[Uveitis: a rational diagnostic program for practice in internal medicine].

Uveitis, as an inflammation of the uvea, the vitreous body or the choroid, should not be regarded as a disease but only as a sign of an underlying multisystem disorder. The cause of iritis cannot be established by examining the eye only. Differential diagnosis should take into consideration geographic, possible environmental and genetic background factors. Furthermore, it should be recognized that some causes are infectious, some allergic and some autoimmune in nature. Many, even sophisticated tests are available to detect and underlying disorder. To establish an expedient program for investigation of uveitis, 39 patients with uveitis were examined prospectively from May 1979 to December 1980. In taking the history, the geographical and genetic background and simultaneous therapy were noted. The full systemic examination paid special attention to accompanying oral or genital ulcerations or joint disorders. A tuberculin skin test, the blood sedimentation rate (BSR), leukocyte count, serological tests for herpes, cytomegaly, mycoplasma, venereal and brucella infections, toxoplasmosis, rheumatoid factor and antinuclear bodies must also be carried in every patient. In each patient a chest radiograph was taken. In 5 patients uveitis was due to toxoplasmosis, in 3 to Behçet's disease in 3 to sarcoidosis, in 2 to ankylosing spondylitis, and in 1 to ulcerative colitis. In 36% uveitis was associated with an underlying disease, while in 64% the investigations failed to disclose an accompanying disorder. A detailed history, a full systemic examination, BSR and a whole blood count, a tuberculin skin test, a TPHA test, a toxoplasma dye test, and a chest radiograph are recommended as an appropriate minimal program.