Uveitis, Anterior, Childhood Follow-up

  • Author: R Christopher Walton, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: May 2, 2012
 

Further Outpatient Care

  • Follow-up care is on a case-by-case basis and depends on the cause of the uveitis, the severity of the uveitis, and the medications used in treatment.
    • In the short term, adequate control of the inflammation must be assessed and monitored. Intraocular pressure must be monitored as elevations may result from inflammation, corticosteroid treatment, or both.
    • Longer term follow-up care additionally focuses on the formation of cataracts, cystoid macular edema, angle-closure glaucoma, and band keratopathy, in addition to the previously mentioned areas.
    • General medical evaluations are required for those patients on systemic immunosuppressants, such as prednisone and methotrexate.
  • The German Uveitis in Children Study Group recommends screening examinations for children with JIA as outlined below.
    • Children with JIA and no previous history of uveitis
      • Oligoarthritis, RF-negative polyarthritis, or early childhood psoriatic arthritis: Screening examinations should be conducted at 6-week intervals for 2 years, then every 3 months for the next 5 years.
      • Systemic arthritis or RF-positive polyarthritis: Screening examinations should be conducted every 3 months for 7 years.
      • Enthesitis-associated arthritis or late onset psoriatic arthritis: Screening examinations should be conducted every 6 months.
    • Children with JIA and a history of uveitis: The intervals of screening examinations should be adjusted based upon the activity and the treatment of the uveitis.
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Inpatient & Outpatient Medications

  • See Medication.
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Complications

Complications of uveitis may include the following:

  • Band keratopathy
  • Cataract
  • Glaucoma
  • Synechiae
  • Cystoid macular edema
  • Amblyopia
  • Hypotony
  • Phthisis
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Prognosis

  • Prognosis in juvenile anterior uveitis varies greatly for the different causes. Systemic infections and Kawasaki disease have relatively benign courses. Uveitis associated with inflammatory bowel disease may be very mild or recurrent and of moderate severity. Reactive arthritis and AS may cause severe recurrent episodes of fibrinous inflammation.
  • Prognosis in sarcoid uveitis may vary widely; intractable cases leading to blindness do occur.
  • Uveitis related to JIA requires aggressive and careful follow-up, as it continues to be a blinding condition. Aggressive and persistent treatment of uveitis is required to avoid the severe complications, which may evolve insidiously.
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Patient Education

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Contributor Information and Disclosures
Author

R Christopher Walton, MD  Professor, Director of Uveitis and Ocular Inflammatory Disease Service, Department of Ophthalmology, University of Tennessee College of Medicine

R Christopher Walton, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Healthcare Executives, American Uveitis Society, Association for Research in Vision and Ophthalmology, and Retina Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Gerhard W Cibis, MD  Clinical Professor, Director of Pediatric Ophthalmology Service, Department of Ophthalmology, University of Kansas School of Medicine

Gerhard W Cibis, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and American Ophthalmological Society

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Steve Charles, MD  Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine; Adjunct Professor of Ophthalmology, Columbia College of Physicians and Surgeons; Clinical Professor Ophthalmology, Chinese University of Hong Kong

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Club Jules Gonin, Macula Society, and Retina Society

Disclosure: Alcon Laboratories Consulting fee Consulting; OptiMedica Ownership interest Other; Topcon Medical Lasers Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous coauthor, Peter H Spiegel, MD, to the development and writing of this article.

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