Indian business : technology : index - domai
How Juvenile Arthritis Affects The Eyes
Juvenile arthritis, also called juvenile rheumatoid arthritis or childhood arthritis, is the most common type of arthritis to affect children. It's can affect many parts of the body, including the eyes.
Children who have juvenile arthritis may develop problems with theireyes. The problems may be caused by the disease or by medications the child takes for the disease.
The most common eye problem is inflammation in a part of the eye called the uvea. Doctors call this condition "uveitis." If it affects specific parts of the uvea, it may also be called iritis or iridocyclitis.
Untreated and severe uveitis can scar the eye. It can also cause vision problems, such as:
Uveitis can start up to 1 year before your child gets a diagnosis of juvenile arthritis. Or it could happen at the same time, or years later. It can even happen years after juvenile arthritis is in remission, which means that the disease is not active.
Eye inflammation may not be painful. And the eyes are not usually as red as they are in conjunctivitis. So many children with juvenile arthritis who develop eye problems may not have any obvious symptoms.
It's rare, but children might complain of blurred vision or of light bothering their eyes. Sometimes, a child's eyes might look red or cloudy. But these types of symptoms usually develop so slowly that permanent eye damage can happen before they notice any trouble with seeing.
In order to find 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's a medical doctor who specializes in children's eye diseases.
Tell the ophthalmologist about the medicines that your child takes. You can get the names of the medicines, the dosages, and the reasons they have been prescribed from your rheumatologist.
During 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 it 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 they can view the inside of each eye.
The doctor might also give your child a "visual field" test to check for any vision changes. This type of exam measures peripheral vision, meaning how far your child can see to the side when they focus their gaze on a central point.
You should carefully follow the medicine guidelines that your child's doctor provided. Keep all appointments with the rheumatologist and the ophthalmologist.
That depends on what type of juvenile arthritis they have, how long they have had it, and what medications they take. Ask your rheumatologist for the schedule.
Uveitis is more common in children with certain types of juvenile arthritis, such as what doctors call the "oligoarticular variant," where just a few joints are affected. Children with this type of juvenile arthritis might need to get their eyes checked 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 keep up with their eye tests after the juvenile arthritis goes into remission.
If any eye problems turn up, your child will need to get checked more often.
Your rheumatologist and ophthalmologist will work with you on this. If your child has uveitis, they might need prescription eyedrops.
Some of these eyedrops dilate the eyes in order to keep the pupils open and help to prevent scars.
Your child might also be prescribed steroid eyedrops. For example, your child might use cortisone drops to curb swelling and lower inflammation. Long-term use of steroid eyedrops can have serious side effects, including glaucoma and cataracts.
If eyedrops don't lower inflammation enough, your child might need to take anti-inflammatory pills. To avoid long-term side effects of steroid medications, your child might also get a drug such as methotrexate, which they would take by mouth or as a shot.
Severe cases of uveitis may need different kinds of drugs that treat immune system conditions.
What Can We Do About Juvenile Arthritis?
Juvenile arthritis (JCA) is a chronic condition which inflames one or more joints and begins before the age of 16.
It can start in several different ways:
A skin rash is often seen, especially when there is a fever. The liver and spleen may be enlarged. Sometimes there is inflammation of the membranes around the heart (pericarditis), lungs (pleurisy) or gut (peritonitis).
At the onset of this form of the disease the main symptoms are fever together with muscle and joint pain. Later these symptoms calm down and the joints become more swollen and painful due to arthritis.
In some children this only affects a few joints. Often however many large and small joints are involved.
Older children can go on to develop one of the adult forms of arthritis. This type is also called 'young girls' type because it affects girls more than boys (70-80 per cent are girls).
The outlook depends on which type of arthritis your son turns out to have. Eighty per cent of those with pauci articular JCA are well after 15 years, but 15 per cent can continue with arthritis and 10 per cent will be blind at ten years.
In those with poly articular JCA only 10 to 15 per cent have severe limitation at 15 years and most spontaneously improve.
Although the systemic onset type is the most serious type it usually lasts for two to five years after which in 50 per cent of cases it calms down or disappears. Thirty-three per cent continue with arthritis and severe joint destruction.
Many other serious diseases can mimic this condition and need to be ruled out before a firm diagnosis can be made and any guidelines given about the prognosis. This may be why nobody can tell you definitely what the future holds for your son at present.
The doctors will probably need to continue doing tests in order to be sure what condition your son has. They need to watch how the disease progresses over the next year to be able to predict how it will affect your son as he grows up.
If your son has JCA his treatment will depend on how he is affected by it. The single most useful agent is the group of drugs known as non steroidal anti inflammatories, these include naproxen, ibuprofen, diclofenac, mefenamic acid and occasionally aspirin (used less nowadays because of a rare association with Reye's syndrome which can affect the liver and brain).
Your son will need steroids if he has life threatening complications of JCA. He may also need steroids as drops in the eyes if these are affected. They are extremely effective but in large or prolonged doses cause thinning of the bones and suppress growth.
For this reason steroids are not usually used as a first line treatment for joint symptoms.
Other drugs are used to calm the disease down- they are called disease modifying drugs (DMARDs) and include hydroxychloroquine, gold, penicillamine, suphasalzine and methotrexate. All these can have side effects and careful monitoring is required throughout treatment.
In addition to drugs the mainstay of treatment is aimed at maintaining joint function, preventing deformities, keeping up with nutrition and ensuring proper growth.
JCA is usually managed by a team or experienced specialists including paediatricians, rheumatologists, physiotherapists, occupational therapists, orthopaedic surgeons and ophthalmologists (eye specialists).
It is essential that you and your family receive counselling to answer any questions and to enable you to share in managing and helping with the care of your son.
Once the diagnosis is clearer the specialist team will also be able to tell you everything about the nature of your son's illness.
For further information contact the Arthritis Research Campaign at www.Arc.Org.Uk or call 0870 850 5000
We recommend readers seek personal medical attention in appropriate circumstances.
Five Horses Killed In Appomattox, Va., Juvenile Charged
© Provided by WJET Erie Five horses killed in Appomattox, Va., juvenile charged APPOMATTOX, Va. (WFXR) — The Appomattox County Sherriff's Office shares that a juvenile has been charged for allegedly killing five horses in the Spout Springs area.
On March 14th, the Appomattox County Sheriff's Office responded to a property in the 1600 block of Double Bridges Road for multiple horses being shot. At the scene, emergency responders found five horses had been killed by gunshot wounds, and three more were wounded. Veterinary care responded to the scene to assist the horses that were wounded.
After a full forensic investigation, detectives developed information that led to a juvenile being arrested and charged.
Anyone with additional information about this incident is encouraged to call the Appomattox County Sherriff's Office at 434-352-8241.
WFXR News will update this story as details are released.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.For the latest news, weather, sports, and streaming video, head to WJET/WFXP/YourErie.Com.
Comments
Post a Comment