Uveitis

What is uveitis?

Uveitis is inflammation of the uveal tissue—or middle layer—of the eye, which includes the iris (colored part of the eye), the ciliary body, and the choroid. The inflammation can damage structures, such as the lens, retina, or optic nerve, and it may affect the blood vessels, causing interrupted blood supply to the eye.

Uveitis can be caused by an autoimmune disease, such as juvenile arthritis, or by an infection or injury. In about half the cases of uveitis in children, the cause is unknown.

Uveitis is relatively rare in children but can lead to permanent vision damage or blindness if left untreated.

What are the symptoms of uveitis?

Initially, your child may experience no symptoms, or they may be vague, such as a complaint of blurry vision. Regular eye checkups are critical for children with certain autoimmune disorders to check for this disease.

In children with symptoms, they may include:

• Eye pain
• Redness in the eyes
• Headache
• Sensitivity to light
• Floaters, or floating spots in vision

An exam from pediatric ophthalmologist can detect uveitis in children.

How is uveitis diagnosed?

It is important to diagnose uveitis early to prevent eye damage. Children with underlying autoimmune conditions may need regular eye exams to look for uveitis, even if they are not experiencing symptoms.

A pediatric ophthalmologist (eye doctor) will look for uveitis through a careful examination using a special microscope called a slit lamp. The ophthalmologist will give your child eyedrops to dilate the pupil, which may cause a little discomfort. The exam is otherwise painless and takes a few minutes.

Children who are diagnosed with uveitis, but who have no known underlying conditions, will be referred to a pediatric rheumatologist to look for underlying causes and to help manage treatment. Rheumatologists have experience with inflammatory conditions and the medications used to treat them.

Your pediatric rheumatologist will work closely with a pediatric ophthalmologist in the diagnosis, treatment, and monitoring of uveitis.

How is uveitis treated?

Physicians at the Pediatric Rheumatology Program work closely with Columbia’s pediatric ophthalmologists to treat uveitis in children.

Uveitis is treated with medications, which may include drops, injections, or oral medications. Treatment will depend on the type, cause, and severity of your child’s condition.

Generally, treatment begins with local medications, given in the form of drops. These include pupil dilators to help prevent scarring and steroids to reduce inflammation.

When drops aren’t effective, your physician will try other medications, which may include methotrexate or other oral or injectable medications. For some cases, injectable treatments called biologics may be used.

Follow Up Care for Uveitis

Your child will be scheduled for regular follow up appointments with both an ophthalmologist and rheumatologist. It is important to continue with your child’s care even when no symptoms are apparent, because uveitis can cause lasting damage to the eye. With early diagnosis and treatment, along with regular follow up appointments, we can help preserve your child’s vision.