How Juvenile Arthritis Affects The Eyes?

June 9, 2009 by · Leave a Comment
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Juvenile arthritis is an autoimmune disease. That means the immune system attacks its own body. The disease is known by several names: juvenile rheumatoid arthritis, childhood arthritis, and Still’s disease. It is the most common type of arthritis to affect children.  In juvenile arthritis, the immune system targets the tissue that lines the inside of joints. That tissue is known as the synovium. The synovium’s response is to make excess fluid called synovial fluid. That causes swelling, pain, and stiffness. Inflammation may cause damage to cartilage and bone and may spread to other parts of the body, such as the eyes.

But, how does juvenile arthritis affect the eyes?  A child who has juvenile arthritis may develop problems with his or her eyes. The problems may be caused by the disease. In some cases, though, the problem may be caused by the medications the child takes for the disease.  The most common eye problem that can develop in children with juvenile arthritis is uveitis. Uveitis is an inflammation of the inner parts of the eye in a section called the uvea. The uvea consists of the following:

1. iris – the colored part of the eye
2. ciliary body – which makes fluid inside the eye and controls the movement of the lens
3. the choroid – the lining that covers the eyeball from the iris all the way around the eye

When uveitis affects specific parts of the eye it may also be called iritis or iridocyclitis.  Untreated and severe uveitis can cause scarring of the eye. It can also cause vision problems. Other complications include:

1. glaucoma – a condition that causes high pressure in the eye
2. cataracts – clouding of the lens of the eye
3. permanent vision damage, including blindness

Uveitis can occur one year before diagnosis with juvenile arthritis. Or it could occur at the same time that juvenile arthritis is diagnosed or even up to 15 years after the diagnosis. Uveitis can also occur several years after juvenile arthritis is in remission when the disease is not active.

How can I tell if my child is developing eye problems related to juvenile arthritis?  Eye inflammation is usually not painful. And the eyes are not usually red as they are in conjunctivitis. So, most children with juvenile arthritis who develop eye problems do not have any symptoms.  On a rare occasion, a child might complain of blurred vision or of light bothering his or her eyes. Sometimes, a child’s eyes might look red or cloudy. However, these types of symptoms usually develop so slowly that permanent eye damage can occur before any trouble seeing is noticed.  In order to detect eye problems early and prevent them from causing damage, your rheumatologist – a doctor who specializes in treating arthritis – will schedule frequent appointments with a pediatric ophthalmologist. That is a medical doctor who specializes in diagnosing and treating eye diseases.

What will happen during my child’s appointment with an ophthalmologist?  The eye exam is painless and lasts several minutes. Tell the ophthalmologist about the medicines that your child is taking. You can get the names of the medicines, the dosages, and the reasons they have been prescribed from your rheumatologist.  Before the eye exam, the ophthalmologist will put drops in your child’s eyes to make the pupils dilate.  The drops may burn a little, but dilating the eyes helps the doctor get a clear view inside the eyes.  To diagnose eye inflammation, the ophthalmologist uses a special kind of microscope. With it, the doctor will shine a thin beam of light into one eye at a time so he or she can view the inside of each eye.  The doctor might also perform a visual field exam to determine if vision has changed in any way. This type of exam measures peripheral vision, meaning how far the patient can see to the side when the eye is focused on a central point.  You should carefully follow the medicine guidelines given by your child’s healthcare provider. You should also keep all scheduled appointments with the rheumatologist and the ophthalmologist.

How often should my child have eye examinations?  The frequency of eye exams for your child will depend on what type of juvenile arthritis he or she has. It will also depend on how long he or she has had the disease and on what medications he or she is taking for treatments.  Uveitis is more common among children with certain types of juvenile arthritis, such as oligoarthritis. A child with this type of juvenile arthritis might be scheduled for eye examinations every 3 to 4 months.  In general, children with polyarthritis need an eye exam every 6 months. Children with systemic juvenile arthritis usually need an examination every 12 months.  Your child should also continue to receive eye examinations after the juvenile arthritis goes into remission.   Ask your rheumatologist and ophthalmologist about the frequency of your child’s eye examinations. Then follow those specific recommendations. If eye problems are detected, your child will need more frequent examinations.

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  • How Does Knee Pain Arthritis Differ From Arthritis in the Foot?

    Arthritis is among those ailments that can appear so broad that they sometimes merit their very own category. Well, that’s true up to a point. Arthritis can come in the form of knee pain, tendonitis, foot pain, joint pain, hip pain etc…

    Despite the variation involved with arthritis however, it’s worth noting also that they are generally caused by the same problems. So regardless where you may be feeling the pain, as long as you are experiencing arthritis you can be confident that your problems are caused by the same things that are plaguing other people who are suffering from arthritis.

    Now, you might probably ask: How does knee pain arthritis differ from arthritis in the foot?

    In order to address that question, we will need to delve a little deeper. For starters, it’s important to remember that the cause of arthritis may extend well beyond the area where you are experiencing pain. What this means is that the pain you’re feeling – knee pain to be specific – is just the tip of the iceberg.

    Now, arthritis has many causes. Some of these may involve the tearing of muscles – a notable problem among people of advanced age. Other causes may involve Tendonitis or severe stress on the muscles resulting from overwork or just plain muscle degradation.

    In the case of the knees, it’s important to remember that this part of the body is connected to many other muscles, some of which extend all the way up to the hips.

    So the first big difference between knee pain and foot pain? It’s the scope. If you develop knee pain, there’s a very good chance that the pain will spread upwards and downwards if left untreated. In contrast foot pain arthritis is less likely to spread and when they do their direction is usually up.

    The second difference between these two types of arthritis that you should be aware of is that foot arthritis tends be comparatively more common as you grow older, whereas knee pain can affect anyone provided the right conditions are in place. For example, an athlete who overexerts himself is likely to experience knee pain even at an early age by virtue of his profession.

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