Diagnostic Testing in Patients With Ocular Inflammation
An accurate and detailed history and physical examination provides the basis for appropriate diagnostic testing. From another perspective, the overreliance on diagnostic testing in the absence of complete knowledge of the patient will often lead to incorrect test result interpretation and may endanger the patient. Excessive use of what would otherwise be considered acceptable tests will also increase the likelihood of false-positive results. The additional benefits that come from knowing a patient's course over time or allowing for ongoing care and observation cannot be overemphasized. Once again, a discussion of diagnostic testing in uveitis is meaningless without the ability to perform a sound history and physical examination (Table 1).
Diagnostic testing begins with the completion of the history, physical examination, and consultations; it may involve risks of morbidity and mortality. These may be minor, such as the inconvenience of a venipuncture, or major, such as an anaphylactic reaction to intravenous fluorescein. Diagnostic testing is performed for three reasons: first, to benefit patients in advising treatment or giving prognosis; second, to pursue further knowledge regarding a disease condition in an individual patient; finally, for academic research interests regarding the disease. The last form of testing is often done under a formal agreement with patients as research subjects.