May 31, 2019 Conference
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
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