Update on the management of uveitis in children: an overview for the clinician

Introduction: Pediatric uveitis comprises a range of ocular inflammatory diseases that may lead to vision impairment. The impact on visual functioning over the lifetime horizon can be substantial, underscoring the importance of appropriate ophthalmic evaluation, diagnostic testing and treatment. This review focuses on the anatomic classification, laboratory diagnosis, associated systemic diseases, and management of pediatric uveitis. Areas covered: A review of the literature was performed to synthesize our current understanding of the anatomic classification of pediatric uveitis, disease epidemiology, and management principles. We also review important corticosteroid-sparing strategies including non-biologic and biologic agents given their key role in the treatment of pediatric uveitis. Recent advances in the assessment of vision-related quality-of-life using the Effects of Youngsters’ Eyesight on Quality of Life (EYE-Q) instrument are discussed. Expert opinion: Pediatric uveitis can lead to long-term vision impairment if not appropriately screened and treated. While topical and systemic corticosteroids are useful for the acute treatment of uveitis, the disease chronicity of many pediatric uveitis syndromes often warrants early escalation of therapy to immunosuppressive medications. Future directions include an improved understanding of risk factors for uveitis and better metrics to evaluate the impact of disease on vision-related quality-of-life of pediatric uveitis patients.