Twee kinderen met reuma en uveïtis: het klinisch belang van oogheelkundige screening bij kinderen met jeugdreuma

- Two girls, aged 8 and 13 years, with a history of arthritis presented with already advanced uveitis. Neither girl had been screened for uveitis by an ophthalmologist according to the recommendations of the American Academy of Pediatrics. Both patients had extensive posterior synechiae (adhesions between lens and iris) at their first ophthalmologic examination, which is associated with an unfavourable prognosis. At the last follow-up, the first patient had undergone seven ocular operations: five for glaucoma and two cataract surgeries. Uveitis occurs in 20 of children with juvenile idiopathic arthritis. The visual outcome of uveitis is negatively influenced by the presence of ocular complications at the first ophthalmologic examination. Ophthalmologic screening of children with juvenile idiopathic arthritis is very important because it is a common cause of uveitis in childhood, the uveitis is usually asymptomatic, and there are sight-threatening complications. Screening is always important, even when the arthritis is in remission.

Ned Tijdschr Geneeskd. 2006;150:2289-93