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Dangerous Eye Complication of Juvenile Arthritis: Uveitis

Updated on November 14, 2015

A few Thanksgivings ago, my great-niece, who suffers from juvenile arthritis and has a history of eye complications known as uveitis, woke with eye pain. While her mom stayed home with the rest of the family her father and uncle wisely drove her to the emergency room where her ophthalmologist was going to meet them because they knew that a delay in treatment could lead to blindness for my niece.

All parents whose children have been diagnosed with juvenile arthritis need to be aware that eye pain or reduced vision requires prompt treatment. Although there are many disorders that are associated with uveitis, this article will stay focused on the association between juvenile arthritis and uveitis.


Touching Video About JRA & Uveitis

Facts About Juvenile Arthritis

Almost 300,000 children under the age of 18 have been diagnosed with juvenile arthritis in the United States and many more children from around the world also suffer from juvenile arthritis. It is a chronic disease and the symptoms are generally felt in the child's joints as pain, swelling and stiffness. The most commonly affected joints are the child's knees, hands and feet. The symptoms may worsen in times of flare-up, may remain steady or may sometimes go away during times of remission.

Facts About Uveitis

Children who have juvenile arthritis are at risk for developing uveitis. Uveitis is the inflammation of the middle layer of the eye. The middle layer consists of the iris (colored portion of the eye) and the lens of the eye (back part of the uvea). If uveitis isn't diagnosed and treated early, the child is at risk for glaucoma, cataracts and permanent visual damage that can lead to blindness in one or both eyes. However, diagnosis can be difficult because the child may not experience symptoms until the eye is already damaged. Once symptoms do occur the onset may be rapid and include: blurred vision, dark floating spots, eye pain and sensitivity to light and redness of the eye(s). Uveitis is most treatable when detected early which is why frequent eye screenings in children who have juvenile arthritis can be critical to saving their sight.

If the inflammation occurs in the iris, the condition is referred to as iritis.

 

New Study Reveals Unexpected Findings About Uveitis in Children With Juvenile Arthritis

A recent study led by Dr. Saurenmann was done by a team of international researchers and published in the June 2010 issue of Arthritis and Rheumatism. Dr. Saurenmann and her cohorts found that 13% of the 1081 children in the study eventually developed uveitis.

Dr. Saurenmann's study may lead to changes in the most current pediatric guidelines because the findings of her international research team suggest that kids diagnosed with juvenile arthritis before age 5 should get eye exams every three months until 7 years after their diagnoses, which is more frequent than the current recommendations. Some other significant findings of this study that differ from what has been previously believed are:

  • The specific kind of arthritis that a child has (called a subtype) doesn't seem to correlate with the child's risk of getting uveitis (although there were a few exceptions).
  • Girls seem to be more at risk of developing uveitis than boys especially when the girl was younger than two when first diagnosed with juvenile arthritis.
  • Age at diagnosis of juvenile arthritis is correlated with increased risk of uveitis, especially for girls.

 

What Parents Need to Know About Juvenile Arthritis and Eye Exams

 In an article that appeared in Arthritis Today, which is published by the Arthritis Foundation, the chief of pediatric rheumatology at Johns Hopkins Children's Center, Dr. Edward Sills, stated that he was familiar with the Saurenmann study and feels it detected important points that practitioners need to be aware of. But he cautioned that kids who do not fall into the Saurenmannn high risk groups should still be having their eyes screened. Dr. Sills' advice to parents of all children diagnosed with rheumatoid arthritis is to have their children's eyes examined by an ophthalmologist at least twice a year and even more frequently if their child is in the higher risk groups identified by the Saurenmann study. This is vital because early diagnosis of uveitis  can allow effective treatment which can help maintain normal vision and minimize the risk of complications from uveitis possibly preventing blindness.

Treatment and Prognosis for Uveitis

Treatment and prognosis (future outcome) will vary depending on which part of the uvea is affected. If it is the iris the condition is called iritis and treatment consists of dark glasses, eye drops to dilate the pupils to relieve pain, and steroid eye drops to alleviate inflammation. With proper treatment for iritis, the condition will usually clear up within days or weeks, but may recur in the future.

If the back part of the uvea is affected, powerful anti-inflammatory medicines called corticosteroids and the use of antibiotics may be required. This is a more serious eye condition and the inflammation may last from months to years with the potential for permanent vision damage despite treatment. Possible complications may include cataracts, fluid within the retina with or without retinal detachment, glaucoma and vision loss.

Test Your Knowledge About Juvenile Arthritis and Uveitis

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Comments

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  • Happyboomernurse profile imageAUTHOR

    Gail Sobotkin 

    6 years ago from South Carolina

    Hi Ricky,

    Thanks so much for the specific feedback and your kind, supportive words and friendship. They mean so much to me.

    Fortunately, my niece is doing well now and is in college pursuing her dream for a career in medicine where she can help others.

    As a patient, she takes an active roll in collaborating with her physician regarding any treatments and keeping up on the latest medical literature about her condition. She is truly awesome and the family is very proud of her.

    In terms of the weather, I am looking forward to some more moderate temps which are being forecast for this week.

    Hub Hugs,

    Gail

  • thelyricwriter profile image

    Richard Ricky Hale 

    6 years ago from West Virginia

    HBN, first off, great informative article. I hope your niece is doing ok. I never have heard of this before, but I am glad to be aware of it now. I am sure many people will find this useful. Your work is always detailed and polished. Your a great writer Gail, hands down. I hate to see any child with complications, I am sure we all do. But if such occurs, glad they will be able to refer to this fantastic article HBN. Voted up and all across but funny. Hope all is well friend. I know it has been hot in mine and your area, so enjoy these cooler days. I know I will:) Take care friend.

  • Happyboomernurse profile imageAUTHOR

    Gail Sobotkin 

    7 years ago from South Carolina

    Thank you, Mickmc. I appreciate your support and am glad you're also writing on important health topics.

  • Mickmc profile image

    Mickmc 

    7 years ago

    Hi Gail, thanks for telling me about this uveitis hub. I will link to it from my juvenile arthritis hubs that I have just written. Keep up the great work!

  • Happyboomernurse profile imageAUTHOR

    Gail Sobotkin 

    7 years ago from South Carolina

    Welcome Peggy W,

    How very true. Thanks for stopping by and leaving a comment.

  • Peggy W profile image

    Peggy Woods 

    7 years ago from Houston, Texas

    It is wonderful to share information like this to raise awareness of this possible problem related to juvenile arthritis. Knowledge is power!

  • Happyboomernurse profile imageAUTHOR

    Gail Sobotkin 

    7 years ago from South Carolina

    Hi Prasetio30, it's always good to hear from you.

    Yes, our eyes are the window of the world. Glad you learned something new, and I appreciate your support and the vote up. I don't need to see you to know that your spirit is warm and sunny.

  • prasetio30 profile image

    prasetio30 

    7 years ago from malang-indonesia

    You have wonderful information. I always care with my eyes as the window of the world. Thanks for writing this. I learn something new from you. Good work, my friend. Vote up. Love and peace!

    Prasetio

  • Happyboomernurse profile imageAUTHOR

    Gail Sobotkin 

    7 years ago from South Carolina

    Hi Christine,

    I'm so glad to hear that you are already taking care of your vision by having regular eye exams. I am not sure about long term computer use as it pertains to someone who has Juvenile Rheumatoid Arthritis. I will try to research the answer and if I find out anything specific I will email you through HubPages.

    God bless you as you continue to do all you can to stay healthy.

  • Emily40 profile image

    Emily40 

    7 years ago

    Geat hub and thank you for sharing. I do suffer from Juvenile Rheumatoid Arthritis since age 11 and has to take regular eye check ups. So far my eyes are ok, thank God.

    Do you know if patients with J.R.A should stay away from certain things as much as they can, like being in front of the computer long or often.. Does it affect your eyes?

    Love

    Christine

  • Happyboomernurse profile imageAUTHOR

    Gail Sobotkin 

    7 years ago from South Carolina

    Thanks Schoolmarm,

    I appreciate you taking time to read my hub and leave a comment and am glad you learned something new from it. Yes, my niece is a wonderful young lady and we're proud of her.

  • schoolmarm profile image

    schoolmarm 

    7 years ago from Florida

    Wow, I had no knowledge of this either. Thank you for sharing. Best of luck to your niece, it sounds as though she is quite a wonderful young lady!

  • Happyboomernurse profile imageAUTHOR

    Gail Sobotkin 

    7 years ago from South Carolina

    Hi Katiem,

    A large part of my nursing career was spent caring for adults and seniors and I wasn't aware of juvenile arthritis until my great niece was diagnosed with it and developed the eye complications. It breaks your heart to see a small child suffer, but she's grown into an amazing young woman- very compassionate and wise for her age, and has just started college with the long range goal of becoming a doctor and/or medical writer. And she also dances, which is good therapy for the arthritis. I admire her ability to transcend the medical challenges she's faced and still faces, especially since she does so with joyful enthusiasm for life.

  • katiem2 profile image

    katiem2 

    7 years ago from I'm outta here

    Thank you for such important information. I had no idea there was such a condition as juvenile arthritis which poses a dangerous eye complication. I though both were an issue for the aging. It's nice to learn the truth about such issues. I appreciate your teaching us parents about juvenile concerns. :)Katie

  • Happyboomernurse profile imageAUTHOR

    Gail Sobotkin 

    7 years ago from South Carolina

    Hi Acaetnna,

    Thanks so much for taking time to read my hub and leave a comment. Yes, sight is something we tend to take for granted until something threatens it. The good news is that if people seek medical care early there are many treatments that can help.

    Hi BobbiRant, Most people think arthritis only affects the elderly, but unfortunately some kids get it, too.

    Sorry about your mom's loss of vision due to complications from diabetes. Although we have many treatments available for eye problems, diabetes is still one of the leading causes of blindness.

  • BobbiRant profile image

    BobbiRant 

    7 years ago from New York

    I did not know this about juvenile arthritis, but I did know my mom lost her sight from diabetes and it was awful. Great hub about this subject.

  • acaetnna profile image

    acaetnna 

    7 years ago from Guildford

    Oh my goodness I am so pleased I read this informative hub. Our sight is so precious and we must be on our guard for any warning signs.

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