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An update on the modern management of paediatric uveitis
  1. Jessy Choi1,
  2. Daniel P Hawley2,
  3. Jane Ashworth3,
  4. Clive Edelsten4,
  5. Alexander S A M Bossuyt5
  1. 1 Department of Ophthalmology, Sheffield Children's Hospital, Sheffield, UK
  2. 2 Department of Rheumatology, Sheffield Children's Hospital, Sheffield, UK
  3. 3 Manchester Royal Eye Hospital, Manchester, UK
  4. 4 Department of Ophthalmology, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
  5. 5 Medical School, University of Nottingham, Nottingham, UK
  1. Correspondence to Jessy Choi, Ophthalmology, Sheffield Children's Hospital, Sheffield S10 2TH, UK; jessy.choi{at}nhs.net

Abstract

Uveitis in children and young people (CYP) is often painless, chronic and persistent. It is an often silent blinding condition. Uveitis can be isolated or develop as a manifestation of a systemic disease. Due to the symptomless nature, it can present late with advanced ocular comorbidities such as band keratopathy, hypotony, cataracts. Inadequate control of the eye inflammation can result in permanent and severe ocular complications, structural damage and visual loss. One of the most common systemic associations is juvenile idiopathic arthritis where uveitis has a cumulative incidence of approximately 10%–14% (though wide variation in incidence is reported) after 5 years. Appropriately targeted uveitis screening is recommended to continue for at least 7 years in some subgroups. Paediatric uveitis poses multiple diagnostic and therapeutic challenges. Clinical manifestation and disease course may differ significantly from adult-onset uveitis. However, some CYP are still managed by adult specialists alone, without the opportunity for the prompt use of National Health Service England approved therapy. Optimal management of paediatric uveitis requires a multidisciplinary approach involving coordinated working of different specialities and healthcare professionals. This article highlights the evidence-based practice for the contemporary management of paediatric uveitis to readers in different specialities who may come across this condition. It raises awareness of early systemic treatment aiming to achieve early and complete disease inactivity thereby improving the chances of a long-term positive outcome.

  • paediatric uveitis
  • juvenile idiopathic arthritis
  • band keratopathy
  • cataract
  • hypotony
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Footnotes

  • Contributors JC conceived of the idea for the article with DH, JA and CE. AB performed the literature search and writing of the article; with input from JC, DH, JA and CE. JC is the guarantor for this article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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