Eye diseases in children with rheumatoid arthritis in 458 children

Background: Besides arthritis or other systemic manifestations, endogenous inflammation (most commonly uveitis) can be a sympton of rheumatoid arthrit is in children. The uveitis of children shows certain differences compared to that in adults. This study will show these differences and their inciden ces. Patients and Methods: Retrospective analysis of the histories of 458 childr en that were admitted to the pediatric clinic due to rheumatism related dis eases. An analysis of the general and pediatric data, laboratory results an d therapy were combined with the ophthalmologic data. Results: 45 (9.8 %) of the 458 patients suttered from uveitis at least once during the studied time period between 1992 and 1996. Most common complica tions of the therapy were clouding of the lens up to full cataract (in both eyes in eight out of nine patients). Seven patients underwent cataract ope ration. Further complications are synechiae, band shaped keratopathy, secun dary glaucoma and retinal diseases. Conclusion: Since the pediatric uveitis usually does not take an acute cour se and since children rarely can articulate themselves precisely, a regular ophthalmologic examination of pediatric rheumatory patients is necessary, as well as every uveitis in children should warrant pediatric-rheumatologic diagnostics. The impact of uveitis is much more severe for children when c ompared to adults, since it not only endangers the vision but the whole dev elopment of the child.