Juvenile Arthritis: How it Affects Your Eyes

Medically Reviewed by Dr. K on 12 April 2021

Table of Contents:

 

  1. How Juvenile Arthritis Affects the Eyes
  2. Symptoms To Look Out For
  3. Ophthalmology Appointments
  4. How often should my child have eye examinations?
  5. Treatment for Juvenile Arthritis of the Eyes

 

 

How Juvenile Arthritis Affects the Eyes

The most common type of arthritis that affects children is juvenile arthritis, also known as juvenile rheumatoid arthritis or childhood arthritis. Many parts of the body, including the eyes, may be affected by it.

Children with juvenile arthritis can develop eye problems. The disease or the medications the child is taking for the disease may be causing the problems too.

Inflammation in part of the eye called uvea is the most common eye infection. This condition is called “uveitis”. It’s also known as iritis or iridocyclitis when it affects specific parts of the uvea.

The eye may be deeply affected by untreated and severe uveitis. It can also lead to eyesight problems, such as:

  • Glaucoma, a condition resulting in high pressure in the eye
  • Cataracts, a clouding of the eye’s lens
  • Blindness, as well as permanent vision loss

The onset of uveitis will occur up to a year before your child is diagnosed with juvenile arthritis. It may occur at the same time or several years later. It can also happen years after the disease has gone into remission, which means it is no longer active.

Symptoms To Look Out For

It is possible that eye inflammation is not painful. Normally the eyes are not as red as they are in conjunctivitis. There may be no obvious symptoms for several children with juvenile arthritis who develop eye problems.

Although it’s uncommon, children can experience blurred vision or have light irritate their eyes. A child’s eyes can appear red or blurry at times. However, since these signs normally appear gradually, permanent eye damage can occur before they experience any vision problems.

Your rheumatologist (a doctor who specialises in treating arthritis) will schedule frequent appointments with a paediatric ophthalmologist in order to detect any eye problems and prevent them from causing harm. A paediatric ophthalmologist is a doctor who specialises in the treatment of children’s eye diseases.

Ophthalmology Appointments

Inform the ophthalmologist about your child’s medications. Your rheumatologist will provide you with the names of the medications, their dosages, and the reasons for their prescription.

The ophthalmologist will put drops in your child’s eyes to dilate the pupils during the eye exam. The drops may sting a little, but they allow the doctor to see inside the eyes clearly.

The ophthalmologist uses a special type of microscope to diagnose eye inflammation. It allows the doctor to see the inside of each eye by shining a thin beam of light into one eye at a time.

Your child’s doctor can also perform a visual field examination to check for any vision changes. This test examines your child’s peripheral vision, or how far they can see to the side while their attention is fixed on a central point.

You should strictly adhere to the medication instructions given by your child’s doctor. Keep all of your rheumatologist and ophthalmologist appointments.

How often should my child have eye examinations?

That depends on the type of juvenile arthritis, how long they’ve had it, and what medications they’re taking. Request a timetable from your rheumatologist.

Uveitis is more common in children who have certain forms of juvenile arthritis, such as the “oligoarticular variant," which affects only a few joints. Children may need to have their eyes checked every 3 to 4 months with this type of juvenile arthritis. Children with polyarthritis should have their eyes examined every 6 months. Children with systemic juvenile arthritis should be examined every 12 months.

After the juvenile arthritis has gone into remission, your child should keep up with their eye exams.

If your child has any eye issues, he or she will need to be checked more frequently.

Treatment

This will be discussed with your rheumatologist and ophthalmologist. If your child has uveitis, prescription eye drops may be needed.

Some of these eye drops dilate the pupils to avoid scarring by keeping them open.

In some cases, your child may be prescribed eye drops with steroids. For instance, your child may use cortisone drops to stop inflammation and swelling. Usage of steroid eye drops for a long period of time can have serious side effects, including glaucoma and cataracts.

If eye drops aren’t enough to reduce inflammation, your child will need to take anti-inflammatory medicine. To prevent the long-term side effects of steroid drugs, your child may be prescribed methotrexate, which they may take orally or by injection.

For severe cases of uveitis, different types of immune system drugs may be needed.

Sources

Referenced on 9.4.2021

  1. https://www.webmd.com/rheumatoid-arthritis/guide/how-juvenile-arthritis-affects-the-eyes
  2. Arthritis Foundation: “Juvenile Rheumatoid Arthritis."
  3. American College of Rheumatology: “Juvenile Idiopathic Arthritis."
  4. Arthritis Foundation: “Juvenile Rheumatoid Arthritis: Treatment Options."
  5. The Johns Hopkins Arthritis Center: “Rheumatoid Arthritis Treatment."

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