

A. Cognitive Skills

1. Describe more advanced principles of history taking and examination of patients with uveitis (e.g., review of systems for Wegener's granulomatosis, polyarteritis nodosa, lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, systemic necrotizing vasculitis; evaluation of skin, cardiac, respiratory, renal, pulmonary, musculoskeletal systems).
   
   
2. List less common signs and symptoms of anterior and posterior uveitis.
   
   
3. List differentiating signs of less common forms of uveitis (e.g., iris nodules, conjunctival ulcer or granuloma).
   
   
4. Describe the differential diagnosis of less common forms of uveitis (e.g., chronic uveitis, intermediate uveitis [e.g., pars planitis], and infectious [e.g., Whipple disease, syphilis] or inflammatory posterior uveitis; masquerade syndromes, including large cell lymphoma).
   
   
5. Evaluate and treat common causes of anterior and posterior uveitis.

B. Technical/Surgical Skills

1. Perform a directed examination of the anterior and posterior segments for uveitis (e.g., slit lamp biomicroscopy, scleral depression, magnified posterior segment exam, vitreous evaluation for cells).
   
   
2. Perform ancillary testing in the evaluation of uveitis (e.g., fluorescein angiography, ultrasound, laboratory testing, radiologic testing).

Advanced Level Goals: PGY-4

A. Cognitive Skills

1. Recognize, evaluate and treat uveitis associated with immunosuppressed individuals (e.g., active and recovered acquired immune deficiency syndrome, pharmacologic immunosuppression).
   
   
2. Recognize, evaluate and treat acquired and congenital ocular syphilis.
   
   
3. Recognize, evaluate and treat (or refer) less common, rare, or tropical conditions associated with uveitis (e.g., Leishmaniasis).
   
   
4. Describe indications and contraindications for corticosteroid treatment of uveitis (e.g., topical, local, systemic), including risks and benefits of therapy.
   
   
5. Describe indications and contraindications for immunuosuppressive therapy in uveitis, use of antimetabolites, cyclosporine, alkylating agents.

B. Technical/Surgical Skills

1. Administer steroids in the treatment of uveitis by various routes.
   
   
2. Administer immunosuppressive agents in uveitis (or refer for administration).
   
   
3. Evaluate and treat the complications of uveitis therapy (e.g., cataract, glaucoma).
   
   
4. Biopsy, when indicated, the vitreous or uveal tract.
   
   
5. Insert intravitreal implants containing antiviral or corticosteroid medications.
   
   
6. Perform, when indicated, vitrectomy or scleral buckling procedures.

Next: Chapter 14. Ocular Oncology

Also see: Table of Contents of the Principles and Guidelines of a Curriculum for Education of the Ophthalmic Specialist