The prevalence of uveitis in juvenile rheumatoid arthritis

Background: Because asymptomatic uveitis has been an important cause of vis ual loss in children with juvenile rheumatoid arthritis, periodic ophthalmo logic screenings of such patients have been recommended. Recently, some aut hors have found a decreased prevalence of uveitis in children with juvenile rheumatoid arthritis. Methods:We studied a total of 76 patients (63 girls and 13 boys, aged ? to 16 years), referred to 3 pediatric ophthalmology pra ctices between March 1976 and October 1999. Follow-up examinations were per formed at intervals of 3 to 6 months according to current guidelines, durin g the following 6 months to 23 years (mean, 55 months). Results: Uveitis de veloped in 10 children (13%). Of these 10 children, 2 were symptomatic (blu rred vision, discomfort) and 7 were diagnosed with uveitis at the initial v isit. Only 1 patient had asymptomatic uveitis after initial negative findin gs on screening examination. Final Visual acuity for all the compliant chil dren in the uveitis group was better than 20/30. Discussion: The prevalence of uveitis in our study is similar to rates found by other recent authors. This decrease may reflect a tendency for systemic medications to prevent t he development of ocular inflammation. We believe that screening guidelines should be reevaluated, especially for asymptomatic children with negative findings on initial examinations.