Middle-aged woman experiences refractory uveitis

A 46-year-old Indian woman was referred by her optometrist for uveitis in the right eye. She initially presented to the optometrist’s office 1 month before the referral with a 1-day history of blurred vision, tearing and photophobia. The optometrist prescribed prednisolone acetate 1% four times per day.On review of systems, she reported dysphagia and odynophagia for the past several months. Ocular history was significant for three to four prior episodes of anterior uveitis beginning 3 to 4 years before presentation, always in the right eye, as well as a choroidal nevus in the right eye with no thickening or adjacent inflammation. No prior laboratory workup was performed to investigate the etiology of the uveitis. There was no significant medical or surgical history. She denied any history of cold sores. Family history was significant for her two children who were diagnosed and treated for latent tuberculosis upon starting grade school in the United States. She did not use any medications, tobacco or alcohol and did not have known drug allergies.