Uveitis is a common sequela to many ocular diseases. Primary treatment goals for
uveitis should be to halt
inflammation, prevent or control complications caused by
inflammation, relieve
pain, and preserve vision. Systemic and topical
NSAIDs are essential components of the pharmaceutic armamentarium currently employed in the management of ocular
inflammation by general practitioners and veterinary ophthalmologists worldwide.
NSAIDs effectively prevent intraoperative
miosis; control
postoperative pain and
inflammation after intraocular procedures, thus optimizing surgical outcome; control symptoms of
allergic conjunctivitis;alleviate
pain from various causes of
uveitis; and circumvent some of the unwanted side effects that occur with
corticosteroid treatment. Systemic
NSAID therapy is necessary to treat
posterior uveitis, because therapeutic concentrations cannot be attained in the retina and choroid with
topical administration alone, and is warranted when diseases, such as
diabetes mellitus or systemic
infection, preclude the use of systemic
corticosteroids. Risk factors have been identified with systemic and
topical administration of
NSAIDs. In general, ophthalmic
NSAIDs may be used safely with other ophthalmic pharmaceutics; however, concurrent use of drugs known to affect the corneal epithelium adversely, such as
gentamicin, may lead to increased corneal penetration of the
NSAID. The concurrent use of
NSAIDs with topical
corticosteroids in the face of significant preexisting corneal
inflammation has been identified as a risk factor in precipitating corneal erosions and melts in people and should be undertaken with caution[8]. Clinicians should remain vigilant in their screening of ophthalmic and systemic complications secondary to
drug therapy and educate owners accordingly. If a sudden increase in patient ocular
pain (as manifested by an increase in
blepharospasm,
photophobia, ocular discharge, or rubbing)is noted, owners should be instructed to contact their veterinarian promptly.