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Episcleritis in childhood
R W Read1, A H Weiss, D D Sherry
1Department of Ophthalmology, University of Washington, Seattle, USA. russellr@hsc.usc.edu
Insights
Episcleritis is rare in children, particularly under age five. Older children with episcleritis often have associated rheumatologic diseases, highlighting the need for systemic evaluation.
Area of Science:
- Ophthalmology
- Pediatrics
- Rheumatology
Background:
- Episcleritis, inflammation of the episclera, is uncommon in pediatric populations.
- Understanding its characteristics and associations is crucial for diagnosis and management.
Purpose of the Study:
- To characterize childhood episcleritis.
- To identify associations with systemic diseases in affected children.
Main Methods:
- Retrospective observational case series.
- Review of 12 children diagnosed with episcleritis between 1981 and 1998.
- Inclusion of complete ocular and systemic evaluations.
Main Results:
- The study included 12 children (10 boys, 2 girls) aged 13 months to 16 years.
- Six of nine children over five years old had rheumatologic conditions including lupus, juvenile rheumatoid arthritis, and inflammatory bowel disease.
- Children under five had simple episcleritis and antecedent viral illness.
Conclusions:
- Episcleritis is rare in childhood, especially in those under five.
- Older children with episcleritis frequently present with underlying rheumatologic diseases.
Objective:
To describe the characteristics and systemic disease associations of episcleritis in childhood.
Design:
Retrospective, observational case series.
Participants:
Twelve children diagnosed with episcleritis between July 1981 and June 1998. METHODS/TESTING: Complete eye and systemic evaluations.
Main Outcome Measures:
Characteristics of episcleritis and presence and nature of concurrent systemic disease.
Results:
The 12 children (10 boys and 2 girls) ranged in age from 13 months to 16 years. Five children had bilateral simple episcleritis, one had bilateral nodular episcleritis, and six had unilateral simple episcleritis. The eye examination was otherwise normal and recovery was uneventful in all cases. Six of the nine children older than 5 years of age had one of the following rheumatologic diseases: systemic lupus erythematosus, juvenile rheumatoid arthritis, spondyloarthropathy, inflammatory bowel disease, rheumatic fever, or polyarteritis nodosa. All three children younger than 5 years of age had simple episcleritis, an antecedent viral illness, and presented within 2 months of each other.
Conclusions:
Episcleritis is a rare occurrence in childhood, especially in children younger than 5 years of age. In older children, it is frequently associated with rheumatologic disease.