Introduction
Children with juvenile idiopathic arthritis (JIA) can develop inflammation in the middle layer of tissue in the eye wall, also known as the ciliary body. This is called uveitis.
Different types of uveitis include:
- anterior – inflammation in the ciliary body and the iris, the coloured part of the eye
- intermediate – inflammation behind the ciliary body and the vitreous, the clear gel inside the eyeball
- posterior – inflammation of the choroid, a thin layer of tissue in the ciliary body, and the retina, tissue at the back of the eyeball
- panuveitis – inflammation in all three major parts of the eye.
Undiagnosed and untreated uveitis can cause severe damage to the eyes and loss of vision.
Signs and symptoms
Symptoms of uveitis can start suddenly and get worse quickly. They can affect one or both eyes and include:
- Redness and pain in the eye
- Photosensitivity – pain when exposed to light
- Blurry vision
- seeing dark, floating spots.
Episodes of uveitis can last anywhere from a few weeks to more than three months.
Diagnosis
Your local doctor or your child’s rheumatologist will refer you to a specialist doctor called an ophthalmologist for diagnosis and management of uveitis.
An ophthalmologist looks after the eyes and vision.
The ophthalmologist may need to do tests and checks, including:
- taking a detailed family and medical history
- taking photos of the inside of the eye
- blood tests
- biopsy – where a sample of tissue is taken and tested.
Treatment
Treatment and management of uveitis focuses on:
- reducing pain and inflammation with medication
- preventing damage to the eye
- restoring any vision loss, where possible
- minimising any side-effects of treatments.
Your child’s doctor will talk to you about different medications and treatments for uveitis and which ones are most suitable.
Children who severe uveitis may need surgery to put an implant inside the eye. These implants slowly release a corticosteroid over some time. Corticosteroids are medications that reduce inflammation.
Management
Vision loss and uveitis
Children who are diagnosed with JIA should have regular eye checks done by an ophthalmologist. They will use a slit lamp to check the eyes for signs of uveitis.
Your child’s treatment team will let you know how often their eyes need to be checked.
Untreated uveitis can cause permanent vision loss.
Early treatment of uveitis gives children a better chance of maintaining their vision.
Speak to your child’s treatment team as soon as possible if you notice any signs of vision loss in your child.