Ocular inflammatory symptoms with concurrent neuro-ophthalmologic manifestations can be diagnostically challenging. We provide a general overview of uveo-meningeal syndromes, which comprises a heterogeneous group of disorders that involve inflammation of the uveal tract, retina, and meninges. The presentation focuses on the uveomeningeal syndrome of Vogt-Koyanagi-Harada (VKH) Disease by providing a comprehensive overview of diagnostic criteria, pathogenesis, clinical course, and management. To demonstrate the heterogeneous clinical presentations and possible neuro-ophthalmological manifestations that can challenge diagnosis, we chronicle three cases of VKH seen at our institution and highlight the diagnostic work-up, management, and outcomes. This presentation summarizes a practical strategy for approaching the clinical heterogeneity of VKH.[1] Brazis PW, Stewart M, Lee A. The Uveo-Meningeal Syndromes. The Neurologist 2004, 10(4):171-184; [2] Tsuboyama M, Chandler JV, Scharf E, et al. Neurologic Complications of Acute Posterior Multifocal Placoid Pigment Epitheliopathy: A Case Series of 4 Patients. Neurohospitalist 2018; 8(3):146-151.; [3] Allegri P, Risotto R, Herbort CP, Murialdo U. CNS Disease and Uveitis. J Ophthalmic Vis Res. 2011; 6(4): 284-308.; [4] Lavezzo MM, Sakata VM, et al. Vogt-Koyanagi-Harada disease: review of a rare autoimmune disease targeting antigens of melanocytes. Ophanet Journal of Rare Diseases. 2016; 11: 29; [5] Read RW, Rao NA: Utility of existing Vogt-Koyanagi-Harada syndrome diagnostic criteria at initial evaluation of the individual patient: a retrospective analysis. Ocul Immunol Inflamm 2000; 8: pp. 227-234.; [6] Read RW, Rao NA, Cunningham ET. Vogt-Koyanagi-Harada Disease. Curr Opin Ophthal. 2000; 11(6):437-442; [7] Read RW, Holland GN, Rao NA, et. al.: Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol 2001; 131: pp. 647-652.; [8] Goto, Rao, and Rao. Ryan's Retina 7th Edition 2022; 76, 1577-1589; [9] Feldman BH, O'Keefe GD, Salcedo HR, et al. Vogt-Koyanagi-Harada Disease. Eyewiki 2023. https://eyewiki.aao.org/Vogt-Koyanagi-Harada_Disease; [10] Dogan B, Erol MK, Cengiz A. Vogt-Koyanagi-Harada disease following BCG vaccination and tuberculosis. Springerplus. 2016; 5: 603; [11] Ferriera FT, Araujo DC, et al. Possible Association between Vogt-Koyanagi-Harada Disease and Coronavirus Disease Vaccine: A report for Four Cases. Ocul Immunol Inflamm. 2022; 1-7; [12] Rao NA, Gupta A, Dustin L, et al. Frequency of distinguishing clinical features in Vogt-Koyanagi-Harada disease. Ophthalmology 2010;117:591-9; [13] Weisz JM, Holland GN, Roer LN, et. al.: Association between Vogt-Koyanagi-Harada syndrome and HLA-DR1 and DR4 in Hispanic patients living in Southern California. Ophthalmology 1995; 102: pp. 1012-1015.; [14] Shi T, Lv W, Zhang L, Chen J, Chen H. Association of HLA-DR4/HLA-DRB1*04 with Vogt-Koyanagi-Harada disease: a systematic review and meta-analysis. Sci Rep. 2014 Nov 10;4:6887
