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Letter
Recurrent hypopyon in chronic anterior uveitis of pauciarticular juvenile idiopathic arthritis
  1. J H Chang1,
  2. P J McCluskey1,
  3. J R Grigg2
  1. 1Department of Ophthalmology, St Vincent’s Hospital, Sydney, and Laboratory of Ocular Immunology, School of Medical Sciences, University of NSW, Sydney, Australia
  2. 2Department of Ophthalmology, Sydney Eye Hospital, Sydney, and Children’s Hospital at Westmead, Sydney, Australia
  1. Correspondence to: Dr John H Chang Department of Ophthalmology, St Vincent’s Clinic, 1004/438 Victoria Street, Darlinghurst, NSW 2010, Australia; jhchang{at}optusnet.com.au

https://doi.org/10.1136/bjo.2006.096313

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    The typical ocular manifestation of pauciarticular juvenile idiopathic arthritis (JIA) is an insidious, non-granulomatous chronic anterior uveitis (CAU). The main risk factors for the development of uveitis in JIA are being female, antinuclear antibody (ANA) positivity, and oligoarticular disease at onset.1,2 Even during acute exacerbations of JIA associated CAU with severe anterior chamber (AC) cellular reaction, it is rare for patients to have symptoms and the eye is invariably white.1,2 This is in distinct contrast to the acutely symptomatic red eye of acute anterior uveitis (AAU). Hypopyon can form within the AC in severe forms of anterior uveitis, particularly HLA-B27 associated AAU.3–5 We report a case of CAU in a patient with pauciarticular JIA, which was complicated by the development of recurrent hypopyon.

    Case report

    A 4 year old white girl first presented with blurred vision in her right eye and was found to have a unilateral, non-granulomatous CAU with extensive posterior synechiae and early band keratopathy. She was initially treated with intensive topical corticosteroids …

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