CHANGING PATTERNS IN UVEITIS OF CHILDHOOD

Background: Although uveitis is relatively uncommon in children, its d iagnosis and management present a distinct clinical challenge for the physician. An improved knowledge of disease patterns and associated mo rbidity will help in the care of children with uveitis. Methods: The a uthors reviewed the records of 130 patients with onset of uveitis at 1 6 years of age or younger. The etiology of uveitis, complications enco untered, treatment administered, and visual results were analyzed. Res ults: Uveitis associated with juvenile rheumatoid arthritis (JRA) was the largest group (41.5%) followed by idiopathic uveitis (21.5%) and p ars 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%), ba nd keratopathy (66%), and hypotony (19%). The most frequent complicati on of pars planitis was maculopathy (55%). Final visual acuity was les s than 20/200 in 26% of eyes with JRA, 10.5% with pars planitis, and 1 4% 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 ca use of ocular morbidity in patients with childhood uveitis. Increased awareness by pediatricians, rheumatologists, and ophthalmologists of t he seriousness of ocular complications of uveitis in childhood may lea d to earlier diagnosis and more effective treatment regimens in the fu ture.