Ophthalmology   

No active joint disease, patient on Hydroxychloroquine and Cimzia. Normal ESR/CRP.

Patient previously trialed two anti-TNFi and Tocilizumab. Avoiding Rituximab due to positive JC virus testing. 

Can nodular scleritis be a presenting manifestation of GCA?

Is the diagnosis of Sjogren's mostly clinical in a patient with a consistent history and physical with positive serologies?

And have you ever seen it occur in isolation without any other manifestations of SLE? 

The patient has no extraocular features of a spondyloarthropathy and is on methotrexate. No active eye disease for past 1 year.

If so, when do you recommend timing for the cataract surgery? 

Patient is asymptomatic. Labs showed +P-ANCA 1:160. Negative MPO and PR3.

Patient has failed methotrexate and adalimumab. 

Patient failed topical ocular therapies, methotrexate, azathioprine.

Is the approach different from uveitis immunosuppression?

Are there specific features that suggest drug-induced uveitis versus de novo uveitis?

Are IL-17 or IL-23 inhibitors helpful?

Patient was previously well controlled on methotrexate, which was discontinued during cancer treatment.