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JIA Associated Uveitis

What is JIA-associated Uveitis?
Uveitis is an inflammation of the uvea, the layer between the sclera and the retina. Uveitis can occur spontaneously as a standalone disorder or it can be caused by infections or autoimmune diseases, in which the immune system mistakenly attacks the body’s own tissues and organs, in this case, the uvea. One such disease is juvenile idiopathic arthritis, a type of autoimmune arthritis in children, hence the term JIA-associated uveitis. 

If the inflammation is not treated promptly, scarring and vision problems develop, including glaucoma, cataracts, and, eventually, loss of vision. Uveitis can occur during or after JIA, and even after the disease is under control and there aren’t other symptoms.  

Symptoms   
Uveitis may not have obvious symptoms, and symptoms tend to develop slowly. Sometimes, children might say the light bothers them or they have blurred vision. If your child has been diagnosed with JIA, it is very important to see a pediatric ophthalmologist regularly and pay attention to the following signs:

 

  • Red eyes 
  • Blurred vision 
  • Sensitivity to light 
  • Dark floating spots in the vision 

 

A child may also have other symptoms associated with the autoimmune disease including joint pain, fever, malaise, fatigue and flu-like symptoms.  

Diagnosis   
A thorough eye exam is usually needed to diagnose uveitis. Blood tests and X-rays can be used to determine whether another underlying disorder, such as JIA, is causing the condition. Eye exams including:

 

  • Dilated eye exam, during which the retina and optic nerves are examined at a close up for signs of damage using a device called ophthalmoscope
  • Tonometry, a test that measures the pressure inside the eye
  • Slit-lamp exam of the structures in the front of the eyes 


Treatment    

  • Steroid eye drops to reduce inflammation and swelling for short-term treatment 
  • Oral steroids
  • Medications that suppress the over-active immune system in JIA
  • A new class of medications called “biologic response modifiers” that can keep the immune system in balance can be used in certain cases.

When to Call for Help
If your child has any of the above symptoms, seek advice from your pediatrician. If your child has been diagnosed with JIA, it is very important to see a pediatric ophthalmologist regularly.

At Hopkins Children’s, JIA associated uveitis is treated by the division of Ophthalmology in tandem with the division of Rheumatology.

External Links:

 

 

National Library of Medicine 

American College of Rheumatology