Inadequacies in uveitis: misnomers, incongruencies, persistence of obsolete terminologies & inappropriate guidelines, treatment inadequacies, and misinterpretations.

Abstract

Background: Inadequacies in medicine are manifold including inadequate influence of opinion leaders and consensus groups on terminology, diagnostic criteria and treatment guidelines, obsolete classifications and terms as well as misinterpretations of disease mechanisms. This is no different for uveitis and possibly even more pronounced as these are rare entities.

Purpose: To underline inadequacies in uveitis including inadequate diagnostic criteria and treatment guidelines, misnomers, obsolescence of terminology, misinterpretation of disease processes and inadequate or underuse of investigative modalities in uveitis. This is a first report to be followed by others.

Methods: A critical retrospective literature review of selected inadequacies in uveitis practice.

Results: We investigate the mechanism of abuse of power of opinion leaders through the historical events such as the delay in acceptance of antiviral treatment for zoster ophthalmicus, report inadequacies and misnomers resulting from opinion articles or opinion surveys, inadequate treatment guidelines such as for Vogt-Koyanagi-Harada disease (VKH) , delays in adopting appropriate classifications, inappropriate pathophysiological interpretations such as for multiple evanescent white dot syndromes (MEWDS), reluctance to implement ICGA use, a crucial biomarker for choroiditis, among others.

Conclusion: Inadequacies in uveitis are not so rare and often result from inadequate influence of opinion leaders oe groups. Some are harmless although annoying, such as misnomers, while others can be harmful such as inadequate treatment guidelines.