Diagnosis and treatment of juvenile idiopathic arthritis-associated uveitis

Abstract

Purpose of review: This review surveys publications from peer-reviewed literature published since 2001on the matter of uveitis associated with juvenile idiopathic arthritis.

Recent findings: 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.

Summary: 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.