Uveitis, Anterior, Childhood Follow-up

Updated: Jun 17, 2016
  • Author: Manolette R Roque, MD, MBA, FPAO; Chief Editor: Hampton Roy, Sr, MD  more...
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Follow-up

Further Outpatient Care

Follow-up 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.

Screening examinations recommended by the German Uveitis in Children Study Group

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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