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How Juvenile RA Affects Binocular Vision

written by: bjlbyron • edited by: Diana Cooper • updated: 11/27/2010

Juvenile rheumatoid arthritis is a serious inflammatory condition that strikes young children and can cause a host of physical problems, including vision loss. Read on to learn about the link between juvenile rheumatoid arthritis and binocular vision problems.

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    A Word About Juvenile Rheumatoid Arthritis

    Juvenile rheumatoid arthritis (JRA) is an often painful joint disease that strikes children of about age 16 and under. Specifically, individuals who are inflicted with JRA experience inflammation in at least one, but typically more, joints of their body. JRA is more commonly seen in girls than boys and its cause (or causes) remains unknown.

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    The Connection Between Juvenile Rheumatoid Arthritis and Loss of Binocular Vision

    Uveitis is a condition in which the uvea, which is the middle layer of the eye, becomes inflamed. Uveitis usually causes reversible decreased vision but, if left untreated, it can lead to permanent vision loss. Sadly, juvenile rheumatoid arthritis is the most common cause of juvenile uveitis in the western world (about 10% of all JRA patients experience symptoms of uveitis). It is not specifically known why uveitis arises in some JRA patients, but it is known that its effects can manifest rapidly in these individuals.

    The type of uveitis that is most commonly seen is JRA individuals is anterior uveitis. Specifically, anterior uveitis is characterized by inflammation in the front portion of the middle layer of the eye, which is known as the iris (for this reason, anterior uveitis is sometimes referred to as iritis).

    Another type of uveitis is posterior uveitis (or what is also called choroiditis), in which the back portion of the middle layer of the eye becomes swollen. This back portion is comprised of blood vessels in a region of the eye known as the choroid layer. Posterior uveitis is sometimes seen in JRA patients, but not nearly as often as anterior uveitis.

    A third type of uveitis is pars planitis, in which the middle portion of the middle layer of the eye (i.e., the area between the iris and choroid) becomes swollen. Pars planitis is rarely, if ever, seen in individuals who are stricken with JRA.

    In some cases in which JRA patients develop uveitis, swelling is limited to only one eye, but in most instances, both eyes are affected. Common symptoms of uveitis include eye pain, eye redness, reduction in binocular vision, blurry vision, "floaters" that appear as dark spots, and an increased sensitivity to light (this latter symptom is more common to anterior uveitis than it is to posterior uveitis). In the worst cases, cataracts, glaucoma, and retinal detachment can occur. No matter which type of uveitis is present, treatment of the disorder in a JRA individual generally consists of one or more of the use of steroid eye drops, drugs that dilate the pupils, and the consistent use of dark glasses, especially when in the presence of any type of moderate-to-bright light.

    In most cases, if properly treated, uveitis symptoms disappear in a few weeks' time or less. However, these symptoms typically recur in JRA patients, and when this happens, the effective treatment course needs to be repeated all over again.

    This article is only meant to provide some basic background information regarding the link between juvenile rheumatoid arthritis and binocular vision problems. If you have any questions about this medical phenomenon or if you are experiencing any of the symptoms described herein, it is recommended that you contact your doctor.

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    I. Asproudis et al., Juvenile idiopathic arthritis-associated uveitis: Data from a region in western Greece, Clinical Ophthalmology 4:343-347 (2010).

    P.E. Carvounis et al., Incidence and outcomes of uveitis in juvenile rheumatoid arthritis, a synthesis of the literature, Graefe's Archive For Clinical And Experimental Ophthalmology 244:281-290 (2005).

    P.E. Carvounis et al., Ocular manifestations of juvenile rheumatoid arthritis in Olmstead County, Minnesota: a population based study, Graefe's Archive For Clinical And Experimental Ophthalmology 243:217-221 (2004).