Uveitis with JIA

JIA is the commonest rheumatic disease in childhood (<16 years)

Associated with patients of european descent

Classification (by the International League of Associations of Rheumatologists)

  • Systemic arthritis
  • Oligoarthritis -persistent
  • Oligoarthritis -extended
  • Polyarthritis -RF negative
  • Polyarthritis -RF positive
  • Psoriatic arthritis
  • Entesitis-related arthritis
  • Undifferentiated

Clinical features

1/3rd develop uveitis

  • Typically a chronic anterior uveitis
  • White eye
  • Typically bilateral

Hot Topic

Higher risk groups for uveitis in JIA

  • Extended oligoarticular disease with ANA-positive disease

  • Females

  • Rheumatoid factor negative

  • Early onset JIA

  • Lower extremity joint involvement

  • Lack of wrist involvement

  • F>M but is worse in males


  • Band keratopathy: can occur in any chronic uveitis but particularly those that begin in childhood
  • Cataract
  • Glaucoma
  • CMO
  • Vitritis and retinal vasculitis are more rare


Hot Topic

Screening of children with uveitis is a hot topic in exams!
  • Initial screening should occur within 6 weeks of referral as uveitis commonly starts soon after onset of arthritis
  • If symptomatic, they should be seen within 1 week
  • Review every 2 months from onset of arthritis for 6 months
  • Then every 3-4 months
  • Patients are generally followed up to approx 11-12 years of age


  • Topical corticosteroids
  • Methotrexate if frequent topical steroid is needed: can be given subcut on a weekly basis rather than orally
  • anti-TNF agents: adalimumab with methotrexate was shown to reduced flares in the SYCAMORE RCT
  • Defer cataract surgery until the eye has been quiet for 3 months (weigh against amblyopia risk in younger patients)
  • Band keratopathy: EDTA chelation or excimer phototherapeutic keratectomy

Was this page helpful?

Intermediate uveitis