C. Michael Samson, MD
Director, Uveitis Service
Sanjay Kedhar, MD
Assistant Director, Uveitis Service
The mission of the Ocular Immunology and Uveitis Service is threefold: to provide outstanding outpatient care in the management of ocular inflammatory disease; comprehensive training of residents and fellows in the management of these complex disorders; and increased general understanding of ocular inflammatory disease by scientific investigations.
The Ocular Immunology and Uveitis Service at New York Eye and Ear Infirmary of Mount Sinai provides consultation services for over 8,000 clinic patients annually. This service comprises the largest staff of attending physicians in the uveitis subspecialty at a single academic center in the tri-state area.
The breadth of diagnostic entities seen on the Service comprises all forms of ocular inflammation. While the majority of patients referred are those with uveitis, the service consults on other inflammatory eye disease such as scleritis, episcleritis, optic neuritis, interstitial keratitis, cicatrizing conjunctivitis, and post-ocular surgery inflammation.
The wide range of diagnostic entities seen include ocular sarcoid, JRA-associated uveitis, Behcet's Disease, Fuchs' Dystrophy, Lyme disease, and serpiginous chorioretinopathy.
Management of these patients can be incredibly complex, and often these patients are co-managed with the other specialty services: cornea, retina, glaucoma, and neuro-ophthalmology services, in particular.
New York Eye and Ear Infirmary Uveitis Clinic is held from 9 AM to 5 PM every Wednesday at the Retinal Diagnostics Center located on the 5th floor of the south building.
First and Second-year residents are taught the methodical approach to the uveitis patient. History-taking skills, review of systems, and physical examination are critical in establishing a targeted diagnostic work-up.
Specific management of infectious etiologies, such as acute retinal necrosis, ocular syphilis, and toxoplasmosis, are learned. Additionally, the resident learns about the management of chronic non-infectious inflammatory disease, including the appropriate use of regional and systemic steroids and, in close conjunction with rheumatologists, the indication and treatment with systemic immunosuppressives, such as methotrexate, adalimumab, and cyclophosphamide.
Senior residents learn the perioperative stabilization of the uveitis patient who will undergo cataract and intraocular surgery. Seniors also learn the intraoperative management of uveitis patients, including anterior and posterior synechiolysis, iris hooks, and intraocular lens choice. Senior residents gain an understanding of the indications for endolaser, pars plana vitrectomy/vitreous biopsy, and chorioretinal biopsy in these patients.