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Special considerations in the evaluation and management of uveitis in children
Gary N Holland1, E Richard Stiehm
1Ocular Inflammatory Disease Center, Jules Stein Eye Institute, Los Angeles, California 90095-7003, USA. uveitis@jsei.ucla.edu
Purpose:
To review issues related to the diagnosis, examination, and treatment of children with uveitis that are important for ophthalmologists.
Design:
Literature review.
Method:
A review was made of pertinent reports from the medical literature, with commentary based on the authors' experiences and on discussions at an international workshop.
Results:
There are differences between children and adults in the differential diagnosis and manifestations of uveitis that should be considered during evaluation. There may be a higher risk of some ocular complications such as uveitic glaucoma, and the presence of other unique complications, such as amblyopia, in young patients during follow-up. With regard to treatment, children with uveitis may have unique dosing requirements and drug-associated risks such as growth retardation with systemic corticosteroids that must be considered. Examination and treatment may also be more difficult with children because of problems with patient cooperation.
Conclusions:
There are unique patient care issues associated with uveitis in children that must be considered by care providers. Attention to these issues will improve the well-being of this patient population.