[Juvenile uveitis]

Chronic anterior uveitis in children suffering from juvenile rheumatoid arthritis may develop very early, when the patient is as young as two or three years old; it affects twice as many girls as boys. The arthritis is often localized in one joint (pauciarticular or oligoarticular form); Still's syndrome is very rare. Local treatment with cycloplegics and steroids has to be combined with systemic immunosuppressive medication with cyclophosphamide. Chronic intermediate uveitis (pars planitis) usually affects teenagers in good health. Peripheral fundus changes can be detected most easily by biomicroscopy with the three-mirror contact lens. Cystoid macular edema is frequent and, together with vitreous opacities, is responsible for a deterioration in central vision. In most cases local treatment with subconjunctival injection of depot steroids is sufficient. Immunosuppressive treatment or surgical intervention is only indicated in severe cases where there is a risk of complete loss of vision.