So your patient has uveitis: what’s next?
Finding the cause requires a little detective work, particularly in terms of knowing which labs to order based on the patient’s history and your examination and systems review. In first-time cases of unilateral, mild uveitis, eyecare practitioners typically do not order labs.
When ordering labs, focus on the etiology you believe is behind your patient’s problem based on a thorough case history of ocular and systemic symptoms as well as your clinical exam findings.
Here’s a quick guide to follow on what labs to order next time you have a patient with uveitis.
How to use this uveitis lab cheat sheet
This guide contains labs and indications for both anterior and posterior uveitis; however, since the indications for anterior uveitis may hold true for posterior uveitis, those should also be considered when ordering labs for posterior uveitis patients.
As always, it’s crucial to use your own clinical judgment and knowledge of your patient’s history and your exam findings when ordering labs and moving forward with treatment and management!
|Complete blood count (CBC) with differential||Infection, anemia, leukemia|
|Erythrocyte sedimentation rate (ESR)||Nonspecific marker of inflammation (can be used to monitor treatment response)|
|C-reactive protein (CRP)||Nonspecific marker of inflammation (can be used to monitor treatment response)|
|Rheumatoid Factor (RF)||Rheumatoid arthritis and Sjogren’s syndrome, Juvenile Idiopathic Arthritis (JIA): iritis in children under the age of 16|
|Anti-nuclear antibody (ANA)||Many systemic autoimmune conditions, such as systemic lupus erythematosus (other labs include anti-SM, anti-dsDNA, anti-SSa/anti-SSb, anti-RNP and anticardiolipin (ACA) for more extensive lupus workup); scleroderma, JIA, psoriasis, and irritable bowel syndrome|
|HLA-B27||Seronegative Spondyloarthropathies: Ankylosing spondylitis, Reactive arthritis, Psoriatic arthritis, Inflammatory bowel disease|
|Chest x-ray||Sarcoidosis (chest x-ray is a better screening test than lab tests), Tuberculosis|
|PPD skin test or Quantiferon Gold serum test||Latent tuberculosis (note: patients have to return in 48-72 hours to interpret the PPD skin test)|
|Urinalysis||Tubulointerstitial nephritis and uveitis (TINU) (rare cause of pediatric bilateral uveitis)|
For ordering labs in cases of posterior uveitis, download the cheat sheet!
While we make every effort to provide accurate information that is helpful to your eyecare practice, this information may contain errors and is not to be used in place of your own professional medical judgment. Under no circumstances shall the author or CovalentCareers be responsible for damages arising from use of this information.