Purpose To describe an approach to diagnosing the uveitides, a collection of about 30 separate diseases characterized by intraocular inflammation. Design Perspective. Methods Integration of clinical approach with a more formal, informatics-derived approach to characterization and a Bayesian approach to laboratory testing. Results The patient’s uveitis is characterized along several dimensions: course, laterality, anatomic location of the inflammation, morphology, presence of active infection, and the host (age, presence of a systemic disease). Posterior uveitis can be characterized further by whether it is primarily a retinitis, choroiditis, or retinal vasculitis, by whether it is paucifocal or multifocal, and by the morphology of the lesions. This characterization narrows the differential diagnosis to one or, at most, a few diseases. Laboratory screening (i.e. testing all patients) should be reserved for those diseases that can present as any type of uveitis, whereas targeted testing (i.e. testing a subset with specific features) is used selectively. Laboratory testing should be used to identify an infection (which will alter therapy) or a systemic disease that will affect the patient’s health. A uveitis that is not one of the established diagnoses is designated as “undifferentiated” with the course, laterality, and anatomic location (e.g. undifferentiated bilateral chronic anterior uveitis). We avoid the term “idiopathic” uveitis as most identified non-infectious uveitic diseases are idiopathic, and most systemic diseases associated with uveitis also are idiopathic (e.g. juvenile idiopathic arthritis). Conclusion This approach should lead to the correct diagnosis of the specific uveitic disease in the large majority of cases without overuse of laboratory testing.

Spectral OCT can be useful in identifying lesion morphology and location, and in tracking the response to treatment in eyes with posterior-segment nodules, presumably secondary to sarcoidosis.

Purpose The field of ophthalmology must become more reflective of the increasingly diverse U.S. population. This study characterizes students intending to pursue ophthalmology and practice in an underserved area versus other surgical and nonsurgical fields. Subjects Deidentified responses from 92,080 U.S. MD students who matriculated in the academic years beginning from 2007 to 2011 were obtained from the Association of American Medical Colleges (AAMC) Graduation Questionnaires. Methods Study participants were those who fully completed the AAMC Graduation Questionnaire. Chi-squared and multivariate logistical regressions were used for analyses. Results Ophthalmology intending graduates (OIG; n = 1,177) compared with other surgical intending graduates (n = 7,955) were more likely to be female (adjusted odds ratio [aOR]: 1.46; 95% confidence interval [CI]: 1.28–1.66), Asian (1.71 [1.46–2.01]), and have conducted a research project with a faculty member (1.58 [1.26–1.98]). OIG compared with nonsurgery intending graduates (n = 35,865) were more likely to have completed a research project with a faculty member (4.78 [3.86–5.92]), to be Asian (1.4 [1.21–1.62]), and have received scholarships (1.18 [1.04–1.34]). OIG were less likely to be female (0.64 [0.57–0.73]) and Black/African American (0.5 [0.33–0.74]). Among OIG, Black/African American students and multiracial students were more likely than non-Hispanic (NH) White students to report intention to practice in underserved areas (IPUA; 14.29 [1.82–111.88] and 2.5 [1.06–5.92]), respectively. OIG with global health experience were more likely to report IPUA (1.64 [1.2–2.25]). Conclusion Females and underrepresented in medicine (URM), respectively, were more likely to be nonsurgery intending graduates than OIG, which, if not addressed, may lead to a persistent underrepresentation of these groups in the field. In addition, URM students, including African American students, were more likely to report IPUA, which further emphasizes the importance of more URM students entering the field to address these growing gaps in medical care. Finally, we recommend increased mentorship to help address these disparities.