Pediatric uveitis: Role of the pediatrician

Abstract

The challenges of childhood uveitis lie in the varied spectrum of its clinical presentation, the often asymptomatic nature of disease, and the evolving nature of the phenotype alongside normal physiological development. These issues can lead to delayed diagnosis which can cause significant morbidity and severe visual impairment. The most common ocular complications include cataracts, band keratopathy, glaucoma, and macular oedema, and the various associated systemic disorders can also result in extra-ophthalmic morbidity. Pediatricians have an important role to play. Their awareness of the various presentations and etiologies of uveitis in children afford the opportunity of prompt diagnosis before complications arise. Juvenile Idiopathic Arthritis (JIA) is one of the most common associated disorders seen in childhood uveitis, but there is a need to recognize other causes. In this review, different causes of uveitis are explored, including infections, autoimmune and autoinflammatory disease. As treatment is often informed by etiology, pediatricians can ensure early ophthalmological referral for children with inflammatory disease at risk of uveitis and can support management decisions for children with uveitis and possible underling multi-system inflammatory disease, thus reducing the risk of the development of irreversible sequelae.

Diagnosis and Treatment of Uveitis in Children: A Summary of the Latest Data from a 5-Year Literature Review (2018–2023)

“…The clinical presentation of uveitis can provide diagnostic clues to facilitate the identification of the relevant disease entity underpinning the ongoing inflammatory process in the eye. Table 2 [ 2 , 13 , 19 , 20 ] and Table 3 [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ] list the symptoms characteristic of uveitis for each disease entity, categorized by infectious and non-infectious agents.…”

“…Most often bilateral posterior CNS, less often anterior CNS with hypopyon. Other observable signs: inflammation of the iris, ciliary body, cornea, epiretinal inflammation, vitreous hemorrhage, cataract, glaucoma, retinal detachment, and aphthous oral ulcer [25].…”

Isolated Depo-Medrol Administration under Tenon’s Capsule for Post-COVID-19 Uveitis in a Child: A Case Report and Literature Review

“…However, systemic steroid therapy can lead to significant adverse effects, including growth and development delays, psychosis, osteoporosis, cataracts, gastrointestinal issues (e.g., peptic ulcers, candidiasis), dermatological problems (hirsutism, striae, impaired wound healing) and hormonal disturbances (weight gain, adrenal suppression, hypertension, hyperglycemia) [ 38 ].…”