Challenges of childhood uveitis

Chronic uveitis is a rare, but potentially sight-threatening disease. The most common cause of chronic non-infectious uveitis is “idiopathic uveitis”. However, some systemic diseases are associated with chronic uveitis in children and are discussed. Chronic uveitis merits special consideration in children. The unique differences in children are highlighted with special consideration for the diagnostic and therapeutic challenges encountered in their management. While corticosteroids remain the mainstay of initial therapy, a wide range of immunosuppressive agents have been used with variable success. The role of immonomodulatory agents such as methotrexate, cyclosproin and some of the new biologic agents such as etanecept, infliximab, adalimumab are reviewed. Successful outcomes may be achieved with appropriate immunosuppressant therapy when given early in the disease, although clinical trials are required to define the true efficacy of this strategy.