Anterior Uveitis Not Controlled by Topical Corticosteroid Drops — What to Do Next

Clinical scenario

This protocol applies when anterior uveitis has not responded adequately to first-line topical therapy. Persistent anterior chamber inflammation despite initial treatment calls for a more targeted approach to drug delivery.

Previous treatment & failure condition

First-line management uses topical corticosteroid eye drops — selected according to the severity of the anterior chamber reaction — alongside a cycloplegic/mydriatic agent. This protocol is indicated when that regimen fails to achieve the required treatment goals: improvement in visual acuity, a meaningful reduction in anterior chamber cells, and absence of anterior chamber flare.

Next-step treatment (partial summary)

The approach at this stage uses a periocular injection route — placing a corticosteroid directly at the periocular site to sustain a high drug concentration where it is most needed. The complete agent selection and protocol are available via the link below.

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References

DOI: 10.4103/0301-4738.58468

Periocular injection is indicated where maximum concentration of the drug is required for a longer time with minimal side-effects.

The drugs which can be considered for periocular injections are dexamethasone or triamcinolone acetonide.

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