Childhood uveitis is treatable, and in most cases vision loss is avoidable. However, when the following takes place, permanent vision loss is more likely:
- Late detection
- Delayed treatment
- Poor control of inflammation
- Damage from recurrent attacks
If given early in the disease, immunosuppressants are more likely to achieve a better visual outcome in the long term. (See Sharma, Dick & Ramanan “Non-infectious pediatric uveitis:an update on immunomodulatory management” Paediatric Drugs, 2009 (11(4) : 229-42)
A parent’s decision to go down this path can be fraught with anxiety, and it can be helpful to be in contact with other parents who have been in your position. Our Forum is a great place to start.
Where children have trace cells, or the uveitis is an uncomplicated one-off event, then it is perfectly acceptable for steroid drops alone to be used in the short term.
Unfortunately, many specialists keep children and adults with chronic uveitis on steroids alone for too long, in the misguided belief that they are safer than immunosuppressant drugs.
However,the faster the inflammation is controlled, the better the outcome. This is why it is becoming more common for experts in treating uveitis to move on to additional drugs more quickly, to avoid complications, and to do their best to stop vision loss occurring from both the uveitis itself, and from the overuse of steroid drops.