Paediatric Uveitis

What is Paediatric Uveitis?

Paediatric uveitis refers to inflammation inside the eye that occurs in children and young adults.

Although relatively uncommon, it is one of the most important causes of preventable visual loss in childhood.

The uvea includes the iris, ciliary body, and choroid, and inflammation can affect one or more of these structures. It can also affect the surrounding structures, including the retina, optic nerve and vitreous.

Because uveitis in children may develop slowly and without obvious symptoms, early recognition and specialist management are essential.

What Causes Uveitis in Children?

Uveitis in children can be caused by a range of conditions. The most frequent form is chronic anterior uveitis associated with Juvenile Idiopathic Arthritis (JIA). This autoimmune condition causes the body’s immune system to attack its own tissues, including the eyes and the joints.

For more detailed information about Juvenile Idiopathic Arthritis–related uveitis

click here

Other causes include autoimmune diseases, such as sarcoidosis; infections (such as toxoplasmosis or viral infections); or it may occur without an identifiable cause (“idiopathic”). Genetic factors and immune dysregulation are thought to play key roles.

Symptoms

Many children with chronic anterior uveitis have few or no symptoms at first. Chronic anterior uveitis, including the JIA-associated uveitis, often develops quietly, without redness or pain, which means a child may not notice any symptoms until the inflammation has already caused damage.

In other types of uveitis and when symptoms do occur, they may include:

Because inflammation can progress silently, especially in JIA-associated uveitis, regular screening of at-risk children is mandatory.

Regular eye screening is essential for all children with JIA, even if their eyes seem normal.

Diagnosis

Diagnosis is made through a comprehensive eye examination by a uveitis specialist. This includes slit-lamp examination, measurement of eye pressure, and imaging of the back of the eye, if needed.

Laboratory tests or scans may be used to identify an underlying cause, such as autoimmune or infectious conditions. Close collaboration with paediatric rheumatologists and other specialists is often required.

Treatment

Treatment aims to control inflammation, prevent tissue damage and complications, and preserve vision.

Management is tailored to each child and usually include:

In non-infectious inflammatory diseases, treatments are not curative but aim at controlling the immune response which is the reason of the inflammatory reaction in the eye.

Regular monitoring to adjust treatment and detect complications like cataract and/or glaucoma is required.

With modern therapies and coordinated care between ophthalmologists and rheumatologists, most children can achieve good long-term visual outcomes.