May 31, 2019 Conference


Pediatric Anterior Uveitis- Part I

Return to Session

Debra Goldstein, northwestern university dept of ophthalmology (Presenter)

Pediatric anterior uveitis - Pearls for diagnosis and management.

Classification of uveitis based on location, timing, laterality, clinical features, associated systemic findings



Onset and duration

  -Sudden or insidious onset, short or long duration

    Unilateral or bilateral

    Granulomatous or non-granulomatous

Systemic features: preceding systemic infection? Antibiotic use? Malaise? Respiratory symptoms? Joint symptoms? GI? Skin rashes?

    **infectious vs non-infectious

Common diagnoses

JIA-associated uveitis. Typically bilateral, chronic, anterior, non granulomatous. ANA+. Pauciarticular srthritis. Most common pitfall: treating as recurrent acute rather than chronic disease. Better outcomes with early institution of immunomodulatory therapy.

TINU. Tubulointerstitial nephritis and uveitis syndrome. Classically presents as bilateral acute anterior uveitis. Often with preceding systemic illness. Posterior segment findings may be under-reported. Often need systemic immunomodulatory therapy

HLA-B27 associated. Typically recurrent acute anterior uveitis, one eye at a time. First episode may be bilateral. May be severe and fibrinous, with hypopyon. Ask about low back pain and stiffness, worse with inactivity.

Granulomatous uveitis. Think of sarcoidosis, Blau syndrome, TB