CHAPTER 24

Uveitis in the Pediatric Age Group

This chapter discusses the features of uveitis occurring in children. See BCSC Section 9, Intraocular Inflammation and Uveitis, for a more detailed description of the clinical features and inflammatory mechanisms of the conditions discussed here.

Epidemiology and Genetics

The incidence of pediatric uveitis varies among studies, but pediatric cases account for 2%–14% of all uveitis cases. The distribution between the sexes is similar to that seen in adults, showing a slight female preponderance. The mean age of diagnosis is 8–9 years, and 75% of patients have bilateral disease. In the United States, approximately 62% of patients are Caucasian. The 2 major etiologies of uveitis in children are idiopathic (25%–54% of cases) and juvenile idiopathic arthritis (15%–47% of cases). Most types of uveitis are not inherited. Some are associated with various human leukocyte antigen (HLA) types; this chapter notes the HLA type in such cases.

Smith JA, Mackensen F, Sen HN, et al. Epidemiology and course of disease in childhood uveitis. Ophthalmology. 2009;116(8):1544–1551.

Classification

As in adults, uveitis in children can be classified according to several factors, including anatomical location (anterior, intermediate, posterior, or panuveitis), pathology (granulomatous or nongranulomatous), course (acute, chronic, or recurrent), or etiology (traumatic, immunologic, infectious [exogenous or endogenous], masquerade, or idiopathic). Anatomical location can be helpful in determining etiology (Table 24-1). Published studies of uveitis in children show that anterior uveitis accounts for 30%–50% of cases; intermediate uveitis, 12%–28%; posterior uveitis, 5%–30%; and panuveitis, 13%–21%.

Table 24-1