uveitis in children
Introduction
Introduction to juvenile uveitis Uveitis in children and children generally refers to uveitis that occurs in people under 16 years of age. Because uveitis in children is different from adult uveitis in clinical manifestations, etiology and type, diagnosis and treatment, it is different. Discussions will benefit clinical diagnosis and treatment. basic knowledge The proportion of illness: 0.001% Susceptible population: generally refers to people who occur under the age of 16 Mode of infection: non-infectious Complications: cataract glaucoma amblyopia
Cause
Causes of uveitis in children and adolescents
Secondary infection with inflammation (98%):
The majority of the causes and types of adult uveitis can also be found in children and adolescents, but the most common cause and type of uveitis in juveniles and children is uveitis and idiopathic uvea associated with juvenile chronic arthritis. inflammation.
Environmental factors (2%):
Do not pay attention to hygiene, so that the eyes are infected with bacteria.
Pathogenesis
The pathogenesis is similar to adult uveitis, with immunological factors involved.
Prevention
Juvenile children with uveitis prevention
The key to preventing blindness in uveitis is early diagnosis and timely and reasonable treatment. The following points should be noted:
1. If you find redness, pain, photophobia, tearing, decreased vision or no redness or pain, but there are black shadows floating in front of you, blurred vision or visual distortion, people with flashing sensation and decreased vision may have uveitis. Go to the relevant specialist for a detailed examination to confirm the diagnosis.
2. Once the diagnosis is uveitis, it should be actively treated. Dilated sputum is a necessary measure for the treatment of anterior uveitis. It can prevent pupil adhesion and avoid the production of secondary glaucoma and complicated cataract. Hormone is the treatment of uveitis. Commonly used drugs, but with side effects, whether systemic or topical, must be used under the guidance of a doctor, should not be abused.
3. Patients with uveitis should be reviewed regularly to prevent recurrence. If symptoms of recurrence are conscious, they should be diagnosed early.
4. Actively exercise, enhance physical fitness, prevent colds, eat less irritating foods, pay attention to work and rest, maintain physical and mental health, and also have important significance in preventing uveitis.
Complication
Children with uveitis complications Complications glaucoma amblyopia
It is easy to cause banded corneal degeneration, complicated cataract, secondary glaucoma, amblyopia and other complications.
Symptom
Juvenile children with uveitis symptoms common symptoms, tears, red eyes, eye pain
1. Early is not easy to be found because the ability of children and young people to express is not perfect, and many patients have no obvious symptoms and signs, such as red eyes, eye pain, photophobia, tearing (ie white uveitis), so in uveitis After a long period of time, it is difficult to be discovered. Many patients are found by parents or teachers when complications such as chalkiness, strabismus or vision loss affect learning.
2. It is often manifested in a specific type of juvenile children with juvenile uveitis associated with chronic arthritis, uveitis caused by Kawasaki disease, retinoblastoma, leukemia, juvenile yellow sarcoma, retinitis pigmentosa, etc. Camouflage syndrome, toxoplasmosis retinal choroiditis, ocular toxoplasmosis, uveitis caused by congenital Toxoplasma gondii, rubella virus, cytomegalovirus, retinitis caused by herpes simplex virus, and these types are in adults It does not happen or rarely occurs, which provides useful clues for our diagnosis objectively.
3. Prone to complications occur in children and adolescents, especially under 10 years old, uveitis is prone to cause zonal degeneration, complicated cataract, secondary glaucoma, amblyopia and other complications, the occurrence of these complications and diseases Less than early diagnosis and timely and effective treatment, on the other hand may be related to the patient's tissue structure and physiological characteristics, in children with chronic anterior uveitis, almost all of the band corneal degeneration can be seen, before the adult chronic In patients with uveitis, such complications are quite rare.
4. Intraocular inflammation is strong after surgery or uveitis is easy to relapse. In general, children have a strong response to traumatic stimulation, especially in patients with uvitis, which often causes obvious anterior chamber flash after surgery. Hui, anterior chamber inflammatory cells, and even anterior chamber fibrinous exudation or empyema and other serious reactions, so these patients should follow the principle of "surgery after complete inflammation control" than adults. It is worth noting that inflammation is completely controlled. It does not refer to the short-term disappearance of inflammation after short-term medication (such as glucocorticoids), but refers to the complete control of inflammation after standard treatment based on a comprehensive understanding of the type of inflammation in patients, due to different patients with uveitis The interval of recurrence is very different. It is not easy to correctly determine whether inflammation is completely controlled. The visual prognosis of cataract patients in this type of uveitis is not as good as that of adult uveitis patients, in large part because inflammation is not Can be completely controlled to perform cataract extraction surgery.
Examine
Examination of juvenile uveitis
Laboratory tests such as anti-nuclear antibodies, erythrocyte sedimentation rate, anti-viral antibodies, anti-Toxoplasma antibodies, HLA-B27 antigen typing, etc. can be accompanied by systemic diseases, which is helpful for diagnosis and differential diagnosis.
According to the patient's systemic history, such as arthritis, joint deformation, rash, nodular erythema, etc., it is helpful to diagnose the ankle joint and if necessary.
Diagnosis
Diagnosis and differentiation of juvenile uveitis
diagnosis
For patients with obvious clinical symptoms, uveitis is not easily missed and misdiagnosed. For patients with chalkiness, strabismus and low vision, a detailed eye examination should be performed. Generally, as long as serious eye examination is performed, the uvea It is not difficult to be diagnosed, but the difficulty is to determine the cause and type. In addition, uveitis is easily missed in patients with inflammatory quiescence. If banding corneal degeneration is found to be helpful in diagnosis, mild anterior chamber flash is found. Hui, mild opacity under the posterior capsule of the lens, can generally make a diagnosis.
Differential diagnosis
Different from other eye diseases.
