CAUSES OF UVEITIS IN THE GENERAL-PRACTICE OF OPHTHALMOLOGY

PURPOSE: Most uveitis case series have come from tertiary care centers , and the relative frequencies of disorders they report may reflect re ferral bias. We sought information about the types of uveitis encounte red in the general practice of ophthalmology. METHODS: We prospectivel y examined 213 con secutive cases of general uveitis, defined as intra ocular inflammation other than cytomegalovirus retinopathy, seen by a group of community-based comprehensive ophthalmologists. This group of cases was compared with 213 consecutive cases of general uveitis exam ined by a uveitis specialist at a university referral center in the sa me community. All cases were categorized by anatomic site of inflammat ion and disease course, and, if possible, they were assigned a specifi c diagnosis. Cases of cytomegalovirus retinopathy and masquerade syndr ome seen during the same intervals were recorded separately. RESULTS: The distribution of general uveitis cases by anatomic site of disease was significantly different between the community-based practices (ant erior, 90.6%; intermediate, 1.4%; posterior, 4.7%; panuveitis, 1.4%) a nd the university referral practice (anterior, 60.6%; intermediate, 12 .2%; posterior, 14.6%; panuveitis, 9.4 %; P < .00005). A cause or clin ical syndrome could be assigned to 47.4% of cases in the community-bas ed practices, and to 57.8% of cases in the university referral practic e (P = .03). HLA-B27-associated anterior uveitis, cytomegalovirus reti nopathy, and toxoplasmic retinochoroiditis were among the five most co mmon forms of uveitis in both practice settings. CONCLUSION: The relat ive frequencies with which various forms of uveitis are seen in a tert iary referral center do not necessarily reflect the experience of opht halmologists from the community in which the center is located. Anteri or uveitis and disorders of sudden onset constitute a greater proporti on of cases seen by community based comprehensive ophthalmologists.