Juvenile Idiopathic Arthritis and Eyesight

Juvenile Idiopathic Arthritis (JIA) is an inflammation of the joints that occurs in children. It is also known as Juvenile Rheumatoid Arthritis (JRA). 

Patients with JIA are at risk for an inflammation inside the eye, a condition known as iritis or anterior uveitis. Unlike the typical patient with iritis or uveitis who tends to have obvious eye symptoms, children with iritis/uveitis due to JIA usually have no symptoms. Despite a lack of symptoms, the inflammation can lead to serious damage within the eye and can result in permanent loss of vision. 

Because of the high chance of eye damage, patients with JIA are required to have routine, regular eye exams to check for iritis. The eye exam will involve looking at the eye with special instrument called a slit-lamp. The frequency of the eye exams will depend on the type of JIA the patient has.

If left untreated, iritis or uveitis can cause glaucoma, cataracts, calcium deposits in the cornea (band keratopathy) or swelling in the retinal or optic nerve (tissues and structures inside the eye). These problems can result in decreased vision and even blindness.  

Treatment

Patients with JIA that have iritis or uveitis are treated with corticosteroid eye drops which work by decreasing the reaction of the immune system in the eye. Dilating drops may also be given to reduce the development of scar tissue inside the eye. Many patients require systemic medications which can help control the iritis as well as any associated arthritis.

Inflammation in the eye can return without symptoms – even after being treated. It is very important for patients with JIA to have regular eye examinations with an ophthalmologist at the recommended intervals as well as to see their rheumatologist. The frequency of these eye exams will be determined by the child’s ophthalmologist and rheumatologist.