The following is a guide for parents who have a child who has developed uveitis. It explains what uveitis is, how it affects the eye, what treatments are used, and how we assess the eye. We hope it answers some of your questions, but the doctors and nurses who know your child will be very happy to answer any more questions you may have.
On this page, we cover:
The term uveitis means there is inflammation within the eye. The uvea is the lining of the eye and the ending itis means inflammation. It may also be described as iritis.
The diagram shows the different parts of the eye. The dotted area is the uvea. Uveitis can affect different areas in the eye so you may hear it said the uveitis is anterior (at the front), intermediate (in the middle) or posterior (at the back) of the eye.
Most of the children who develop uveitis have arthritis. Some children have other medical problems, like inflammatory bowel disease, Behcet’s syndrome or sarcoid. For some children, even after tests, no underlying cause is found, when it is called idiopathic uveitis. The treatment is very similar whatever the cause.
Yes, chronic, intermediate and acute uveitis all occur in children. The symptoms tend to be different.
- Chronic uveitis tends to develop gradually and the eyes do not look red and are not painful. This is the type most commonly associated with arthritis.
- Acute uveitis can develop quickly over a period of days, and cause pain and redness of the eye.
Ongoing inflammation in the eye eventually damages the delicate structures of the eye. The main problems it can cause are cataract, which is clouding of the lens of the eye, high pressure in the eye, called glaucoma, and the inflammation can lead to reduced vision.
Whatever the type of uveitis the aim of treatment is to control the inflammation in the eye.
Uveitis is treated with eye drops or medicines. Generally, mild forms of uveitis are treated with eye drops alone until the inflammation settles down. The standard type of eye drop which is used is a steroid eye drop. For a few patients where the inflammation settles down quickly, and stays away, this may be all the treatment that is needed. However additional treatment is considered if steroid eye drops do not settle down the inflammation promptly, or if the inflammation returns when the drops are reduced.
The aim of treatment for uveitis is to control the inflammation within the eye without the need for ongoing steroid eye drops. Long term the steroid eye drops can damage the eye themselves.
A number of different medicines can reduce inflammation in the body by damping down the immune system. The medicines may be given as liquids, tablets or by injection. These can be very good at treating uveitis and your Doctor or Nurse will discuss these with you if your child needs them. Paediatric Rheumatology Doctors and Rheumatology Nurse Specialists frequently work with the ophthalmologists when these medicines are used, and will give you information about the use of these treatments.
Uveitis may have periods of good control, and periods when the inflammation returns. In many children, particularly the youngest, the eye does not go red, painful, or have any symptoms at all. So regular eye checks are an important part of the care your child. In some children uveitis can cause redness and pain; always ask for advice if your child is complaining of sore eyes, or their eyes become very sensitive to light.
First your child’s vision will be measured. This is usually done by reading letters on a letter chart. In young children pictures will be used. Then the eyes will be examined using a microscope. This is called a slit lamp because the little beam of light used to examine the eyes has a slit shape. This examination can be tricky in young children as the head has to be kept still. You can help with this part of the examination by gently holding your child in a comfortable position beside the microscope.
When your child goes to clinic they may need to have some eye drops put in to make the pupils large. The drops are slightly stingy. They usually take about half an hour to work and they can last for up to 12 hours. During this time your child’s vision can be a little blurry. This allows the doctor to get a better look inside the eye. This is done to look for any inflammation deeper inside the eye.
Remember inflammation causes damage to the eye if left untreated so regular checks of your child’s eyes, and treatment of the inflammation when it is present are the best way to protect the eye.
Arthritis and uveitis both end in itis. Itis means inflammation, arth means joint, so the word arthritis just means inflamed joints, and uveitis means inflammation of the bit of the eye medically called the uvea, which is the inside lining of the eye.
The medical word idiopathic means the cause is unknown. Many medical conditions are idiopathic. We know how to treat many conditions even when their cause is unknown.
Chronic means going on over time, acute means suddenly. These words describe the way the inflammation behaves in different types of uveitis.
Anterior means at the front, intermediate means in the middle and posterior means back. These terms describe where the inflammation is found in the eye.