Janet L Davis
Reverse evolution from isolated subspecialties to a unified ophthalmologic workforce dedicated to evidence-based management of uveitis is in line with the vision of Edward Jackson but achievable only with the ready availability of information acquired over the last 40 years within the subspecialty of uveitis. Artificial intelligence will further help to dissect clinical problems and point to possible solutions. Predictions for the future of uveitis are ambitious and depend on dissemination of knowledge to all ophthalmologists.
OBJECTIVE: Compare Edward Jackson's advocacy for an ophthalmologic specialty within medicine to the current partitioning of ophthalmology into subspecialties, in the context of uveitis and ocular immunology in the new era of exceptional access to medical knowledge.
DESIGN: Perspective METHODS: Expert opinion. Focused review of US workforce, patients, guidelines and consensus initiatives. De-identified review of diagnoses and providers in the Intelligent Research in Sight (IRIS®) Registry and membership records of the American Academy of Ophthalmology (AAO).
RESULTS: Jackson foresaw that specialized education in ophthalmology would ensure the best clinical care. He did not foresee technology-driven, distinct subspecialties within ophthalmology. Uveitis/ocular immunology has relevance to many subspecialties but is threatened by extinction due to few practitioners and unfilled fellowship spots. Uveitis is a significant cause of visual impairment and blindness despite advancements in nomenclature, validated treatments, consensus-based international collaborations and a robust environment of published basic and clinical research. To counteract geographic limitations in access to uveitis specialists, educational materials are readily available to other ophthalmologists who need to care for these rare and difficult patients. Formal instruction organized by the AAO with courses, manuals, seminars and an annual Uveitis Subspecialty Day will help bridge the knowledge gap.
CONCLUSION: Reverse evolution from isolated subspecialties to a unified ophthalmologic workforce dedicated to evidence-based management of uveitis is in line with the vision of Edward Jackson but achievable only with the ready availability of information acquired over the last 40 years within the subspecialty of uveitis. Artificial intelligence will further help to dissect clinical problems and point to possible solutions. Predictions for the future of uveitis are ambitious and depend on dissemination of knowledge to all ophthalmologists.