Eyes

March 18, 1999

Suzie,

My daughter has never had any eye inflammation, and she has been Systemic

JRA since age 2. Sorry I don't know. I hope it is nothing more than an

allergy.

All the best,

----------

> From: suziejones@...

> onelist

> Subject: [ ] eyes

> Date: Thursday, March 18, 1999 6:49 PM

>

> From: suziejones@...

>

> Hi all,

> Another question: My son had his eyes checked in Jan. and everything was

fine. Our docs said it is very uncommon (1%) for systemic JRA kids to have

eye inflammation and that although his chances are low, they will check him

regularly and that I am to notify them immed. if there is any irritation.

This past week he has started blinking rapidly and often. I asked him what

was wrong w/ them and he can't explain - he's 4. He now says it feels like

there is dirt in them. He may be just saying this because I am bugging him

about it. Anyway, I really had to push hard to get him a sooner (than May)

appointment and we are still not being seen until next Wed. The assistant

said that blinking isn't a sign of inflammation and that I was preoccupied

w/ it... UGH! Do any of you have experiences you can share w/ the onset of

eye problems due to JRA? Have your children started by blinking? (this

very well could be allergies as the trees are starting to blossom or could

be the start of a nervous habbit as he does

March 19, 1999

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<html>

Hi Suzie,

I wish I could be of more help but my son Josh hasn't had any eye problems

due to the jra, aside from the 'early cataracts' that his eye doctor discovered.

He has no symptoms from that, though. I was looking briefly on drdoc's

website and found the following info listed not under the systemic jra

subset but under the pauciarticular onset subset:

1) Pauciarticular onset JCA

These patients have involvement of up to 4 joints. A number of these

may evolve

into Juvenile Spondylo Arthropathy or Psoriasis. The majority of these

present

between 1 and 3 years of age. It occurs more frequently in females

and usually

present because the child has a limp. They usually have no significant

fevers or

constitutional symptoms. Commonest joints involved, are the knee -

approximately 50%, but the ankles, elbows or small joints of the hand

can also be

involved. There is a large association with Anti-nuclear Antibodies

- between 40 - 75% of

these children, and they are frequently associated with a Chronic

eye disease -

Uveitis - especially if the child is female and under 2 years with

positive

Anti-nuclear Antibodies. Routine eye examinations therefore, become

essential

and Iris irregularity may be seen on slit lamp microscopic examination.

The eye

disease can be unilateral or bilateral - the eye disease is not

related to the pattern

of the arthritis course. With Pauciarticular Arthritis in males

- there is a stronger association with Sacroiliitis and Spondyloarthropathy

with enthosopathy. There is an association in

these children, with HLA B27 gene subtype. Iritis is also common

in this group.

Another type of this Arthritis occurs with children with small joint

involvement in

the hands and usually this occurs in girls - rather than the boys,

and these patients

may subsequently develop psoriasis.

Okay, but remember this was listed in the pauciarticular and not systemic

subset!

Then, I found out a little more about uveitis:

Uveitis is a subspecialty of Ophthalmology that deals with inflammation

in or around the eye. Many cases of uveitis are caused by infections (such

as bacteria, fungi or viruses), autoimmune diseases (such as rheumatoid

arthritis or lupus) or tumours. There are a

large group of patients in which an underlying etiology cannot be found

and these are known as idiopathic.

Because uveitis has such varied etiologies and can affect any structure

of the eye, uveitis subspecialists work closely with other ophthalmologists

in the fields of cornea, retina and glaucoma as well as other medical

specialists

including rheumatologists, oncologists, and infectious disease physicians.

The treatment of uveitis depends on its cause. Commonly used methods

include corticosteroid and nonsteroidal anti-inflammatory drops. In severe

cases, systemic steroids and other medications that alter the immune system

have to be used. Occasionally, surgery is also necessary.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Anterior uveitis

Anterior uveitis, the most common form, occurs in the iris. Most often

it is associated with autoimmune diseases such as rheumatoid arthritis

and Lupus. This disease is most common between 20 and 50 years old and

can affect one or both eyes. Also called iritis or non-granulomatous uveitis,

anterior uveitis can be treated by applying warm compresses, analgesics

or dilating eye drops to help decrease pain. Steroid drops can help decrease

the inflammation. Anterior uveitis usually lasts a few days to a few weeks

even with treatment and recurrences are common.

Well, now we've all learned a little more about uveitis :-) & nbsp; Suzie,

good luck at the eye doctor appointment. You're probably right, that it's

a symptom of some form of allergy or maybe, like you said, a nervous habit.

Try not to worry too much. And be sure to let us know what they say about

your son's exam.

Take care,

Georgina

suziejones@... wrote:

<blockquote TYPE=CITE>From: suziejones@...

Hi all,

Another question: & nbsp; My son had his eyes checked in Jan. and everything

was fine. & nbsp; Our docs said it is very uncommon (1%) for systemic JRA

kids to have eye inflammation and that although his chances are low, they

will check him regularly and that I am to notify them immed. if there is

any irritation. & nbsp; This past week he has started blinking rapidly and

often. & nbsp; I asked him what was wrong w/ them and he can't explain -

he's 4. & nbsp; He now says it feels like there is dirt in them. & nbsp; He

may be just saying this because I am bugging him about it. & nbsp; Anyway,

I really had to push hard to get him a sooner (than May) appointment and

we are still not being seen until next Wed. & nbsp; The assistant said that

blinking isn't a sign of inflammation and that I was preoccupied w/ it...

UGH! & nbsp; Do any of you have experiences you can share w/ the onset of

eye problems due to JRA? & nbsp; Have your children started by blinking? & nbsp;

(this very well could be allergies as the trees are starting to blossom

or could be the start of a

nervous habbit as he does bite his nails but I am not taking any chances!).

Thanks for your response,

Suzie

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March 19, 1999

Hi Suzie,

My son Diego had a eye infection the last week.. The doctor said maybe was a

spider sting... (I'm not sure). He is taking dicloxiciline and ophtalmic

drops and he is better again...

Regards,

--------------

[ ] eyes

From: suziejones@...

Hi all,

Another question: My son had his eyes checked in Jan. and everything was