PMID: 11698748

Issn Print: 0020-8167

Publication Date: 2001/10/01


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Uveitis in Children: Diagnosis and Management

C. Michael Samson; Anthony Ekong; C. Stephen Foster

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Excerpt

Uveitis encountered in a pediatric patient is always accompanied by a level of anxiety for the treating clinician. This is so in part because of the uncommonness of pediatric uveitis—even more uncommon than in adult patients. There are fewer cases of uveitis in the pediatric population than would be predicted if there were an even age distribution among uveitis patients. Case series estimate that children account for only 6% to 10% of patients seen in uveitis clinics. 1–3 This rarity has resulted in relatively little information about pediatric uveitis in the literature.
Another reason for the higher anxiety provoked by pediatric uveitis patients is the practical difficulties that surround caring for the child. Patient history and symptoms are critically important in the management of the uveitis patient; young children are either unable or unwilling to offer useful histories with regard to recent symptoms. In some instances, uveitis in the pediatric patient is not accompanied by symptoms or signs typically seen in adult patients. Additionally, young children cannot always cooperate with adequate examinations at the slit lamp or the administration of ocular drops.
Amblyopia is another concern unique to the uveitis patient in this young age group. Impaired vision for prolonged periods due to active inflammation or cystoid macular edema in adult patients can still be associated with recovery of good vision, whereas in children younger than 7 years, recovery of vision may be limited, particularly if the uveitis is asymmetrical.
Finally, the factor that brings the greatest anxiety to the treatment of uveitis in pediatric patients is parental anxiety, which can have profound effects on both the patient and the treating physician.
The purpose of this chapter, along with the accompanying chapter in this volume on juvenile rheumatoid arthritis (JRA)–associated uveitis, is to offer the clinician a framework on which to approach the evaluation and treatment of children with uveitis.
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