Vogt-Koyanagi-Harada syndrome is a chronic, progressive bilateral panuveitis that is associated with exudative retinal detachments and may be accompanied by meningeal irritation, auditory disturbances, and skin changes. It is rare in children, but those affected experience a higher frequency of ocular complications such as cataract and glaucoma and have a poorer visual prognosis than do adults.

Martin TD, Rathinam SR, Cunningham ET Jr. Prevalence, clinical characteristics, and causes of vision loss in children with Vogt-Koyanagi-Harada disease in South India. Retina. 2010; 30(7):1113–1121.

Other Causes of Posterior Uveitis and Panuveitis

Other causes of posterior uveitis and panuveitis are listed in Table 24-1.

Masquerade Syndromes

Various conditions can simulate pediatric uveitis. Table 24-4 lists these masquerade syndromes and their diagnostic features.

Table 24-4

Evaluation of Pediatric Uveitis

Establishing the correct diagnosis is important in managing a pediatric patient with uveitis, but some ophthalmologists defer the workup of isolated anterior uveitis unless it is recurrent or unresponsive to initial therapy. Accurate diagnosis requires a detailed history, thorough ophthalmic examination, and selected laboratory tests. An examination under anesthesia may be needed if the child is not cooperative enough for an office evaluation. Laboratory investigations are chosen based on the suspected diagnoses (Table 24-5; also see Table 24-4).

Table 24-5