Many patients with ocular inflammatory disease such as uveitis, scleritis, orbital inflammation, or mucous membrane pemphigoid, are best managed with immunosuppression by an internist in collaboration with an ophthalmologist. Choice of treatment is influenced by variables which include the specific diagnosis, disease severity, anatomic location of the inflammation, and patient preference and uniqueness. Infection and malignancy must be excluded as mimickers of inflammation. Methotrexate, mycophenolate and azathioprine are popular corticosteroid sparing drugs. Adalimumab is the only FDA-approved biologic option for patients with intermediate, posterior or panuveitis who fail other avenues of treatment. A collaborative model with an ophthalmologist optimizes care.