What is Uveitis?
Uveitis is an inflammatory condition affecting the uvea, the middle layer of the eye. In children, it can lead to severe visual impairment if not promptly diagnosed and treated. It is classified based on the part of the uvea affected: anterior, intermediate, posterior, or panuveitis.
What are the Causes of Uveitis in Children?
The causes of uveitis in children can be broadly categorized into infectious and non-infectious origin. Non-infectious causes are often associated with systemic autoimmune diseases like
juvenile idiopathic arthritis (JIA), sarcoidosis, or inflammatory bowel disease. Infectious causes include toxoplasmosis, herpes simplex virus, and tuberculosis.
What are the Symptoms of Uveitis in Children?
Symptoms can vary based on the type and severity of uveitis. Common symptoms include
redness, pain, blurred vision, light sensitivity, and floaters. In younger children, identifying these symptoms can be challenging, and they may only present with irritability or rubbing their eyes frequently.
How is Uveitis Diagnosed in Children?
Diagnosis involves a thorough medical and family history, along with a comprehensive eye examination.
Slit-lamp examination is crucial for detecting inflammation in the anterior chamber. Additional tests such as optical coherence tomography (OCT), fluorescein angiography, and laboratory tests for underlying systemic conditions may be necessary.
Corticosteroids: Administered topically, orally, or via injections to reduce inflammation.
Immunosuppressive agents: Used when corticosteroids alone are insufficient or in cases of chronic uveitis. Examples include methotrexate, azathioprine, and mycophenolate mofetil.
Biologic agents: Utilized for refractory cases or when other treatments fail, such as adalimumab and infliximab.
Cycloplegic agents: Help alleviate pain and prevent posterior synechiae.
What is the Prognosis for Children with Uveitis?
The prognosis depends on the underlying cause, promptness of treatment, and adherence to management protocols. With appropriate treatment, many children achieve good visual outcomes. However, chronic or recurrent uveitis requires ongoing management to prevent long-term complications.
How Can Uveitis be Prevented in Children?
Prevention strategies focus on managing underlying systemic conditions and avoiding known triggers. Regular screening and early intervention in children with conditions like JIA can help prevent the onset or progression of uveitis.
Conclusion
Uveitis in children is a complex condition requiring a multidisciplinary approach for effective management. Early diagnosis, tailored treatment plans, and regular monitoring are crucial for preserving vision and improving quality of life in affected children.
