Granulomatous Uveitis Treatment: Which combination?

• A. Prednisolone acetate 1% q2h and Cyclopentolate
• B. Difluprednate 0.05% qid, Atropine 0.5% bid
• C. Prednisolone acetate 0.5% qd and Cyclopentolate
• D. Ketorolac and Tropicamide

Answer: (B)

Granulomatous anterior uveitis needs strong suppression of inflammation along with a reliable cycloplegia to prevent adhesions and relieve pain. Difluprednate 0.05% given four times daily provides a high-potency topical corticosteroid with excellent ocular surface penetration, making it effective at rapidly controlling granulomatous inflammation. Pairing this with atropine 0.5% twice daily gives a long-acting cycloplegic to keep the pupil dilated and to break up synechiae, which is crucial in granulomatous cases.

Other options fall short because they rely on less potent steroids or shorter-acting cycloplegics, or they combine a non-steroidal approach (like ketorolac) with a short-acting mydriatic, which is not sufficient for the inflammatory control required in granulomatous uveitis.