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How Juvenile Arthritis Affects the Eyes

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What will happen during my child's appointment with an ophthalmologist? continued...

Before the eye exam, the ophthalmologist will put drops in your child's eyes to make the pupils dilate. The drops may burn a little, but it helps the doctor get a clear view inside the eyes.

To diagnose eye inflammation, the ophthalmologist uses a special kind of microscope. With it, the doctor will shine a thin beam of light into one eye at a time so he can view the inside of each eye.

The doctor might also give your child a “visual field” test to check for any vision changes. This type of exam measures peripheral vision, meaning how far your child can see to the side when she focuses her gaze on a central point.

You should carefully follow the medicine guidelines that your child’s doctor provided. Keep all appointments with the rheumatologist and the ophthalmologist.

How often should my child have eye examinations?

That depends on what type of juvenile arthritis she has, how long she has had it, and what medications she takes. Ask your rheumatologist for the schedule.

Uveitis is more common in children with certain types of juvenile arthritis, such as what doctors call the “oligoarticular variant,” where just a few joints are affected. A child with this type of juvenile arthritis might need to get her eyes checked every 3 to 4 months. In general, children with polyarthritis need an eye exam every 6 months. Children with systemic juvenile arthritis usually need an examination every 12 months.

Your child should also keep up with her eye tests after the juvenile arthritis goes into remission.

If any eye problems turn up, your child will need to get checked more often.

What’s the treatment for eye problems linked to juvenile arthritis?

Your rheumatologist and ophthalmologist will work with you on this. If your child has uveitis, she might need prescription eyedrops.

Some of these eyedrops dilate the eyes in order to keep the pupils open and help to prevent scars.

Your child might also be prescribed steroid eyedrops. For example, your child might use cortisone drops to curb swelling and lower inflammation. Long-term use of steroid eyedrops can have serious side effects, including glaucoma and cataracts.

If eyedrops don’t lower inflammation enough, your child might need to take steroid pills. To avoid long-term side effects of steroids, your child might also get a drug called methotrexate, which they would take by mouth or as a shot.

Severe cases of uveitis may need different kinds of drugs that treat immune system conditions.

WebMD Medical Reference

Reviewed by David Zelman, MD on April 15, 2015
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