How Juvenile Arthritis Affects the Eyes
What will happen during my child's appointment with an ophthalmologist?
Tell the ophthalmologist about the medicines that your child is taking. You can get the names of the medicines, the dosages, and the reasons they have been prescribed from your rheumatologist.
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 dilating the eyes 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 or she can view the inside of each eye.
The doctor might also perform a visual field exam to determine if vision has changed in any way. This type of exam measures peripheral vision, meaning how far the patient can see to the side when the eye is focused on a central point.
You should carefully follow the medicine guidelines given by your child's health care provider. You should also keep all scheduled appointments with the rheumatologist and the ophthalmologist.
How often should my child have eye examinations?
The frequency of eye exams for your child will depend on what type of juvenile arthritis he or she has. It will also depend on how long he or she has had the disease and on what medications he or she is taking for treatments.
Uveitis is more common among children with certain types of juvenile arthritis, such as oligoarthritis. A child with this type of juvenile arthritis might be scheduled for eye examinations every three to four months. In general, children with polyarthritis need an eye exam every six months. Children with systemic juvenile arthritis usually need an examination every 12 months.
Your child should also continue to receive eye examinations after the juvenile arthritis goes into remission.
Ask your rheumatologist and ophthalmologist about the frequency of your child's eye examinations. Then follow those specific recommendations. If eye problems are detected, your child will need more frequent examinations.
How are eye problems associated with juvenile arthritis treated?
If eye problems do occur, your rheumatologist and ophthalmologist will discuss treatment methods to prevent permanent eye and vision damage. If your child is diagnosed with uveitis, different types of eye drops might be prescribed. Your child might need eye drops to dilate the eyes in order to keep the pupils open and help prevent scarring.
Your child might also be prescribed steroid eyedrops. For example, your child might use cortisone drops to reduce swelling and decrease inflammation. Long-term use of steroid eyedrops, however, can have serious side effects, including glaucoma and cataracts.
If eyedrops do not decrease the inflammation adequately, your child might be prescribed oral steroids to be taken by mouth. To avoid long-term side effects of steroids, your child might be prescribed a drug called methotrexate in oral or injectable form. For severe cases of uveitis newer types of drugs might be treated with newer drugs, such as Remicade, that are used to treat autoimmune diseases.