Children With Juvenile Arthritis

Arthritis in children: Juvenile arthritis and how it affects the eye

The common notion is only elderly people can suffer from arthritis but studies have defied this usual belief of people because arthritis can also hit children, it is called Juvenile Arthritis (JA).

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIH) defines Juvenile arthritis as a condition where children suffer from arthritis. It is also called pediatric rheumatic disease where children suffer from various diseases that involve the inflammation of the synovium, the tissue that outlines the inner parts of joints,that can cause pain, swelling, stiffness and loss of motion.

This kind of condition is an autoimmune disease wherein the immune system attacks the body instead of protecting the body from viruses which is its primary role. JA is considered to be idiopathic because it has no exact cause on why some children are being inflicted with this condition. But experts believe that JA can be linked to the genetic composition of children, infections and environmental triggers.

Juvenile arthritis can affect children aged 16 and below. In the United States, research showed that nearly 300,000 children were identified to suffer from this kind of condition.

There are different diseases under JA such as; Juvenile idiopathic arthritis (JIA), Juvenile dermatomyositis,  Juvenile lupus, Juvenile scleroderma, Kawasaki disease, Mixed connective tissue disease and Fibromyalgia.  All these diseases share common symptoms such as; inflammatory, pain, joint swelling, redness and warmth. Juvenile arthritis can also affect the musculoskeletal system, the skin, muscles, gastrointestinal tract and the eyes.

JA related eye problems

Children suffering from JA may also have eye problems may it be due to the disease or a result of the medication. The most common eye problem that they can have is the inflammation of the “uvea” which is also referred to as “uveitis”. Uveitis is the serious complication that a child with juvenile arthritis can have. It is a non-joint related complication that can be present in a child with arthritis. There are different types of Uveitis; Anterior uveitis, Intermediate uveitis, Posterior uveitis.

1. Anterior uveitis
– It involves the inflammation in the eye’s anterior chamber, iris or ciliary body.

2. Intermediate uveitis
-The inflammation occurs on the vitreous humor part of the eye.

3. Posterior uveitis
-This concerns the inflammation of the eye’s retina or choroid.

Once a child is infected with Uveitis or any other eye inflammation brought byJA , there are higher chances for complication with other eye related problems. Such complications could be; Band keratopathy, Cataracts, Glaucoma, Macular edema, Posterior synechia, and Retinal detachment.

Symptoms for JA related eye problems

There are no evident symptoms if a child with Juvenile arthritis is infected with Uveitis or with any other eye inflammatory problems unlike other kinds of eye problem. So, it is important that children with JA should always undergo eye examinations to detect.

Eye treatment

Children with JA and infected with eye problems should see a rheumatologist and an ophthalmologist. For those infected with uveitis, specific eyedrops will most likely be prescribed by the eye doctor to help dilate the eyes, keep the pupils open and avoid scars. For severe cases, other drugs that treat the immune system can also be prescribed by the doctor. Aside from the daily treatment, eye check every three to four months should be conducted. Also, eye exams should be done every six months and regular monitoring of any vision changes is very important for the child. In the long run, untreated eye related problems linked to juvenile arthritis can cause permanent vision damage or worse blindness.

Early Diagnosis

JA is not an ordinary disease and its diagnosis is also not easy. It is highly recommended by experts that children who are suspected to suffer from this kind of condition must see a doctor immediately and undergo series of different medical exam and at the same time trace back the child’s family medical history. In treating JA, accurate diagnosis is a must because there are different kinds of diseases that fall under this condition. There are also many complications that can rise such as the inflammation of the eye that’s why correct diagnosis is really crucial for a child to have the right treatment.

A good lifestyle

A child with JA may limit his/her childhood because the pain may prevent the child to do various activities just like a normal child does. It will really be a big adjustment for the child and as well as the whole family. Aside from the medical treatment of the child other things could also be done for the child to have the best care. To reduce the symptoms of arthritis the child may be involved in physical activities and exercise to maintain the function of the joints. A good support system to the child will also be a great help so working with social workers or joining a support group for more encouragement could be an option. It will also be helpful if the whole family and the child’s school are knowledgeable about the child’s disease and treatment. Lastly, it is important to continuously talk to the child for emotional support.

Conclusion

Overall, treating JA should focus on relieving inflammation, pain control and improving the child’s life. JA in general has no cure. But early and proper diagnosis plus the good treatment can lead to possible remission.The whole treatment process must be holistic and should involve proper medication, physical activities, healthy food and healthy lifestyle. Another important part in treating JA is teaching the child on how to address emotional and social effects of JA. It will be very challenging but will surely be helpful in the holistic kind of treatment.

Given the fact that Juvenile arthritis may affect the eye and can cause serious eye problems, eye care is also a very important component in treating JA for severe eye problems may cause total blindness.

Clear vision is a vital part of our everyday living and should not be taken for granted. It is also a sense that should continuously be enjoyed by everyone, especially the young ones.

So, to prevent severe JA related eye problems, aggressive eye care is a must.

Additional reading:

http://www.arthritis.org/about-arthritis/types/juvenile-arthritis/
http://www.niams.nih.gov/health_info/juv_arthritis/juvenile_arthritis_ff.asp
http://www.webmd.com/rheumatoid-arthritis/diagnosing-juvenile-arthritis
http://www.webmd.com/rheumatoid-arthritis/guide/how-juvenile-arthritis-affects-the-eyes?page=2
http://www.kidsgetarthritistoo.org/living-with-ja/medical-care/health-effects/arthritis-eye-complications-3.php

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