Diagnosis and treatment of juvenile idiopathic arthritis-associated uveitis.
OBJECTIVE
This review surveys publications from peer-reviewed literature published since 2001on the matter of uveitis associated with juvenile idiopathic arthritis.


RESULTS
Uveitis associated with juvenile idiopathic arthritis (JIA) continues to blind substantial numbers of children every year, even in the most developed of societies. This is so because of delayed diagnosis (as a consequence of the silent, asymptomatic nature of ocular inflammation in some patients), and because of delayed referral by general ophthalmologists of children with JIA-associated uveitis to ocular immunologists prepared to move on to systemic immunomodulatory therapy in those instances where the child's uveitis is chronic or continues to recur with each attempt at tapering corticosteroid. The evidence for this is vast.


CONCLUSIONS
Progress in the matter of reducing the prevalence of blindness secondary to this disease will require the increasing willingness of the world's ophthalmologists to refer patients with JIA-associated uveitis much earlier in the course of his or her disease for consideration of immunomodulatory therapy, and will require legislation mandating visual acuity testing in children attending day care centers.
Foster
C Stephen
CS
Ocular Immunology and Uveitis Service, Massachusetts Eye and Ear Infirmary, Boston, 02114, USA. fosters@uveitis.org
D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000150:complications*; D005901:Glaucoma / Q000209:etiology / Q000601:surgery; D006130:Growth Disorders / Q000139:chemically induced; D006801:Humans; D015995:Prevalence; D014605:Uveitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D014786:Vision Disorders / Q000453:epidemiology / Q000209:etiology
D000305:Adrenal Cortex Hormones