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Uveitis

The Manchester Uveitis Clinic (MUC) was inaugurated in 1991 at the Manchester Royal Eye Hospital by consultant Mr Jones, to offer specialist care to those with severe, sight-threatening and complex inflammations inside the eye. There are now five consultants with expertise in the management of uveitis who work in MUC:

  • Miss Kanchan Bhan (Uveitis and general ophthalmology)
  • Miss Romi Chhabra (Uveitis and medical retina)
  • Mr Assad Jalil (Uveitis and vitreoretinal surgery)
  • Professor Nicholas Jones (Uveitis)
  • Miss Laura Steeples (Uveitis and general ophthalmology)

Two associate specialists, Mr Khalid Aziz and Miss Binu John, also work within the MUC.  The clinic has an international reputation for providing high-quality care and there are two senior clinical fellows in uveitis on the unit at any one time, training to become experts in the area. The clinic also trains medical retina fellows in the management of uveitis, in addition to general ophthalmological trainee doctors.

Most episodes of uveitis are fairly short, and straightforward to treat by local ophthalmologists. However, the management of severe uveitis may be complex, may become chronic and often requires the use of oral immunosuppression. The MUC is one of the few units in the UK, and the only unit in the Northwest, who have expert in-house immunosuppression management for uveitis. We have a wide network of expert physicians with whom we liaise, as uveitis can be part of a multi-system problem. These include rheumatologists, chest physicians, gastroenterologists and genitourinary medicine physicians. Some patients with uveitis require biologic treatment with monoclonal antibodies, and this also can be managed through MUC.

The diagnosis and management of uveitis relies on high-quality imaging of the interior of the eye. Manchester Royal Eye Hospital (MREH) is at the forefront of imaging technology, including digital wide-field fluorescein and indocyanine-green angiography, enhanced-depth swept-source optical coherence tomography (OCT), anterior segment OCT and ultrasound, and OCT angiography.

Uveitis, when severe or chronic, frequently leads to complications including cataract, glaucoma and retinal problems. The MUC team and their colleagues in other areas at MREH are expert in dealing with these complications, and in carrying out surgery if required.

 

Manchester Uveitis Clinics all take place at the Manchester Royal Eye Hospital:

  • Monday pm (Miss Bhan)
  • Tuesday am (Prof Jones, Mr Jalil and Miss Steeples)
  • Wednesday am (Miss Bhan)
  • Thursday am (Prof Jones, Miss Chhabra and Miss Steeples)
  • Friday am (Miss Bhan and Miss Steeples)

 

Urgent uveitis

New patients with acute uveitis are seen in the Emergency Eye Department at MREH. If their eye inflammation is straightforward and short-lasting, they will not need to attend the MUC. Twice a week there is a uveitis urgency clinic staffed by the uveitis fellows. Any patient with severe or difficult uveitis seen within the Emergency Eye Department is transferred urgently to the uveitis team, who will take over care.

 

Uveitis in Children

There is also a paediatric uveitis clinic at MREH, which takes place fortnightly on Wednesday morning. The consultants involved are:

  • Miss Jane Ashworth (Paediatric ophthalmology and uveitis)
  • Professor Nicholas Jones
  • Mr Vinod Sharma (Paediatric ophthalmology and uveitis)
  • Miss Laura Steeples

Children with uveitis may also require immunosuppression or biologic treatment, and this treatment can be arranged at MUC under the supervision of our paediatric rheumatology consultant colleagues Dr Alice Chieng and Dr Phil Riley.

 

Uveitis Fellowships

The Manchester Uveitis Clinic at Manchester Royal Eye Hospital is well-known both nationally and internationally as a training centre for ophthalmologists who wish to specialist in uveitis and inflammatory disease. At any one time there are two Senior Clinical Fellows in Uveitis and Medical Retina, who each spend one year at MREH before being accredited as an expert in this area. These fellowships are recognised for training purposes by the Royal College of Ophthalmologists and are open to international applications. Posts are advertised at variable intervals on the NHS Jobs website and in the British Medical Journal. Interested doctors are welcome to make informal approaches to discuss training possibilities with any of the MUC consultants. The MUC also provides training (to a much less advanced level) for the several Medical Retina fellows at MREH.