Regular eye exams for JIA are important as many children and teens with JIA are at risk for uveitis, which can lead to other eye conditions such as cataracts or glaucoma.
Why are eye exams important?
Eye inflammation is called iritis or uveitis. It is another key feature of JIA. There is a high risk (approximately 20%) of eye inflammation among young people with oligoarticular JIA. The risk is highest among young girls who test positive on a blood test called an antinuclear antibody (ANA). However, eye inflammation can still occur in other types of JIA and in those who test negative for ANA.
Most importantly, eye inflammation usually occurs without any eye symptoms until it is too late. Eye inflammation can lead to other eye conditions such as cataracts or glaucoma. A cataract is when the lens of the eye becomes cloudy. Glaucoma is high pressure in the eye, and it also has no early symptoms.
This is why having regular eye exams with an eye doctor is important if for children and teens who have JIA.
How are eye exams done?
First, someone will test your child's vision.
Next, the eye doctor might put numbing drops in the eyes followed by some other drops. These drops will temporarily dilate the pupils of the eyes, which means the pupils will be larger. It will take 20 to 40 minutes for the drops to take effect, at which time your child's vision will be quite blurry and sensitive to light. These drops will give the eye doctor a clear view of the inside of the eye.
Another part of the eye exam is called a slit lamp exam. The eye doctor will use a machine called a slit lamp to look at the front parts of the eye. The slit-lamp is a type of microscope. It gives off a blue light. It allows the eye doctor to see any inflammation cells floating in the eye.
The slit lamp can also help the doctor find other complications such as cataracts or glaucoma. If your child is being tested for glaucoma, they will receive another set of eye drops that allows the eye doctor to test the pressure in the eye.
Other methods to check eye pressure include a machine that squeezes a puff of air into the eye or using a small hand-held device that looks like a pen, which gently touches the eye. These are painless tests due to the numbing drops they will have already received.
The entire eye exam is completely painless. Once the exam is over, your child can go home, but they will still have large pupils and blurry vision from the drops. They may also be sensitive to bright light due to the enlargement of the pupils. The blurry vision will last six or more hours. The effect on your child's pupil will last about 24 hours. Bring sunglasses for your child to wear on the way home.
The recommended frequency of eye checkups will be based on the type of JIA your child has, how long they have had JIA and the presence or absence of autoantibodies.