This is an inflammatory arthritis affecting children under 16 years. There are three types, of which the pauciarticular type is particularly associated with iritis. The iritis is unusual in that there are frequently no symptoms (red eye, pain) to alert the patient or his parents that there is something wrong with the eye. Diagnosis of iritis is therefore frequently delayed.
| Pauciarticular - associated with iritis in 20%. Fewer than 5 joints affected (usually knees) |
| Polyarticular - associated with iritis in 5%. More than 5 joints affected. May lead to deformity |
| Systemic (Still's disease) - rarely associated with iritis. Fever, rash, enlargement of liver and spleen, joint pain, arthritis |
| HLA-B27 is positive in those who are prone to relapsing (acute) iritis |
| ANA (anti-nuclear antibody) is present in 80% of those with both JCA and iritis (present in only 30% of those with JCA only). |
| RhF (rheumatoid factor) is usually not associated with iritis but may be associated with early onset rheumatoid arthritis |
Early complications
| Iritis with a white, non-painful eye |
| Posterior synechiae (very common) - avoided by treatment with dilating drops |
Late complications (these complications are due to long-standing iritis)
| Deposition of calcium on the cornea (band keratopathy) (occurs eventually in 40%) |
| Cataract (30%) |
| Glaucoma (15%) |
| Steroid drops |
| Dilating drops esp. atropine |
| Non-steroidal anti-inflammatory drugs (NSAIDS) |
| Oral steroids |
| Chlorambucil |
| Surgical treatment of cataract, glaucoma, and band keratopathy |
Depends on the severity of the initial inflammation and the duration of the delay in the diagnosis