The medical approach to diagnosing these problems includes several levels:
1. The specialist examines the patient and defines the extent and severity of the eye problem.
2. An attempt is then made to find a cause and look for other health problems which may underlie the eye problem.
3. A decision whether treatment is required, and what treatment to use.
Typically, patients with ocular inflammation undergo a clinical assessment (describing their symptoms and answering relevant medical history questions). This is followed by examination of the eyes and, when relevant, a general medical physical examination. In many, but not all cases, further workup is required including laboratory and imaging tests. The need for such tests is determined by the specialist based on his/her clinical impression.
After conducting a medical assessment and laboratory workup, the specialist may arrive at one of the following conclusions:
1. The condition is limited to the eye and is the result of a specific, treatable problem (for instance, an infection with toxoplasma or a herpes virus)
2. The condition is limited to the eye and is the result of an immune disorder of an unknown cause (for instance, vasculitis of the retina)
3. The condition is part of a systemic problem (involving other organs than the eye), and is the result of a specific, treatable problem (for instance an infection with tuberculosis or the herpes virus)
4. The condition is part of a systemic immune disorder of unknown cause (for instance sarcoidosis, ankylosing spondylitis, Behcet’s disease). While many of these conditions have specific medical names, there is no clear understanding why they occur, and they are treated using similar general principles and similar drugs. However, given their potential effect on other organs, there is often a need for a team of doctors to be involved, most commonly an ophthalmologist and a rheumatologist.
Practically speaking, in many patients who have inflammatory eye diseases such as uveitis or scleritis no cause is found for the problem. In others, the disease is characteristic and has a medical name (for instance, sarcoidosis) and may involve other parts of the body, but there is no understanding why it occurred and what caused it.