Uveitis Case Presentation CASE NUMBER INSERT NUMBER HERE

Uveitis Case Presentation CASE NUMBER [INSERT NUMBER HERE] MODERATOR [INSERT NAME HERE] DATE [INSERT DATE HERE DD/MM/YYYY]

Submitting Ophthalmologist [INSERT NAME HERE] [INSERT TOWN/CITY HERE] [INSERT COUNTRY HERE]

Table of Contents 1. Case Report 2. Investigations 3. Summary of Current Findings 4. Current Management 5. Advice Requested

1. Case Report (1) Uveitis History with Clinical Findings and Treatments Ø [Insert concise information on patient’s details, uveitis history (onset, duration) and clinical findings with relevant dates, including any previous medical and surgical treatments - maximum 3 slides]

1. Case Report (2) Uveitis History with Clinical Findings and Treatments Ø [Insert text here]

1. Case Report (3) Uveitis History with Clinical Findings and Treatments Ø [Insert text here]

1. Case Report (4) Other Relevant Ophthalmic History Ø [Insert brief details of any other relevant ophthalmic history]

1. Case Report (5) Past Medical History Ø [Insert brief details of relevant past medical history]

1. Case Report (6) Other Relevant History Ø [Insert brief details of any other relevant history e. g. social, family, occupation, travel, living environment, drug allergies etc. ]

2. Investigations - Serology Ø [Insert relevant blood results here]

2. Investigations - Other Intraocular Fluid analysis Ø [Insert relevant results here] Other investigations Ø [Insert relevant results here]

2. Investigations - Imaging (1) [Insert relevant images with type of imaging, date and label which eye, maximum 6 images per slide – maximum 4 slides, text should be Calibri 18 pt]

2. Investigations - Imaging (2) [Insert relevant images with type of imaging, date and label which eye, maximum 6 images per slide – maximum 4 slides, text should be Calibri 18 pt]

2. Investigations - Imaging (3) [Insert relevant images with type of imaging, date and label which eye, maximum 6 images per slide – maximum 4 slides, text should be Calibri 18 pt]

2. Investigations - Imaging (4) [Insert relevant images with type of imaging, date and label which eye, maximum 6 images per slide – maximum 4 slides, text should be Calibri 18 pt]

3. Summary of Current Findings Ø [Insert relevant current findings here]

4. Current Management Topical therapy Systemic therapy Otherapy [Insert current topical meds here, dose, eye, date when initiated] [Insert current systemic meds here, dose, date when initiated] [Insert current other treatments here, dose, date when initiated]

5. Advice Requested 1. [Insert here the question(s) asked by the submitting ophthalmologist]

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