tailieunhanh - Ebook Harley’s pediatric ophthalmology (6/E): Part 2

Part 2 book “Harley’s pediatric ophthalmology” has contents: Diseases of the retina and vitreous, congenital abnormalities of the optic disk, disorders of the lacrimal apparatus in infancy and childhood, pediatric eyelid disorders, systemic hamartomatoses, pediatric neuroophthalmology, . And other contents. | 13 Pediatric Uveitis Grace T. Liu • Alex V. Levin INTRODUCTION Uveitis in the pediatric population is a significant cause of ophthalmic morbidity. Approximately 2% to 14% of patients seen in uveitis clinics are children (1–3). Unique to the pediatric age group in the management and timely diagnosis of uveitis is the threat of amblyopia. In addition, the associated systemic disease profile is much different than that seen in adults. Children more often (71%) have an associated systemic illness than adults (55%) (4). Although juvenile idiopathic arthritis (JIA) is the predominant cause of anterior uveitis in children (5,6), it is important to recognize that uveitis in a child can be due to a wide range of etiologies, including serious life-threatening masquerade syndromes such as retinoblastoma and leukemia. Presenting signs and symptoms are often not recognized until advanced stages, and the disorder may even be entirely asymptomatic until irreversible ocular damage has been sustained (Fig. ). The child may be unable to verbalize his/her symptoms, and can often function normally with visual acuity well below 20/20 for activities of daily living, especially when the disease is unilateral and the child is younger. The approach to pediatric uveitis requires the understanding that early recognition through screening, where appropriate, can be of utmost importance. Table summarizes the diagnostic approach to the child with pediatric uveitis. To the contrary, a study from the US National Eye Institute found that idiopathic uveitis () was the leading etiology in the United States, followed by JIA (), and pars planitis (). A retrospective study characterizing disease characteristics and visual outcome of 527 children in the United States with uveitis, found that 54% were female; 62% White, 15% Hispanic, 12% Black, 3% Asian, and 2% multiracial (9). The median age at diagnosis was years. CLASSIFICATION Although consortium-driven classification .