BACKGROUND: Although
uveitis is relatively uncommon in children, its diagnosis and management present a distinct clinical challenge for the physician. An improved knowledge of
disease patterns and associated
morbidity will help in the care of children with
uveitis. METHODS: The authors reviewed the records of 130 patients with onset of
uveitis at 16 years of age or younger. The
etiology of
uveitis, complications encountered, treatment administered, and
visual results were analyzed. RESULTS:
Uveitis associated with
juvenile rheumatoid arthritis (JRA) was the largest group (41.5%) followed by
idiopathic uveitis (21.5%) and
pars planitis (15.3%). Twenty-six percent of the
eyes had less than 20/200
visual acuity at the time of first referral. Patients with JRA had the highest rate of complications:
cataract (71%),
glaucoma (30%),
band keratopathy (66%), and hypotony (19%). The most frequent complication of
pars planitis was
maculopathy (55%). Final
visual acuity was less than 20/200 in 26% of
eyes with JRA, 10.5% with
pars planitis, and 14% with
idiopathic uveitis. CONCLUSION:
Uveitis beginning in childhood is a serious disease associated with sight-threatening complications. Juvenile
rheumatoid arthritis-associated
uveitis remains a leading cause of ocular
morbidity in patients with childhood
uveitis. Increased
awareness by
pediatricians,
rheumatologists, and
ophthalmologists of the seriousness of ocular complications of
uveitis in childhood may lead to earlier diagnosis and more effective treatment regimens in the future.
