LXXXIII Jackson Memorial Lecture: Predicting the Future of Uveitis.

PURPOSE: To compare Edward Jackson's advocacy for an ophthalmologic specialty within medicine with the current partitioning of ophthalmology into subspecialties, in the context of uveitis and ocular immunology in the new era of exceptional access to medical knowledge.

DESIGN

Perspective

METHODS

Expert opinion. Focused review of US workforce, patients, guidelines, and consensus initiatives. Deidentified review of diagnoses and providers in the Intelligent Research in Sight Registry and membership records of the American Academy of Ophthalmology.

RESULTS

Jackson foresaw that specialized education in ophthalmology would ensure the best clinical care. He did not foresee technology-driven, distinct subspecialties emerging within ophthalmology. Uveitis/ocular immunology has relevance to many subspecialties but is threatened by extinction due to few practitioners and unfilled fellowship spots. Uveitis is a significant cause of visual impairment and blindness despite advancements in nomenclature, validated treatments, consensus-based international collaborations, and a robust environment of published basic and clinical research. To counteract geographic limitations in access to uveitis specialists, educational materials are readily available to other ophthalmologists who need to care for these rare and difficult patients. Formal instruction organized by the American Academy of Ophthalmology, including courses, manuals, seminars, and an annual Uveitis Subspecialty Day, will help bridge the knowledge gap.

CONCLUSIONS

Reverse evolution from isolated subspecialties to a unified ophthalmologic workforce dedicated to evidence-based management of uveitis is in line with Edward Jackson's vision but is achievable only with the ready availability of information acquired in the last 40 years within the uveitis subspecialty. Artificial intelligence will further help to dissect clinical problems and point to possible solutions. Predictions for the future of uveitis are ambitious and depend on the dissemination of knowledge to all ophthalmologists.