We use cookies to help us improve the website and your experience using it. You may delete and block all cookies from this site at any time. However, please note this may result in parts of the site no longer working correctly. If you continue without changing your settings we will assume you are happy to receive all cookies on this site.

Close

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 Manchester Royal Eye Hospital 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 Manchester Royal Eye Hospital.

 

Feedback from recent Uveitis Fellows and TSC Doctors

One of the challenges in the treatment of patients presenting with uveitis is that one often has to adopt an experiential rather than evidential approach . As a medical ophthalmologist, I had the fortune of working in uveitis clinics from the inception of my training programme. My experience notwithstanding, I was exposed to a plethora of challenging cases that I could only have diagnosed or managed through the expert guidance from my mentor, Professor Nicholas Jones. As a Clinical Fellow, knowledge relating to the diagnosis and management of ocular inflammatory disease was inculcated through clinics, dedicated teaching sessions, and, more importantly, ad hoc discussions relating to individual cases. The clinics are well organised and supported by the requisite clinical staff. This allows the Clinical Fellow to work at an appropriate pace in order to learn from their patients. Moreover, Professor Jones and his team have created a congenial environment in which to work thus encouraging one to ask questions without feeling intimidated. Finally, in addition to enhancing my clinical acumen, the Fellowship has increased the number of experts that I may contact in the future when faced with challenging cases. Such experts are not only trustworthy colleagues but are people who I regard as my friends.

Dr Greg Heath (now Consultant, York Hospitals NHS Trust, UK)

 

My 12 months on the uveitis firm was a fantastic educational experience. I would highly recommend this fellowship and firmly believe the clinical exposure, training structure and research opportunities are first class. The firm allows in-depth exposure to adult and paediatric uveitis cases, including complex and challenging cases. There is close collaboration with other specialties and opportunities for involvement in multi-disciplinary teams, such as paediatric rheumatology and Behcet's MDT. I also gained significant experience in use of imaging technologies and MREH offers a vast array. Overall, the firm provides a very stimulating environment and I feel I developed significantly as a uveitis clinician. Close clinical supervision is provided with opportunities to discuss management strategies in-depth. Within this very supportive environment, there are also significant opportunities to assess new clinical cases and formulate management strategies. The firm allows significant personal development and gives opportunities for increased clinical responsibility including decision-making and supervision of junior colleagues in many aspects of clinical duties. Mr Jones is a very supportive educational supervisor and offered fantastic mentorship. There are enormous opportunities for involvement in research and publications and as a direct result of this post I published a number of peer-reviewed papers and presented work at national meetings.

Miss Laura Steeples (now Consultant, Manchester Royal Eye Hospital, UK)

 

This Fellowship was an incredibly valuable experience. The best part was the experience gained in the 3 professorial uveitis clinics per week.  Another new development during my time was the Uveitis Acute Referral clinic, which was a little challenging early on in the fellowship but highly satisfying during the remainder. I elected to contribute towards the hospital's education programme for Manchester University medical students instead of a research project, which I greatly enjoyed. There was no formally allocated theatre session to the fellowship, however I was able to attend and operate on a cataract list once a fortnight, with a consultant.  Prof Jones' pre-op assessment clinic was also very helpful and I made an effort to attend each one although it was not a part of my rostered timetable.  The Beh├žet's MDT meetings were a good insight into the management challenges of this condition and also a good opportunity to hear the perspective of the rheumatologist and the neurologist.  I would have no hesitation in recommending this Fellowship.

Dr Jane Wells (now Uveitis & MR Staff Specialist, Canberra Hospital, Australia)

 

I joined the MREH uveitis team for my fellowship in November 2015. I wouldn't be exaggerating when I say that I enjoyed every moment of it. The team was so supportive and provided an excellent learning environment. My timetable involved exposure to adult and paediatric uveitis clinics which allowed me to acquire the knowledge skills and competence in the management of uveitis. There is one to one supervision in clinic and this provides a platform for systematic discussions for enhanced learning. Regular 2-weekly uveitis team teaching and MDT sessions are added features of this fellowship. There are also opportunities for audit and clinical research. Overall, my fellowship period was so productive and I accomplished the necessary competence in the management of intraocular inflammatory disorders. I would definitely recommend this fellowship to any colleague who aspires to be a Uveitis specialist.

Dr Archana Pradeep (now Uveitis Fellow, Birmingham & Midland Eye Centre)

 

My time in Manchester as a uveitis fellow gave me skills in diagnosis and management of complex patients.  I had the opportunity to prescribe a range of immunosuppressive drugs, to understand potential side effects, interactions with other medical problems, and then I was able to observe the efficacy of treatment.  A particular highlight of this fellowship is that I could follow these patients myself (with support) over the year.  I was involved in teaching sessions and I built up a selection of great cases, which I have used in teaching registrars on my return home.  I particularly valued working with Mr Jones.  He was always accessible and happy to really discuss and 'nut out' a case for my benefit.  He has a wealth of experience to draw upon and is very generous with sharing his knowledge.   Because of my experience in Manchester, I felt equipped to start my career as a consultant with confidence that I had an approach to manage difficult uveitis patients

Dr Robyn Troutbeck (now Consultant Ophthalmologist, Melbourne, Australia)

 

Uveitis is not only profoundly challenging but the subspecialty is also vital in understanding the broader medical retina field. Having completed the uveitis fellowship at MREH, I can sincerely state that the post provides an extensive and detailed insight into this demanding area of ophthalmology.

The dedicated tertiary Manchester Uveitis Clinic is the referral centre for a very large region with a variety of interesting cases, which cover the whole spectrum of uveitis, including rare entities. There are also plenty of opportunities to participate in academic projects and studies. In addition, the fellow organises the uveitis academic teaching where the most interesting cases are presented and productively discussed.

Among the highlights of the fellowship was having the honour to work in a multidisciplinary team, which included rheumatologists, paediatricians, respiratory physicians and immunologists. Moreover, our immunosuppressed patients were managed holistically by the uveitis team, overseeing complex therapies, monitoring, side effects and switching medications.

Mr Nikolaos Krassas (now Senior Clinical Fellow in Medical Retina, Manchester Royal Eye Hospital)

 

I look back to my fellowship in the Manchester Uveitis Clinic and I cannot think of a better post to start my professional path in the UK. Professor Jones runs the Manchester Uveitis Clinic, one of the main uveitis referral clinics in the UK. Clinics run smoothly and you are exposed to all type of uveitis cases and you will learn to manage treatment of all kinds including immunosuppressant and biologic therapies. Professor Jones is readily availabile for helping on any case and shares his vast knowledge in the field, making possible an enjoyable learning atmosphere. Clinics are fully equipped with caring non-medical staff and most updated imaging techniques and auxiliary room for blood tests and minor interventions. Opportunities for theatre and research are discussed early at the start of the post. You will be organize regular teaching sessions, always followed by a valuable clinical discussion. I was also in charge of the Urgent Uveitis Clinic where I managed new cases of all kinds; this was extremely valuable for my development in the field. You are also involved in the medical retina section including regular clinics, intravitreal injection sessions and retinal laser clinics. Consultants are very helpful and have great experience in the field. Overall, if you want to go wise in uveitis this is your place and your team. Do not hesitate and apply now. Good luck!

Dr Guillermo de la Mata Perez (now Medical Retina Fellow, Moorfields Eye Hospital, UK)