When should I consider referring a patient with uveitis to an ophthalmologist for further evaluation?

Refer a patient with uveitis to an ophthalmologist promptly if they present with any signs of active inflammation, visual acuity changes, or complications such as suspected optic nerve involvement or macular abnormalities. Uveitis can cause sight-threatening complications that require specialist assessment and management Yang et al. 2018.

Specifically, urgent referral is warranted if the patient reports a decline in visual function or acuity, or if clinical examination suggests posterior segment involvement, such as macular edema or optic nerve damage. These features necessitate detailed ophthalmic evaluation including imaging and tailored treatment (Yang et al., 2018; NICE NG82).

Additionally, referral should be considered when initial management in primary care is insufficient to control inflammation or when diagnostic uncertainty exists. Ophthalmologists have the specialist qualifications and experience to perform detailed ocular assessments, including slit lamp biomicroscopy and indirect ophthalmoscopy, essential for diagnosis and management planning (NICE NG81).

In summary, any patient with uveitis who has active inflammation, visual symptoms, or suspected complications should be referred to an ophthalmologist for further evaluation and management to prevent irreversible sight loss. Early specialist involvement improves outcomes and guides appropriate treatment (Yang et al., 2018; NICE NG81, NICE NG82).