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Clinical Course of Ocular Hypotony in Pediatric Uveitis

Nida Khan1, Parthopratim Dutta Majumder1, Amala Elizabeth George1

  • 1Uvea Services, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, India.

Ocular Immunology and Inflammation
|April 7, 2026
PubMed

Insights

Ocular hypotony in pediatric uveitis is a serious complication. Despite aggressive management, many eyes had limited recovery, with nearly a quarter progressing to phthisis, highlighting the need for early diagnosis and monitoring.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Uveitis Management

Background:

  • Ocular hypotony, a severe complication of pediatric uveitis, can lead to significant vision loss.
  • Effective management strategies for pediatric uveitis-associated hypotony are crucial for preserving ocular health.

Purpose of the Study:

  • To evaluate the clinical course and outcomes of ocular hypotony in children diagnosed with uveitis.
  • To assess the effectiveness of various medical and surgical interventions for managing pediatric uveitis-induced hypotony.

Main Methods:

  • Retrospective review of electronic medical records for pediatric patients with uveitis and subsequent ocular hypotony.
  • Analysis of treatment modalities including topical/oral therapies, periocular injections, intravitreal steroids, and surgical interventions (silicon oil insertion, pars plana vitrectomy with ciliary body membrane removal).

Main Results:

  • The study included 41 eyes from 30 pediatric patients. Panuveitis was the most common diagnosis (61%).
  • 39% of eyes showed improved intraocular pressure (IOP) after treatment. However, 22% of eyes progressed to phthisis.
  • Visual acuity showed a slight improvement from baseline (2.08 log MAR) to last visit (1.82 log MAR).

Conclusions:

  • Pediatric uveitis-associated ocular hypotony is a severe condition with challenging outcomes.
  • Aggressive medical and surgical treatments yielded limited recovery in a significant proportion of cases, with a notable rate of progression to phthisis.
  • Emphasizes the critical need for early detection, individualized treatment plans, and diligent monitoring to optimize visual and anatomical results in affected children.
Abstract

Keywords:
JIA-associated uveitisocular hypotonypediatric uveitisphthisis

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