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Inflammatory eye disease (uveitis) can
develop as a complication in children who have
juvenile idiopathic arthritis (JIA). Children and
adults who have JIA can develop
corneal degeneration (band keratopathy), or vision
The incidence of eye disease is 2 to 34 out of 100 children who have JIA.footnote 1 It is most common in oligoarticular and RF-negative polyarticular forms of the disease. Eye disease associated with JIA often has no
symptoms, although blurred vision may be an early sign. To prevent eye problems
from progressing to the point that vision loss occurs, regular eye examinations
ophthalmologist are very important for children who
Eye disease develops in about 30 out of 100 children who have
oligoarticular JIA, particularly children who have a positive
antinuclear antibody (ANA) test result.footnote 2
Early detection and treatment of inflammatory eye disease gives a child
the best chance of a good outcome. Discuss the appropriate examination schedule
with your doctor. Your doctor will consider many things when deciding how often to recommend an eye examination. He or she will think about the type of arthritis, the age of
the child when the disease began, how long the child has had JIA, and whether
or not eye disease is present. Over time, the child may need fewer examinations each year. But he
or she should continue to have regular eye examinations.
children with inflammatory eye disease maintain good vision. Some do
If eye disease occurs, most children are treated with
corticosteroids and prescription eyedrops. More severe or continuing eye
disease may require other medicines such as methotrexate. If eye disease does
not respond to these treatments, either cyclosporine or TNF inhibitors such as
etanercept may help.footnote 3
The outlook for
inflammatory eye disease has improved. Early and aggressive treatment of
uveitis has reduced the complications of eye disease in JIA. Before treatment
with methotrexate and TNF inhibitors became common, only about 1 out of 4
children had a good long-term vision outcome. Today, because of early
treatment and better medicines, children with eye inflammation have a better
chance of having a good vision outcome with less treatment.footnote 1
Cassidy J, et al. (2006). Ophthalmologic examinations in children with juvenile rheumatoid arthritis. Pediatrics, 117(5): 1843–1845.
Nistala K, et al. (2009). Juvenile idiopathic arthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 8th ed., vol. 2, pp. 1657–1675. Philadelphia: Saunders Elsevier.
Giannini EH, Brunner HI (2005). Treatment of juvenile rheumatoid arthritis. In WJ Koopman, LW Moreland, eds., Arthritis and Allied Conditions, 15th ed., vol. 1, pp. 1301–1318. Philadelphia: Lippincott Williams and Wilkins.
Other Works Consulted
Hsu JJ, et al. (2013). Treatment of juvenile idiopathic arthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 9th ed., vol. 2, pp. 1752–1770. Philadelphia: Saunders.
ByHealthwise StaffPrimary Medical ReviewerSusan C. Kim, MD - PediatricsE. Gregory Thompson, MD - Internal MedicineMartin J. Gabica, MD - Family MedicineSpecialist Medical ReviewerJohn Pope, MD - Pediatrics
Current as ofFebruary 24, 2016
Current as of:
February 24, 2016
Susan C. Kim, MD - Pediatrics
& E. Gregory Thompson, MD - Internal Medicine & Martin J. Gabica, MD - Family Medicine & John Pope, MD - Pediatrics
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