Non-Granulomatous Uveitis Treatment: Which regimen?

• A. Prednisolone acetate 1% q2h or Difluprednate 0.05% qid, Cyclopentolate 1% tid
• B. Prednisolone acetate 0.5% qd
• C. Ketorolac 0.5% qid
• D. Cyclopentolate 1% qid alone

Answer: (A)

Treating non-granulomatous anterior uveitis requires rapid suppression of inflammation with a potent topical steroid, plus a cycloplegic to relieve pain and prevent synechiae. The best regimen uses a strong anti-inflammatory delivered frequently to achieve adequate ocular tissue levels: prednisolone acetate 1% every two hours, or difluprednate 0.05% four times daily. This level of dosing is necessary at the outset to control the inflammatory process quickly. Pairing this with a cycloplegic such as cyclopentolate 1% three times daily helps relax the ciliary muscle, reduces pain from ciliary spasm, and lowers the risk of posterior synechiae.

NSAIDs by themselves don’t provide sufficient control of active anterior uveitis, and using a cycloplegic alone doesn’t address the underlying inflammation. The combination of a high-frequency topical steroid with a cycloplegic targets both inflammation and pain, which is why this regimen is preferred.