Endogenous uveitis in children

Abstract

Endogenous uveitis, with its ocular sequalae, accounts for a significant number of blind children in the world today. Even though these children are asymptomatic by ophthalmic history, they usually present with ocular pathology compatible with chronic intraocular inflammation. Although loss of vision is invariably due to cataract formation, fluorescein angiogram, binocular indirect ophthalmoloscopy, and fundus contact lens examination often reveal pathology of the optic nerve and retina, accounting for a significant degree of visual loss. While actual etiologic agents are usually not identified in the majority of children, toxoplasmosis, sarcoidosis, and childhood arthropathies occur with such high frequency that mention is made of these diseases. Conventional surgical procedures for ocular sequalae such as cataract and glaucoma, are known to yield poor results. Corticosteroids administered either topically, periocularly, or systemically appear to be of value in the treatment of these diseases, although control studies have not been done. Efforts to lessen the visual morbidity in these children should begin by a cross-fertilization of information between primary care physicians, pediatricians, and ophthalmologists.