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There is a general tendency among ophthalmologists to treat all forms of uveitis with corticosteroids. Patients with various inflammations of the uveal tract are usually treated with steroids first and investigated later. These patients are subjected to an investigation of the cause of their uveitis only when corticosteroids have failed to control their disease. Even when the cause of their uveitis is known or strongly suspected, such patients often fail to receive appropriate antimicrobial therapy during the period that their inflammatory responses are being suppressed by corticosteroids or by other immunosuppressive agents.
The article by Nicholson and Wolchok in this issue of the Archives illustrates the folly of such treatment programs. The patient described by them was the victim of some unknown lymphoproliferative disorder. She was treated with systemically administered corticosteroids for this disorder, and, while receiving this oral corticosteroid therapy, developed widespread paravascular inflammatory lesions of both retinae. Since
O'Connor GR, Frenkel JK. Dangers of Steroid Treatment in ToxoplasmosisPeriocular Injections and Systemic Therapy. Arch Ophthalmol. 1976;94(2):213. doi:10.1001/archopht.1976.03910030093001